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InsuranceHealth insuranceGlossary

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 insurerName of modelPartnerTelephone number
AgrisanoAGRI-contact 1Medgate0844 844 911
AMBSanaTel 1Medi240800 726 283
AssuraAssurCall 1Medgate0844 844 911
AtupriFlexCare 1Medgate0844 844 777
AtupriTelFirst 1Medgate0844 844 777
AvenirCallDoc 1Medi240800 963 963
AvenirPrimaTel 1Medi240800 852 852
AvenirSanaTel 1Medi240800 726 283
CM Vallée d'EntremontSanaTel 1Medi240800 726 283
CompactCompact One 1Medgate0844 111 365
CSSCallmed 1, 2Medgate058 277 77 77
CSSMultimed 1, 2Medgate058 277 77 77
CSS – ArcosanaCallmed 1, 2Medgate058 277 77 77
CSS – ArcosanaMultimed 1, 2Medgate058 277 77 77
CSS – IntrasCallmed 1, 2Medgate058 277 77 77
CSS – IntrasFirst Call 1, 2Medgate058 277 77 77
Easy SanaCallDoc 1Medi240800 963 963
Easy SanaPrimaTel 1Medi240800 852 852
Easy SanaSanaTel 1Medi240800 726 283
EGK-GesundheitskasseTelCare 1, 2Medgate0800 800 735
HelsanaBeneFit Plus Telmed 1Medgate0800 800 090
HelsanaPremed-24 1Medgate0800 773 633
KK SteffisburgSanmed24 1, 2Medgate0844 844 911
KK VisperterminenTelmedMedgate0844 844 911
KPTWin.easy 1Medi24058 310 98 99
KPTWin.win 1Medi240844 946 946
KVFCasamed 24 2Medgate0848 227 224
KVFCasamed Select 2Medgate0848 227 224
Mutuel AssuranceCallDoc 1Medi240800 963 963
Mutuel AssurancePrimaTel 1Medi240800 852 852
Mutuel AssuranceSanaTel 1Medi240800 726 283
ÖKKCasamed 24 2Medgate0848 227 224
ÖKKCasamed Select 2Medgate0848 227 224
PhilosCallDoc 1Medi240800 963 963
PhilosPrimaTel 1Medi240800 852 852
PhilosSanaTel 1Medi240800 726 283
ProgrèsBeneFit Plus Telmed 1Medgate0800 800 090
ProgrèsPremed-24 1Medgate0800 773 633
ProvitaMedpharm 3Santé24044 404 86 86
RhenusanaSanmed24 1Medgate0844 844 911
Sana24Med Call 1Medi240800 633 225
Sana24Tel Care 1Medi240800 633 225
SanagateSanaCall 1, 2Medgate058 911 80 00
SanitasCallMed 1Medgate0844 124 365
SanitasMedbase MultiAccess 1Medgate0848 888 777
SlkkTelCare 1Medgate0844 844 911
SodalisTelmed 4Medgate0844 844 911
Sumiswalder KKsumis24Telmed 1Medi240800 786 47 24
SwicaFavorit Medpharm 3Santé24044 404 86 86
SwicaFavorit Telmed 3Santé24044 404 86 86
Sympany – KolpingFlexhelp 24 1Medgate0844 654 654
Sympany – KolpingMedhelp 24 1Medgate0844 852 852
Sympany – KolpingPharmhelp 24 1Medgate0844 852 852
Sympany – MooveCallmed 24 1Medgate0844 852 852
Sympany – VivaoCallmed 24 1Medgate0844 852 852
VisanaMed Call 1Medi240800 633 225
VisanaTel Doc 1Medi240800 633 225
VivacareMed Call 1Medi240800 633 225
VivacareTel Care 1Medi240800 633 225
VivacareTel Doc 1Medi240800 633 225

Information correct as at: 13 November 2019

1If policyholders do not contact the medical helpline first, they may be transferred to the standard model after an advance warning.
2If policyholders do not contact the medical helpline first, none of the costs are covered.
3sante24 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.
4If policyholders receive treatment without consulting a Medgate physician first, only 50% of the cost can be reimbursed.
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