For every new health problem, the policyholder has to call a consultation hotline before seeing a doctor for the first time. There, medical experts give advice, make recommendations on how to behave or refer patients to a doctor, a hospital or a therapist.
Thanks to the consultation by phone prior to consulting a doctor, costs can be saved. Policyholders in the Telmed model receive a premium reduction of 15 to 20 percent compared to the standard basic insurance.
| Health insurance company | Name of model | Partner | Telephone |
|---|---|---|---|
| Arcosana | Callmed 1, 2 | Medgate | 058 277 77 77 |
| Atupri | FlexCare 1 | Medgate/Medbase | |
| Atupri | TelFirst | Medgate | 0844 844 777 |
| Avanex | Premed-24 1 | Medgate | 0800 773 633 |
| Avenir | SanaTel 1 | Medi24 | 0800 726 283 |
| Compact | Compact One | Medgate | 0844 111 365 |
| CSS | Callmed 1, 2 | Medgate | 058 277 77 77 |
| Easy Sana | SanaTel 1 | Medi24 | 0800 726 283 |
| EGK-Gesundheitskasse | TelCare 1, 2 | Medgate | 0800 800 735 |
| EGK-Gesundheitskasse | TelMed 1, 2 | Medgate | 0800 800 735 |
| Helsana | Premed-24 1 | Medgate | 0800 800 090 |
| Helsana | Premed-24 1 | Medi 24 | 0800 100 008 |
| Intras | Callmed 1, 2 | Medgate | 058 277 77 77 |
| KK Steffisburg | Sanmed24 1, 2 | Medgate | 0844 844 911 |
| KK Visperterminen | Telmed | Medgate | 0844 844 911 |
| Kolping | MedHelp24 1 | Medgate | 0844 654 654 |
| KPT/CPT | Win.win 1 | Medi 24 | 0844 946 946 |
| Maxi.ch | maxi.zero 1, 2 | Medgate | 0800 800 803 |
| Moove Sympany | Callmed24 1 | Medgate | 0844 852 852 |
| Mutuel Assurance | SanaTel 1 | Medi24 | 0800 726 283 |
| ÖKK | Casamed 24 2 | Medgate | 0848 227 224 |
| Philos | SanaTel 1 | Medi24 | 0800 726 283 |
| Progrès | Premed-24 1 | Medgate | 0800 773 633 |
| Rhenusana | Sanmed24 1 | Medgate | 0844 844 911 |
| Sana24 | Med Call 1 | Medi24 | 0800 633 225 |
| Sanagate | SanaCall 1, 2 | Medgate | 058 911 80 00 |
| Sanitas | Callmed 1 | Medgate | 0844 124 365 |
| Sansan | Premed-24 1 | Medgate | 0800 773 633 |
| Slkk | TelCare 1 | Medgate | 0844 844 911 |
| Sodalis | Telmed 4 | Medgate | 0844 844 911 |
| Swica | Favorit Telmed 3 | Santé24 | 044 404 86 86 |
| Sumiswalder KK | sumis24Telmed 1 | Medi24 | 0800 786 47 24 |
| Visana | Med Call 1 | Medi24 | 0800 633 225 |
| Vivacare | Med Call 1 | Medi24 | 0800 633 225 |
| Sympany | Callmed 24 1 | Medgate | 0844 852 852 |
| Wincare | Callmed | Medgate | 0844 124 365 |
As of: 9 May 2014
| 1 | In case of non-use of the help-line, policyholders may be reallocated to the standard model after an advance warning. |
| 2 | In case of non-use of the help-line, none of the costs are covered. |
| 3 | sante24 offers advice from competent experts and doctors. If required, sante24 arranges an appointment at one of Swica's partner practices or with an independently practising doctor or specialist on behalf of Swica Telmed. In case of non-use of the help-line, policyholders may be reallocated to the standard model. |
| 4 | Cost of treatments that were initiated without consulting a Medgate physician can only be reimbursed at 50 percent. |
The general terms of contract envision various procedures for dealing with policyholders who consult a doctor without having called the telephone helpline first. They range from refusal to reimburse the costs to downgrading to the standard basic insurance (exclusion from the Telmed model).
Telephone consultation before seeing a doctor is not required for the following cases:
- Emergencies
- Annual gynaecological preventive check-ups
- Examinations by an eye specialist (in some cases only for children)
- Other services (depends on insurance company)