I am about to get my first health insurance as a newcomer in Switzerland and I am confused about the different models. I like the idea of having an app or a hotline where I can give my symptoms and then I can be referred to a doctor. Even better those models are one of the cheapest. But there is something strange. I will give ÖKK’s models as an example. But I saw the same with other companies.
They have the ÖKK Casamed Select which they state that the initial contact should be via telmed, app or pharmacy. They also have ÖKK Casamed 24 which is the same, but the initial contact can only be made via telmed or app. No option for pharmacy.
What I don’t understand is why is the model with less options (no pharmacy, only app and telmed) more expensive? More options should result in higher price not the other way around. What am I missing?
Sometimes it doesn’t make sense, it’s just market segmentation. (Was the same a few years ago with kpt win.win being cheaper than a more restrictive model)
Yes, I even asked a KPT employee on the phone about this because it made 0 sense. She also didn’t really know the answer, apart from that KPT wanted to push this win.win model this year.
@Tualatin, something to check is whether your choice of doctors (after consulting app/phone) is more limited in the cheaper one.
Theoretically, the pharmacy model can work out cheaper for insurers because, for smaller issues, many people will be content with a pharmacist’s diagnosis. At this point at least, people aren’t likely to accept an app’s diagnosis, or even a diagnosis via video call. Most people will still want to see a doctor. So I would argue that a pharmacy would do a better job at weeding out the cases that do not require a doctor. Since pharmacies have an incentive (sell a salve for the allergic reaction or a syrup for that cough), they are likely to make a favorable deal with the insurance company which costs the insurance very little.
Have you wrapped your head around excess (“Franchise”) and deductible (“Selbstbehalt”) yet? What about supplementary insurances? This federal info might help.
The only difference between ÖKK CASAMED SELECT and ÖKK CASAMED 24 is, that the ÖKK CASAMED SELECT model gives you the option for a pharmacy consultation and this is the reason why we recommend ÖKK CASAMED SELECT.
So I guess all of you were right. Thanks for all the inputs!
As for Franchise and Selbstbehalt, I think I already made my mind.
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