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

Information correct as at: 13 November 2019