Learn all about the Telmed model with CSS

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Telmed is one of Switzerland's health insurance models. To benefit from it, you need to contact a health insurance company. Here, we present the Telmed solution from CSS, one of Switzerland's leading health insurance providers, with over 1.6 million customers. What are the features of CSS Telmed? What are its strengths and weaknesses? How much does the CSS Telmed model cost?

Health insurance: the CSS Telmed

There are four health insurance models in Switzerland:

Standard;
HMO;
Family doctor;
And Telmed.

What does the Telmed health insurance model consist of? What benefits are covered by CSS Telmed?

Telmed model: what is it?

The Telmed model is based on telemedicine. Indeed, policyholders who have chosen Telmed health insurance must, in the event of a health problem, contact a dedicated telephone platform. The purpose of this call is to make an initial diagnosis and determine the medical pathway to be followed by the policyholder. Indeed, following this interview, the insured receives instructions as to which healthcare professional he/she should consult and the timeframe within which he/she should make an appointment. If the procedure is not followed, the insured will not be entitled to treatment and may even be excluded from the CSS Telmed offer.

It should be noted that in the event of an emergency, it is possible to receive treatment without having called the platform. But the policyholder must prevoke his/her health insurance fund, as soon as possible for coverage of the care received.

Policyholders choosing the Telmed model automatically benefit from a premium reduction.

CSS: Callmed

CSS offers a Telmed health insurance called Callmed. It covers all treatments covered by the basic benefit, namely:

Outpatient treatment and conventional medicine;
Outpatient treatment and alternative medicine;
Hospital stay;
Health promotion and prevention;
Emergency treatment abroad;
Prescribed medication when on the Federal Office of Public Health (FOPH) list;
Spa and convalescence treatments ;
Maternity and breastfeeding care;
Auxiliary means and appliances;
Preventive examinations and vaccination;
Transport and rescue costs in Switzerland ;
Eyeglasses and contact lenses;
Home care;
Care in nursing homes (EMS);
Dental care;
Psychotherapy.

To benefit from the coverage of these treatments, it is imperative that policyholders contact the CSS to be referred to a healthcare professional. To do this, the health insurance company provides two tools:

A telephone platform accessible 24/7 on +41 (0)58 277 77 77;
A mobile application.

Only four types of examination can be carried out without first contacting the call center:

Emergencies;
Gynecological examinations;
Ophthalmological check-ups;
Dental visits and check-ups.

CSS Telmed policyholders benefit from a 9% reduction on the health insurance premium.

CSS Telmed: advantages and disadvantages

Policyholders choosing CSS Telmed enjoy many advantages, but must also comply with a number of obligations.

Why choose CSS Telmed?

Opting for the Telmed model offered by CSS enables:

Benefit from high-quality medical advice from the outset of care;
Be called back by a doctor when necessary;
Access to a healthcare professional 24/7;
Group all your medical records on the application and have access to these documents at any time;
To book a medical appointment directly from the app;
To benefit from the same coverage as that offered by compulsory health insurance at a lower cost;
The care pathway is coordinated, thus avoiding unnecessary consultations;
Etc.

What are the limitations of CSS Telmed?

The limitations of CSS Telmed health insurance are linked to the obligation to go through the call center or app before consulting a healthcare professional. In the event of non-compliance with this procedure, policyholders are subject to a decrease in coverage and in the discount granted on the premium.

Telmed CSS: zoom on rates

How much does the Telmed health insurance offered by CSS cost? Is it possible to benefit from an additional premium reduction? What are the deductibles applied by CSS?

How much does CSS Telmed health insurance cost?

This is a difficult question to answer. Indeed, the cost of health insurance varies according to the age of the insured, the canton in which they live and many other factors. However, all policyholders who choose CSS Telmed health insurance automatically benefit from a reduction of 9% on the premium they would have paid with the basic model, better known as LAMal.

Is it possible to benefit from a premium reduction?

It is possible to obtain an additional reduction, particularly for people experiencing financial difficulties. Indeed, under certain conditions, cantons can grant subsidies to help their most precarious constituents finance their compulsory health insurance. To take advantage of these subsidies, contact your canton's health insurance department.

How much is the deductible?

The deductible for CSS Telmed health insurance varies according to the plan chosen and the coverage in question. It is therefore advisable to contact the insurance company to find out all the conditions applied to the Telmed offer you have chosen. You can also use our Comparea insurance comparator to get an idea of the conditions you can benefit from under the CSS Telmed model.