Health insurance: Restricted choice of providers

You can save up to 20% if you agree to a restricted choice of physicians and hospitals under an HMO or GP insurance model.

A wide variety of insurance models are available. The best known are the GP and HMO (health maintenance organisation) models.

Reductions relate to the premium for standard insurance with accident cover.

HMO model

Under the HMO model, treatment is provided at an HMO centre (e.g. group practice).

GP model

With the GP model, patients are always required (except in an emergency) to consult their own GP first, who then decides whether they need to see a specialist. It is advisable to study the terms and conditions of insurance carefully.

Please note:

If this type of insurance is combined with an optional deductible, it may not be possible for the full reduction to be granted owing to the legal requirements concerning the minimum premium. The minimum premium corresponds to 50% of the standard premium (deductible 300 [children deductible 0], without insurance model restricting the choice of service provider, including accident cover. This minimum premium must not fall below, not even with an insurance without accident cover.

Last modification 28.01.2021

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Contact

Federal Office of Public Health FOPH
Health and Accident Insurance Directorate
Governance Supervision Section
Schwarzenburgstrasse 157
3003 Berne
Switzerland
Tel. +41 58 462 21 11
E-mail

Print contact

https://www.bag.admin.ch/content/bag/en/home/versicherungen/krankenversicherung/krankenversicherung-versicherte-mit-wohnsitz-in-der-schweiz/besondere-versicherungsformen/modelle-eingeschraenkte-wahl.html