Managed care models in Switzerland: what is managed care?
In basic health insurance, there are various alternative health insurance models to choose from. Which models are managed care models? Comparis explains.
29.07.2022
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1. What are managed care models?
Managed care models are alternative health insurance models. With these models, you have a limited choice of service providers. You no longer have free choice of doctor. In exchange, you benefit from lower premiums than with the standard model.
n managed care models, one doctor is responsible for managing a patient's healthcare. This means that patients should first contact their chosen doctor, referred to as the «gatekeeper», in the event of illness. This might be a GP or family doctor, for example. This gatekeeper then determines the course of the treatment.
2. What are the different managed care models?
The most common managed care models are HMO models and family doctor models.
HMO model: in the event of illness, you must always consult a particular HMO practice first.
Family doctor model: with this model, your first point of contact in the event of illness is always your designated family doctor.
Another way to save on premiums is to choose a Telmed model. With this model, instead of consulting a doctor or an HMO practice, you usually call a telephone hotline first.
3. What advantages do managed care models offer?
In exchange for not being able to freely choose your doctor for different ailments, you benefit from a premium discount. This central coordination of treatment is also designed to improve the quality of medical care.
