Family doctor model – go directly to your own doctor
The family doctor model is a version of mandatory basic insurance. You always ask your family practice first whenever you have concerns about your health.Calculate premium
You like to consult your family practice about health problems but would also like to save on premiums? Then the family doctor model is perfect for you.
Under the family doctor model, you always ask your family practice first. Your own doctor is familiar with your medical history and knows what treatment is best for you.
Premiums depend on where you live, your age and what deductible you choose.
Practically nothing will change for you on switching to the family doctor model. Except, of course, that you can save on premiums.
Your family practice will refer you directly to a specialist or to a hospital if necessary. You use the referral confirmation form to let CSS know about this before treatment begins. You can go directly to the following medical professionals: eye doctors, gynaecologists and midwives.
You can go straight to physiotherapists, occupational therapists, issuers of aids and appliances, pharmacies, Spitex and dieticians with a prescription from your family practice. You don’t need confirmation of referral for this.
You must always go to your family practice first in an emergency. If they cannot be reached, you must contact their locum or the emergency service.
The rules include always asking your family practice first when you have a health issue you wish to discuss. Don’t forget about the referral confirmation. Under the family doctor model you buy low-cost generics, thus helping to lower healthcare costs. That way, you pay lower premiums.
Anyone not following the rules will face financial consequences. You will have to pay up to CHF 500 per doctor’s bill from your own pocket. If you use original products, additional costs may arise.
Cost coverage according to the tariff, throughout Switzerland, for treatment by recognised doctors, chiropractors, dieticians, midwives, speech therapists, physiotherapists, ergotherapists, nurses and nursing auxiliaries
Acupuncture, anthroposophic medicine, Chinese medicine, homeopathy and phytotherapy: Cost coverage according to the tariff, throughout Switzerland, for treatment by recognised doctors with an FMH qualification in the respective field of complementary medicine
Cost coverage without limit to sum or duration in the general ward (hospital/acute-care hospital) in accordance with the current cantonal hospital list
As stipulated in article 12 of the Health Insurance Benefits Ordinance
Cost coverage in the general ward in emergencies for outpatient or inpatient treatment, up to a maximum of twice the tariff of the canton of residence in Switzerland. The special provisions in force under the bilateral agreements apply in the case of EU countries (incl. Iceland, the Principality of Liechtenstein and Norway)
Spa treatments: CHF 10 per day, 21 days per year, plus the cost of medical treatment
Recovery cures: The cost of medical treatment only
7 check-ups during pregnancy and one following the birth, 2 ultrasound examinations for a normal pregnancy, home birth or hospital birth, maximum CHF 150 for antenatal courses, maximum 3 sessions of 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
Rescue costs: 50% of costs, max. CHF 5,000 per calendar year
Up to age 18: CHF 180 per year, on a doctor’s prescription
Cost coverage for medically prescribed examinations, treatment and nursing care by recognised Spitex organisations at home or in nursing homes
Cost coverage for severe jaw disease or if treatment becomes necessary because of a serious general illness. Primary treatment of dental accidents (if accident cover included)
Cost coverage for psychotherapy with a doctor