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InsuranceHealth insuranceGlossaryFamily doctor model
Glossary

Family doctor model

If you choose the family doctor model, you forego the benefit of free choice of doctor. You are obliged to consult the agreed family doctor (gatekeeper) first in the event of illness (as under the HMO model). This requirement does not apply to emergencies, annual gynaecological check-ups and regular eye examinations.

The health insurance providers define which doctors you may select as your "family doctor" (or general practitioner) in the family doctor model. These doctors are either affiliated to family doctor networks or independently practising physicians. While some health insurance companies list specific doctors, others allow their policyholders to choose any general practitioner or paediatrician within the insurance company's region.

Your chosen family doctor is responsible for your medical care. This doctor will refer you to a specialist if necessary.

This selective referral method is expected to generate cost savings in comparison with the procedure used in standard basic insurance. Therefore, the premiums for family doctor insurance products are around 15-20 percent cheaper than those for standard basic insurance.

Changing family doctor

Under the family doctor model, you are allowed to switch to a different family doctor. However, you may be charged extra if you change your family doctor without giving a reason (the same applies to the HMO model). Reasons for changing your family doctor include:

  • Moving home
  • Closure of doctor's practice
  • Breach of trust

You should contact your insurance company before switching. They will help you with any queries, and can provide a list of doctors to choose from.

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