What’s the cheaper model? They might control the call centers so it could be cheaper than to pay a doctor.
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I also think they can control their costs better with the alternative models (HMO, family doc, Callmed). You can cause a lot more “damage” by freely going to specialists and such than under one of the other regimes, I would assume.
By the way, if you’re wondering why health insurance costs are rising and rising: The Swiss healthcare system is increasingly becoming a self-service shop.
I take the cheapest KVG offer and I pay every doctors visit myself. I never had costs above 1000 per year so why bother? Mostof the years, I have zero doctors visits.
I can also go to some specialist and what not if I want. Well, the day I need a 100’000CHF liver transplant, I’ll figure out what to do.
I wonder how this is not the approach of anyone here who has no chronical condition.
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The cheapest offer might not have free Telmed. If all you need is a recipe from a doctor via phone, such a model is often cheaper than saving 3.-/month for the cheapest insurance w/o free Telmed.
In the end it depends on the behavior/frequency and what kind of doctor consultancy you need. E.g. some want to see a real person, while others try to avoid that.
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My cheapest offer (it’s an HMO) would involve a 50 minute way. That’s too far if I am really sick. I can walk to our general doctor in 5 minutes. That’s much easier.
Whatever restrictions HMO, Telmed, Qualimed…
Unless you plan to spend >2500/y, there is no outcome that your insurance pays anything anyway. That’s why I go for the cheapest offer no matter the restrictions and then I go to the doctor I want to go.
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Emphasis mine. What I want to protect against can’t be planned, it is that 100k liver transplant and other cases like it. I don’t want to deal with extra administrative hassle (best case), extra constraints that don’t suit me or legal battles (worst case) while I’m undergoing cancer treatment and seriously don’t have the mental space to want to deal with that.
The time when I have the mental space to plan for it is now. It is worth a few 10s of CHF per month to take the 2nd, 3rd or 4th cheapest plan that best works for me if I become really ill.
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With the risk of repeating myself, but that’s not the case for Telmed. In my plan I get free advice from doctors via Telmed (including recipes) from day 1.
Of course doesnt work for anything more complicated or where you need to do additional tests/scans etc.
In many AGBs its written that worst case they put you back to the “original plan” if you don’t comply. So I wouldn’t know what legal battles you would expect, unless you would want to battle their decision to ask you to pay the standard fees instead of the reduced fee?
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Reading this thread, it looks like Telemedicine offers (Medgate etc.) are (subjectively) confusing and (objectively) intransparent (?). I am not desperate for the absolutely cheapest model, so these models are out for me.
HMO, on the other hand, looks like not that restrictive. If you have to go to a doctor, is it that important to which one?
Looks like I can have significant savings with a model where I have to give up my general doctor and only use a Medbase center.
Would anyone be kind to comment on your own experience with Medbase? How difficult is it to get an urgent (not emergency) appointment? I hardly ever have planned medical visits, and if I do, it is rather with a specialist, not with a general doctor. So far they were always able to schedule a same/next day appointment, if necessary with another doctor of the same practice. I don’t absolutely want to keep access to my general doctor, but if I give it up and as a result I can’t get a doctor appointment within a reasonable delay, I don’t need it.
So, comments are appreciated!
I would still recommend to look at some offers that provide both (Telmed + HMO/Family Doc). E.g. Flexhelp from Sympany or WinWin from KPT. They are among the cheapest and if you dont like the telmed part, just go to the doctor directly.
Regarding Medbase, I don’t have any experience…
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Sure. For me they are equivalent to “family doctor” or “HMO” models. Unfortunately my general doctor is not in the list for those models, and I am not looking for a new one just for this.
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I took out Sanitas Compact one insurance (Telmed - must consult via Medgate first) for the first time in 2024. Prior to this I had a more expensive SWICA model “call us first but then completely free choice of Dr”. Based on my experience so far I am even happier with the Sanitas model than the prior one and I will keep it for 2025.
Plus points based on 2 interactions:
-convenient and avoids consultation costs: Free consultation over the app and then if needed by phone even on the weekend with prescription sent to local pharmacy without needing to make an appointment or paying to see a Dr
-Free referral to specialist from Medgate based on description of symptoms without needing to pay to see a general Dr
-They invited me to choose a specialist convenient for me, They told me that in practise so long as the Dr charges the official rates there is no issue
An interesting point: the specialist charged me an hour’s consultation (paid by myself from my excess) and Sanitas asked me to confirm in the app if it was correct, in reality it was only 45 minutes. They did not challenge the bill since I guess the difference was small. It seems like a practical control against Drs who over charge that in the future might result in a lower bill for me and everyone else … I like this approach.
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Thanks for the feedback! Just note, everyone, that there are Medgate (call center) and Medbase (medical centers). Very intuitive distinction, I know.
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Hello,
Looking at some health costs coming up next year. Are any of the following inadvisable regarding reimbursements?
I’m with Atupri at the moment and if nothing speaks against it would tend to just change from maximum to minimum franchise for the year.
We were with ÖKK Select this year, and I can’t complain. We had zero issues and contact with them was always quick and efficient.
We will however change for 2025 as the premium if staying with ÖKK will go up 26% next year,that’s crazy.
Just a friendly reminder, for anyone who hasn’t checked yet whether it makes sense to change basic insurance for 2025:
The cancellation of the old one has to arrive at the current insurer latest by the 29.11.
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Just to share that with KPT you can cancel the insurance with just a message in the portal, so no paper, no money and it’s valid instantly.
You need to specify your name and that you want to cancel the insurance.
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Indeed, I used this to change my franchise due to a upcoming operation and vice versa this year.
I recommand to do the cancelation always your self. A good friend finally changes his insurance for 2024 but the new company messed up to send the cancellation letter. Lucky for him he could talk the new company to reimburse all the extra cost and he was moved to the new company in the middle if the year.
Few weeks ago I read a similar case on the SRF app, seems to be a risk.
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Hello, for 2025 I’m moving from Sanitas to Assura (it’s cheaper).
In the termination confirmation letter I got from Sanitas it states that I need to make sure to send to Sanitas the “confirmation of insurance” from Assura:
You must also submit to us a confirmation of insurance from your new health
insurer. If these conditions are not met, we are obliged to continue your basic health insurance cover.
So I forwarded the confirmation I got from Assura to Sanitas, and from Sanitas they reply:
That’s not the correct document.
We need a real confirmation of insurance.
The insurance has to send it to us, not you.
- It IS the correct document, in the title it states “Insurance confirmation” with all my details and it’s signed by Assura.
- What does it mean “real”?
- Apparently Assura has to send it, but Sanitas clearly write in the Termination “you must send us”, and so I did.
I will reply to Sanitas, explaining the situation.
Do you have other ideas or experience on how to solve this mess? Thanks