The family doctor model is a version of mandatory basic insurance in which your family doctor is always your first point of contact.
Calculate premiumYou 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.
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.
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.
You must always go to your family doctor first in emergency situations. If they cannot be reached, contact their locum or the emergency service. In urgent cases, please contact an emergency doctor directly.
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)
Medically prescribed medication on the Federal Office of Public Health (BAG) «New list of generic medicine with differentiated retention fees for original preparations and generic medicines», the drug formulary or the Specialty List
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 aids in accordance with the aids and appliances list
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
The family doctor model offered by CSS is called Profit Family Doctor Insurance. You'll find it mentioned under this name on the policy.
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 don’t stick to the rules, you will face financial consequences.
You can change your family doctor at any time. Please notify us of your new doctor.
The easiest way to find recognised doctors near you is to use the premium calculator or the family doctor search function.
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.
Pay the bill and send us the refund form. It couldn’t be easier!
Premiums depend on where you live, your age and what deductible you choose.
