Telmed model explained and important phone numbers

The Telmed model is one of the basic health insurance models. Comparis provides information on Telmed and its conditions.

Magdalena Soll Foto
Magdalena Soll

25.07.2023

A woman sits at her laptop talking to a doctor online.

iStock/MTStock Studio

1.What is the Telmed model?
2.How does Telmed work?
3.Telmed in Switzerland: what are the exceptions?
4.What if I go directly to the doctor?
5.Pros and cons of Telmed
6.How is Telmed different to the family doctor model and the HMO model?
7.List of Telmed telephone numbers for the largest insurers

What is the Telmed model?

The Telmed model is a telephone model for health insurance companies. It is one of the alternative insurance models for basic health insurance.

With Telmed, free choice of doctor is restricted. This means that in the event of health problems, you must always contact the health insurance company’s telephone helpline first.

2. How does Telmed work?

Medical professionals help patients in various ways via the helpline:

  • They provide information and determine the next treatment steps.

  • If necessary, they will refer the insured to a suitable specialist for a physical consultation.

3. Telmed in Switzerland: what are the exceptions?

For some medical exceptions, you are not required to contact the helpline under the Telmed model. These exceptions are the following:

  • Emergencies – you need to report them afterwards 

  • Annual gynaecological check-ups

  • Examinations by an eye specialist (in some cases for children only)

  • Dental treatment (with most providers)

  • Visits to the paediatrician (with most providers)

  • Other services (depends on insurance company)

4. What if I go directly to the doctor?

The health insurance companies act differently in the event of a breach of the terms of the contract. A violation means that you go to a doctor without a prior call to the helpline

The consequences range from the health insurer refusing to cover costs to downgrading your policy to the standard basic health insurance model with free choice of doctor (exclusion from the Telmed model). Downgrading means that you lose your premium discount and will have to pay the premiums of the standard model. You will find out more about how Telmed works with the largest providers in the table below.

5. Pros and cons of Telmed

Pros

  • Providing advice over the phone allows you to pay lower premiums. In the Telmed model, a premium reduction of around 1% to 30% is possible compared to the standard basic insurance model.

  • For medical helplines, waiting times are often shorter than for walk-in visits to the doctor.

  • You can discuss and resolve problems on the telephone without having to go to the doctor at all.

  • Health insurance companies’ telemedicine specialists can often issue a doctor’s note. Many employers accept this. 

Cons

  • Remote diagnosis over the phone can lead to incorrect assessments. This can have health consequences.

  • In the event of a dispute, the Telmed doctor’s note has no probative value due to the lack of a personal examination.

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6. How is Telmed different to the family doctor model and the HMO model?

The HMO model and the family doctor model are also alternative health insurance models.

Telmed vs. HMO

With the HMO model, your first point of contact for medical treatments is a specific group practice or a network of doctors. There, you will clarify the further treatment steps.

Telmed vs. family doctor model

With the family doctor model, you have a fixed family doctor or GP as a contact person for health problems. If necessary, they can then refer you to a specialist.

7. List of Telmed telephone numbers for the largest insurers

Here you can find an overview of the Telmed numbers of the ten largest health insurance companies.

Health insurer Name of model Partner Phone number
Assura
  • AssurCall [1]
  • QualiMed [1]
Medgate 021 555 10 55
Concordia smartDoc [2] Medgate 041 228 18 28
CSS
  • Callmed [1, 2]
  • Multimed [1, 2]
Medgate 058 277 77 77
Helsana BeneFit Plus Telmed [1] Medi24 0800 800 090
Helsana Premed-24 [1] Medi24 0800 773 633
KPT
  • Win.easy [1]
  • Win.win [1]
Medi24 058 310 99 99
Mutuel Assurance PrimaFlex [1] Medgate 0800 852 852
Mutuel Assurance SanaTel [1] Medi24 0800 726 283
Sanitas CallMed [1] Medgate 0844 124 365
Sanitas Medbase MultiAccess [1] Medgate 0848 888 777
Sanitas – Compact Compact One [1] Medgate 0844 111 365
Swica
  • Favorit Medpharm [3]
  • Favorit Telmed [3]
Santé24 044 404 86 86
Visana
  • Med Call [1]
  • Tel Doc [1]
Medi24 0800 633 225

[1] If the policyholder does not contact the telephone helpline first, they will be transferred to the standard basic insurance model after an advance warning.

[2] If policyholders do not contact the medical helpline first, none of the costs are covered.

[3] Santé24 offers advice from qualified experts. If required, Santé24 arranges an appointment for Swica Telmed policyholders at one of Swica’s partner practices or with an independent doctor or specialist. If policyholders do not contact the medical helpline first, they may be transferred to the standard model.

Last update: July 2023

This article was first published on 25.07.2023

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