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Family doctor model

The family doctor model is a version of mandatory basic insurance in which your family doctor is always your first point of contact.

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The advantages for you

  • The family doctor you know and trust is your main point of contact.
  • Medical advice is available 24/7 on +41 58 277 77 77.
  • You get a discount at least 9% on the premium for your basic insurance.

Good to know

You like to consult your family doctor about health problems but would also like to save on premiums? Then the family doctor model is perfect for you.

Treatment from a doctor
If necessary, go directly to your family doctor, who will organise your treatment.
Low-cost generics
If a generic is available, your doctor will prescribe it whenever possible.
Go directly to a specialist
You can see an eye doctor, gynaecologist, dentist or midwife without giving us prior notice.

How the family doctor model works

Always consult your family doctor first

Under the family doctor model, you always ask your family doctor first. Your own doctor is familiar with your medical history and knows what treatment is best for you.

Treatment by a specialist

Your family doctor refers you directly to a specialist. Send us the referral confirmation from your family doctor. That way, you’ll make sure that CSS pays your treatment costs.

Straight to a doctor in emergencies

You must always go to your family doctor first in emergency situations. If they cannot be reached, contact their locum or the emergency service.

Your premium at a glance

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Basic insurance benefits

Overview of benefits

Outpatient treatment – classical medicine

Cost coverage according to the tariff for treatment by recognised doctors, chiropractors, dieticians, midwives, logopedists, physiotherapists, ergotherapists, nurses and nursing auxiliaries throughout Switzerland

Outpatient treatment – alternative medicine

Acupuncture, anthroposophic medicine, Chinese medicine, homeopathy and phytotherapy: costs are covered according to the tariffs prevailing in the canton of residence or at the place of work for treatment by recognised doctors with an FMH qualification in the discipline of complementary medicine

Hospitalisation

Cover for all costs in the canton of residence according to the HIA (public hospital/acute hospital), unlimited as to sum or duration in a general ward

Health promotion/prevention

In accordance with Article 12 of the Ordinance on Compulsory Health Insurance Benefits

Benefits abroad

Cover for costs incurred in emergencies for outpatient or inpatient treatment on a general ward up to a maximum of twice the tariff of the canton of residence in Switzerland. Special conditions apply in EU states (incl. Iceland, the Principality of Liechtenstein and Norway) as determined in the bilateral agreements

Medication

Medically prescribed medication on the list of generic drugs maintained by the Federal Office of Public Health (FOPH), the list of medicines with tariffs or the specialities list

Spa cures/convalescence cures

Spa cures: CHF 10 per day, 21 days per year plus medical costs
Convalescence cures: only medical costs

Maternity/breastfeeding

Eight check-ups, two ultrasound examinations for a normal pregnancy, home birth or hospital birth, max. CHF 150 for prenatal courses, max. three sessions for breastfeeding advice

Aids

Contributions to aids in accordance with the official aids and appliances list compiled by the Federal Office of Public Health (FOPH)

Preventive examinations/vaccinations

Contributions to preventive health measures e.g. vaccination of children, preventive gynaecological examinations, etc.

Transport and rescue costs

Cost of transport: 50% of costs, max. CHF 500 per calendar year
Cost of rescue: 50% of costs, max. CHF 5,000 per calendar year (Switzerland)

Glasses/contact lenses

Up to 18 years of age: CHF 180 per year with a medical prescription

Home nursing/care in a nursing home

Costs are covered for examinations, treatment and nursing care prescribed by a physician and carried out at home or in nursing homes by recognised Spitex organisations

Dental treatment

Costs are covered for serious jaw disease or if treatment becomes necessary because of a serious general illness. Initial treatment in case of accident (if accident cover included)

Psychotherapy

Costs for psychotherapy by a doctor

Frequently asked questions

What is Profit and FIRST MED?

Profit, FIRST MED and the family doctor model – these are the names of family doctor insurance plans available from the CSS Group. They all provide the same service and benefits.

Can I go straight to a doctor?

No. Your family doctor is your first point of contact. If you require specialist treatment, you will be referred by your family doctor. Please send us the referral confirmation form, completed by your family doctor. If you do not stick to the rules, it will not be possible to reimburse your treatment costs.

Can I change my family doctor?

You can change your family doctor at any time. Please notify us of your new doctor.

Is my family doctor recognised?

The easiest way to find recognised doctors near you is to use the premium calculator or the family doctor search function.

1249785334

Personal advice

Get in touch for a personal consultation.

How to save on premiums

Premiums depend on where you live, your age and what deductible you choose.

Higher deductible
The higher the deductible, the lower the premium. What deductible would you like?
Change insurance
Switch model
Change your medical point of contact and pay less.
Choose option
Exclude accident cover
Do you work at least eight hours a week? Then you can save on premiums.
Change accident cover
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