Family doctor model: how does it work?
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The family doctor system is one of the most widespread alternative insurance models in Switzerland. It involves choosing a general practitioner as your first point of contact, simplifying your medical pathway and saving you money. Comparea can help you find the insurance contract best suited to your needs.
How does the family doctor model work?
The family doctor model involves choosing a practitioner who is responsible for his or her medical care. This is usually a general practitioner belonging to a network of family doctors.
When a person who has opted for this model suffers from a health problem, they must consult their family doctor as a matter of priority. The latter then determines whether to refer them to a specialist. The insured person cannot therefore consult a specialist directly, with the exception of emergency situations, gynaecological check-ups, dental care or ophthalmological examinations.
The family doctor model is an alternative to the standard model, the HMO (Heath Maintenance Organizations) model or the Telmed model.
What are the advantages of the family doctor model?
As an insured person, there are 4 major advantages to the family doctor model:
- This system allows you to make significant savings on your insurance premiums. In some cases, savings can exceed 20% compared with the standard model;
- It simplifies your medical pathway, particularly when you don't know which specialty your consultation falls under;
- Your family doctor knows your lifestyle, your medical history and your specific needs. He can therefore prescribe a more suitable treatment for you;
- Family doctors can be found all over Switzerland, including in rural areas.
For the state and the medical community, the benefit of this model is to avoid saturation of services. In particular, it avoids a practitioner being consulted for a disorder that does not fall within his or her specialty or that could be treated by a GP.
Family doctor model: are there any drawbacks?
While the family doctor model has many advantages, there are also a few drawbacks to consider compared with standard or HMO models. For example, in most situations, it's not possible to consult a specialist doctor directly, even if you're certain you need one. You will necessarily have to go through your family doctor first, which you might consider a waste of time.
Furthermore, since the majority of your treatments are the responsibility of your family doctor, obtaining a second opinion will generally be at your expense. In the event that you wish to be able to choose your practitioner in all circumstances, it's best to turn to other healthcare models. However, in most cases, the family doctor model remains very advantageous, both financially and practically.
How to switch to the family doctor model?
Want to change your health insurer and opt for the family doctor model? Comparea.ch makes it easy to find the health insurance contract that suits your needs. To guarantee simplicity, transparency and the right price, we let you compare over 40 companies in just a few minutes.
Comparea is a totally independent group, not owned by any insurance company. Entirely digital, our comparison service is free, with no hidden charges and no obligation. Since 2019, we've already helped more than 15,000 customers change their insurance. So don't wait any longer, and find the right contract for you right now.
Can you change your family doctor?
In most health insurance companies, it is possible to change your family doctor. Often, the change is conditional on the practitioner ceasing to practice, or you moving house. However, with some companies such as CSS, it is possible to change doctors at any time, as long as you inform the organization.
What happens if I consult another doctor?
By opting for the family doctor model, you undertake to first consult the chosen practitioner. Similarly, you waive your right to free choice of doctor for non-urgent consultations. It is this commitment that enables you to obtain a premium discount.
As a result, if you consult another doctor (excluding exceptions), financial consequences apply. These depend on your health insurance fund. That said, most organizations refuse to pay the practitioner's bill if you haven't contacted your family doctor beforehand. If the situation is repeated, some organizations may also downgrade you to the standard model.
As you can see, it's important to choose your health insurance model with full knowledge of the facts. Comparea's experts are here to guide you towards the most suitable contract.
Updated on: 01.02.2024Written by Alexis MilonHead of health insurance department at Comparea.To learn more about our team click here.
Frequently Asked Questions
Health insurers generally have a list of selected doctors. So you won't have a choice.
If you have any health concerns, you should consult your family doctor first. Should you fail to do so, your health insurance company reserves the right not to pay any benefits received.
