Is the Hausarzt model really a mustachian choice? Whenever I need to see a specialist, I pay around 200 CHF to meet my Hausarzt, who always checks my blood pressure. Is it the same for everyone? Thinking that Telmed is a much better option to avoid this 200 CHF fee.
Probably not, as you already insinuate.
I have a combo telmed/hausartz, so am able to pick what I want (if I need the GP first, or know already which specialist I need - so can skip the unnecessary fees).
Coincidentally it was also the cheapest model (KPT win.win), this year nearly so again - I probably stay with it.
Honestly, in the last several years every time I ever used Telmed (Swica) they sent me to the hausarzt first. Even when the doctor then sent me to obvious specialist need.
So in my opinion you have the double whammy of having to deal with the telephone operators (long waiting line, zero expertise other than reading a decision tree script) and also to pay for the doctor.
Other insurers may have better service, so YMMV
In the Smartmed program of Aquilana you talk with a doctor who is able to give a prescription and a sick leave note. So definitely different.
Good to know.
With KPT win.win I had over the phone an “approval” for a direct specialist visit with 0 fuss (and fees).
Basically they just sent me an email confirmation “yes you may book a specialist appointment for this purpose yourself within the next year”.
Then it was on me to find one nearby.
KPT win.win seems more flexible, but with a lower discount.
Just be careful because each alternative model is different for each insurer with different restriction and sanction!
The French-speaking consumer federation (in French) has analysed all the alternative models:
In short, it’s very complex…
Also one big issue with Hausartz, it’s that in a lot of cantons, it’s impossible to find one, they don’t accept new patients. Most doctors on the insurer list don’t take new patients.
I have also seen some alternative models which force you to go in Medbase centers (a company owned by Migros) and they do themselves all the coordination with specialists. It seems quite risky, because
an insurer having a partnership with a specific private company risks to put pressure to reduce the costs, instead of providing a good treatment.
If the discount is so big, I think it’s better to take the standard coverage.
I like the Telmed model a lot. As mentioned already by others i think its the cheapest because in my situation the premiums are cheaper and also we can often avoid the visit to a doctor. For example they can prescribe medication through telmed consulting for certain situations (flu or my yearly medication for pollen allergy).
PS. for me this year’s Telmed plan would cost more than the doctor one… go figure.
One more real-life case study here, have called today due to Covid and Swica confirms that Telmed cannot provide doctor’s certificate for the employer (ok, fine) and also they cannot provide prescriptions for pharmaceuticals without first visiting a hausarzt - which you have to find yourself within your surroundings, and Telmed qualifies your eligibility to visit it for this specific illness.
So, not very helpful vs. other models to be honest.
Do you actually have to pay anything for the Telmed phone consultation or is that included in the monthly insurance price?
With aquilana it is 60 CHF (59.90 to be exact). Still cheaper than the doctor…
Great question, I would be outraged if they did as they are utterly useless, but I believe it’s included with Swica.
I have used Telmed (Medgate app) under Sympany Vivao throughout 2023. Consultations via the app were good and for free (included). In the past I had HMO model and had to first go Medbase/Sanacare, pay ~100 chf for nothing and finally get the appointment with the specialist.
This year I need to change as Sympany increased monthly premiums by 50chf, but I am also stuck checking which insurance has a fully free Telmed.
Just be careful, there is not one Telmed model, but one per insurance with different conditions.
You’re right to the point, there are many variations and it is not easy to find out what is included or not. For example with Agrisano and their Agrismart (Telmed) offer it is not clear if one has to pay for the medgate consultation. I guess I’ll have to read the fine print to find this out…