Supplemental insurance comparison

The standard model is the statutory standard version of mandatory basic insurance. It is offered by all health insurance companies. The benefits covered under basic insurance are set out in the Health Insurance Act (KVG). This is why all benefits under any insurance model are identical with all health insurance companies. As the standard model grants free choice of doctors, it is the most expensive option compared to the alternative insurance models.

Pros:

• Free choice of doctors at all times
• You can go to a specialist directly

Policyholders choosing the family doctor model forgo free choice of doctors and commit themselves to always consulting their fixed GP/family doctor in the event of illness. The health insurance companies determine which doctors can be chosen by policyholders in the family doctor model. These doctors are either affiliated to family doctor networks or independently practising physicians. The family doctor is responsible for the medical care of the policyholders who have chosen him/her. If medically necessary, he/she will refer the patient to a specialist.

Emergencies as well as the annual gynaecological check-up and regular eye examinations are exempt from this obligation.

Pros:

• Fixed point of contact for any health-related issues
• Premium reduction of about 15 to 20 percent compared to the standard model

Policyholders choosing the HMO model forgo free choice of doctors. They commit themselves to always first consulting a doctor based at the HMO practice in the event of illness. An HMO practice is a group practice including not only GPs but usually also specialists and therapists from various areas of medical specialisation. HMO is short for Health Maintenance Organisation.

Emergencies as well as the annual gynaecological check-up and regular eye examinations are exempt from this obligation.

Pros:

• Several medical specialists under one roof
• Premium reduction of up to 25 percent compared to the standard model

For every newly appearing health problem, policyholders have to call a consultation hotline before consulting 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.

Pros:

• Medical advice around the clock
• Few restrictions as you are usually free to choose your doctor after the telephone consultation
• Premium reduction of about 15 to 20 percent compared to the standard model