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Telmed: in simple terms
- What is the Telmed model?
- When does Telmed allow me to go straight to the doctor or hospital?
- What happens if I don't comply with the Telmed procedure?
- Advantages of Telmed
- List of Telmed providers and telephone numbers
What is the Telmed model?
The Telmed model is an alternative insurance model for basic health insurance. For every new health problem, Telmed policyholders must first call a medical helpline before seeing a doctor. Via the medical helpline, a medical expert will give advice, make recommendations or refer the policyholder to a doctor, hospital or therapist.
When does Telmed allow me to go straight to the doctor or hospital?
Telmed policyholders can go straight to a doctor or hospital without contacting the medical helpline in the following cases:
- In an emergency
- For an annual gynaecological check-up
- For an examination by an eye specialist (in some cases for children only)
- Other services (depends on insurance company)
What happens if I don't comply with the Telmed procedure?
The general contract terms stipulate various procedures for dealing with policyholders who consult a doctor without having called the medical helpline first. They range from refusing to reimburse the costs to downgrading the policyholder to the standard insurance model (exclusion from the Telmed model). You can find more specific details of how this is handled in the table below.
Advantages of Telmed
Providing medical advice to policyholders over the phone before referring them to a doctor reduces costs. Premiums for the Telmed model cost some 15-20% less than those for the standard basic insurance model.
Since the medical helpline staff are easy to reach, waiting times are often shorter than for unannounced visits to the doctor. In addition, you can often resolve certain issues and problems on the telephone without having to go to the doctor at all.
List of Telmed providers and telephone numbers
| Health insurer | Name of model | Partner | Telephone number |
|---|---|---|---|
| Agrisano | AGRI-contact 1 | Medgate | 0844 844 911 |
| AMB | SanaTel 1 | Medi24 | 0800 726 283 |
| Assura | AssurCall 1 | Medgate | 0844 844 911 |
| Atupri | FlexCare 1 | Medgate | 0844 844 777 |
| Atupri | TelFirst 1 | Medgate | 0844 844 777 |
| Avenir | CallDoc 1 | Medi24 | 0800 963 963 |
| Avenir | PrimaTel 1 | Medi24 | 0800 852 852 |
| Avenir | SanaTel 1 | Medi24 | 0800 726 283 |
| CM Vallée d'Entremont | SanaTel 1 | Medi24 | 0800 726 283 |
| Compact | Compact One 1 | Medgate | 0844 111 365 |
| CSS | Callmed 1, 2 | Medgate | 058 277 77 77 |
| CSS | Multimed 1, 2 | Medgate | 058 277 77 77 |
| CSS – Arcosana | Callmed 1, 2 | Medgate | 058 277 77 77 |
| CSS – Arcosana | Multimed 1, 2 | Medgate | 058 277 77 77 |
| CSS – Intras | Callmed 1, 2 | Medgate | 058 277 77 77 |
| CSS – Intras | First Call 1, 2 | Medgate | 058 277 77 77 |
| Easy Sana | CallDoc 1 | Medi24 | 0800 963 963 |
| Easy Sana | PrimaTel 1 | Medi24 | 0800 852 852 |
| Easy Sana | SanaTel 1 | Medi24 | 0800 726 283 |
| EGK-Gesundheitskasse | TelCare 1, 2 | Medgate | 0800 800 735 |
| Helsana | BeneFit Plus Telmed 1 | Medgate | 0800 800 090 |
| Helsana | Premed-24 1 | Medgate | 0800 773 633 |
| KK Steffisburg | Sanmed24 1, 2 | Medgate | 0844 844 911 |
| KK Visperterminen | Telmed | Medgate | 0844 844 911 |
| KPT | Win.easy 1 | Medi24 | 058 310 98 99 |
| KPT | Win.win 1 | Medi24 | 0844 946 946 |
| KVF | Casamed 24 2 | Medgate | 0848 227 224 |
| KVF | Casamed Select 2 | Medgate | 0848 227 224 |
| Mutuel Assurance | CallDoc 1 | Medi24 | 0800 963 963 |
| Mutuel Assurance | PrimaTel 1 | Medi24 | 0800 852 852 |
| Mutuel Assurance | SanaTel 1 | Medi24 | 0800 726 283 |
| ÖKK | Casamed 24 2 | Medgate | 0848 227 224 |
| ÖKK | Casamed Select 2 | Medgate | 0848 227 224 |
| Philos | CallDoc 1 | Medi24 | 0800 963 963 |
| Philos | PrimaTel 1 | Medi24 | 0800 852 852 |
| Philos | SanaTel 1 | Medi24 | 0800 726 283 |
| Progrès | BeneFit Plus Telmed 1 | Medgate | 0800 800 090 |
| Progrès | Premed-24 1 | Medgate | 0800 773 633 |
| Provita | Medpharm 3 | Santé24 | 044 404 86 86 |
| Rhenusana | Sanmed24 1 | Medgate | 0844 844 911 |
| Sana24 | Med Call 1 | Medi24 | 0800 633 225 |
| Sana24 | Tel Care 1 | Medi24 | 0800 633 225 |
| Sanagate | SanaCall 1, 2 | Medgate | 058 911 80 00 |
| Sanitas | CallMed 1 | Medgate | 0844 124 365 |
| Sanitas | Medbase MultiAccess 1 | Medgate | 0848 888 777 |
| Slkk | TelCare 1 | Medgate | 0844 844 911 |
| Sodalis | Telmed 4 | Medgate | 0844 844 911 |
| Sumiswalder KK | sumis24Telmed 1 | Medi24 | 0800 786 47 24 |
| Swica | Favorit Medpharm 3 | Santé24 | 044 404 86 86 |
| Swica | Favorit Telmed 3 | Santé24 | 044 404 86 86 |
| Sympany – Kolping | Flexhelp 24 1 | Medgate | 0844 654 654 |
| Sympany – Kolping | Medhelp 24 1 | Medgate | 0844 852 852 |
| Sympany – Kolping | Pharmhelp 24 1 | Medgate | 0844 852 852 |
| Sympany – Moove | Callmed 24 1 | Medgate | 0844 852 852 |
| Sympany – Vivao | Callmed 24 1 | Medgate | 0844 852 852 |
| Visana | Med Call 1 | Medi24 | 0800 633 225 |
| Visana | Tel Doc 1 | Medi24 | 0800 633 225 |
| Vivacare | Med Call 1 | Medi24 | 0800 633 225 |
| Vivacare | Tel Care 1 | Medi24 | 0800 633 225 |
| Vivacare | Tel Doc 1 | Medi24 | 0800 633 225 |
Information correct as at: 13 November 2019
| 1 | If policyholders do not contact the medical helpline first, they may be transferred to the standard model after an advance warning. |
| 2 | If policyholders do not contact the medical helpline first, none of the costs are covered. |
| 3 | sante24 offers advice from qualified experts and doctors. If required, sante24 arranges an appointment for Swica Telmed policyholders at one of Swica's partner practices or with an independently practising doctor or specialist. If policyholders do not contact the medical helpline first, they may be transferred to the standard model. |
| 4 | If policyholders receive treatment without consulting a Medgate physician first, only 50% of the cost can be reimbursed. |
Whether basic or supplemental insurance...