With the choice of this model, policyholders agree on doing without free choice of doctors.
They oblige themselves (as with HMO) to always consult
their GP (gatekeeper) in the case of illness. Emergencies
are the exception to this rule.
The health insurances companies define which doctors can be chosen by the policyholders as an own GP in the GP model.
These doctors are either affiliated to the GP networks or are nonattachedly practicing doctors. While some health insurance companies
have explicit lists of doctors, others allow to chose the doctor from all internists, GPs and paediatricians within the
insurance company's region.
The selected GP is responsible for the policyholder's treatment. If necessary,
he may refer his patients to a specialist.
It is expected that aimed transfer of policyholders to specialists through the GP will generate less costs
than standard health insurance. This
is why premiums for GP health insurance products are 5 to 20% less than those of standard basic health insurance. |
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