HMO model – all the benefits of a medical network
The HMO model is a version of mandatory basic insurance in which a doctor from your medical network or group practice is always your first point of contact.Calculate premium
HMO stands for Health Maintenance Organisation and is built around group medical practices.
Under the HMO model, you always consult your doctor from your medical network or group practice first. A group practice consists of several doctors working together in the same place. A medical network is made up of doctors in different locations.
In an emergency, you can go straight to your doctor, their locum or an A&E department. You should then inform your doctor or the telemedicine centre about the emergency and any follow-up treatment that may be required.
This model lets you benefit from the experience of all the members of the network. You always contact your own doctor first and, in return, enjoy an attractive discount. Are you looking for the cheapest possible premium? Then the HMO model is perfect for you.
Cost coverage according to the tariff for treatment by recognised doctors, chiropractors, dieticians, midwives, logopedists, physiotherapists, ergotherapists, nurses and nursing auxiliaries throughout Switzerland
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
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
In accordance with Article 12 of the Ordinance on Compulsory Health Insurance Benefits
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
Spa cures: CHF 10 per day, 21 days per year plus medical costs
Convalescence cures: only medical costs
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
Contributions to preventive health measures e.g. vaccination of children, preventive gynaecological examinations, etc.
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)
Up to 18 years of age: CHF 180 per year with a medical prescription
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
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)
Costs for psychotherapy by a doctor