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.Calculate premium
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.
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
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.
No. Your family doctor is your first point of contact. If you require specialist treatment, you will be referred by your family doctor. If you do not stick to the rules, it will not be possible to reimburse your treatment costs.