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Advantages of forgoing a free choice of doctor

Lower premiums, same service and a fixed point of contact. Switching to an alternative model of basic insurance has many advantages and comes with a few rules.

The advantages for you

  • You get a discount of at least 10% on the premium for your basic insurance.
  • Your first point of contact depends on the model.
  • All models pay the same benefits for illness, accident and maternity.
  • Medical advice is available 24/7 on 058 277 77 77.

How an alternative basic insurance model works

Under these models, you forgo a free choice of doctor and always turn to your chosen point of contact first. Thanks to these rules, premiums are cheaper.

HMO model – all the benefits of a doctors’ network

You always go to your own doctor from the medical network first. They will coordinate your treatment and refer you if need be.

Family doctor model – go directly to your own doctor

You always go to your family doctor first. They know the best way to treat you and will refer you to a specialist if need be.

Multimed – ideal for high medical bills

You contact either the telemedicine centre or your family doctor first. Unique to this model: you pay CHF 300 less as a retention fee.

Telmed – advice digitally or by phone

You call the telemedicine centre or use the Well app first before making an appointment to see a doctor.

If you choose to forgo a free choice of doctor, these rules are important

You pay less in premiums, but there are a few restrictions attached. Here’s what happens if you go directly to another doctor, fail to report an emergency or don’t opt for generic medicine.

  1. CSS will remind you of the correct procedure. CSS will pay the doctor’s fees, minus any deductible and retention fee.
  2. Each time you go directly to another doctor after that, you will have to pay up to CHF 500 per bill from your own pocket. This amount will not be set off against the deductible or retention fee.
  3. If you use original products instead of generic medicines, additional costs may arise.
  4. You’d prefer to have a free choice of doctor? You can change model as of 1 January each year.

Referral to another doctor

Does the person treating you (e.g. doctor, physiotherapist) want to refer you? Then ask your chosen medical practice or the telemedicine centre. This approval is necessary and will be passed on to CSS. Only then are we able to cover the costs. Who you should contact may vary depending on your basic insurance.

Chronic disease

Are you chronically ill? Then your chosen medical practice or the telemedicine centre may issue an approval for an extended period of time – ensuring you receive the best support from the right professional.

Emergencies, gynaecologist and more

For emergency treatment, please contact your chosen doctor's practice. If it cannot be reached, contact an emergency practice or hospital directly. Inform your contact person of the emergency treatment within 10 days.

You can also go directly to an eye doctor, gynaecologist, dentist or midwife. If a generic is available, your doctor will prescribe it whenever possible.

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Forgoing a free choice of doctor

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Choose your basic insurance

Go directly to your family doctor

Family doctor model

  • The family doctor you know and trust is your main point of contact.
  • You can see an eye doctor, gynaecologist or midwife directly.
  • At least 10% premium discount.
Calculate your premium Change model
Recommendation

All the benefits of a doctors’ network

HMO model

  • The chosen doctor’s practice from the medical network or the group practice is your first point of contact.
  • You can see an eye doctor, gynaecologist or midwife directly.
  • At least 13% premium discount.
Calculate your premium Change model

Advice digitally or by phone

Telmed

  • Your first point of contact is the Well app or the telemedicine centre.
  • You can see an eye doctor, gynaecologist or midwife directly.
  • At least 10% premium discount.
Calculate your premium Change model

Ideal for high medical bills

Multimed

  • The Multimed practice, telemedicine centre or Well app is your first point of contact.
  • You can see an eye doctor, gynaecologist or midwife directly.
  • Premium discount of at least 15% and CHF 300 less as a retention fee.
Calculate your premium Change model

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