All about the Telmed model with Helsana

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Health insurance is compulsory in Switzerland. It is possible to choose LAMal, the basic offering, or to prefer an alternative solution that may prove more attractive in terms of coverage and services. This is what Helsana offers with its BeneFit Plus Telmed health insurance. What are the special features of Helsana Telmed? How much does it cost? Find out everything you need to know about Helsana Telmed health insurance here.

Swiss health insurance: Helsana's Telmed

What are the special features of the Telmed system? What benefits does Helsana offer in its Benefit Plus Telmed package?

What are the special features of the Telmed system?

The Telmed system is one of the alternative health insurance packages available to the Swiss. The main feature of this system is that policyholders must follow a specific procedure in order to receive full reimbursement for their care. In fact, the Telmed system requires policyholders to contact a call center before visiting a healthcare professional. This call center is actually a medical advice center. The aim of this telephone consultation is:

To make an initial diagnosis
To refer the patient to the appropriate healthcare professional if necessary;
Or to propose the appropriate treatment directly on issue of a prescription.

To help make a diagnosis, it is possible to send photos to the interlocutors, who are all healthcare professionals.

In return,insured persons benefit from a reduction on their insurance premium.

Helsana: BeneFit PLUS Telmed

Helsana, Switzerland's leading health and accident insurer, offers a Telmed package called BeneFit PLUS Telmed. It provides partial or full coverage, depending on the case:

Hospital stays on Swiss territory (short stays, care and treatment in general wards);
Emergency treatment abroad;
Transport and rescue in Switzerland;
Medication when prescribed by a doctor on the list of specialties;
Outpatient treatments within the framework of academic medicine, but also complementary medicine;
Examinations and preventive measures;
Means and appliances (canes, blood glucose meters, compression stockings, etc.);
Exams carried out as part of pregnancy monitoring and childbirth preparation measures;
Care at home or in a medical-social center;
Bathing cures.

To benefit from this coverage, Helsana Telmed policyholders must first contact the group's independent telemedicine center on 0800 800 090, which can be reached 24/7.

Helsana Telmed: advantages and disadvantages

Taking out Helsana Telmed has a number of advantages, but also a few constraints.

Why choose Helsana's Telmed offer?

Choosing Helsana Telmed health insurance offers a number of advantages:

Policyholders automatically get a 15% reduction on basic health insurance premiums;
They have access to totally free medical support 24 hours a day, 7 days a week;
All advisors are healthcare professionals and can, if necessary, call on specialists such as pediatricians ;
Medical advice can be delivered in several languages (German, English, French and Italian);
The medical course and treatments are perfectly coordinated, thus avoiding unnecessary consultations;
It is possible, in certain cases, to obtain a prescription following the telephone consultation, without having to visit a doctor;
Etc.

What are the limitations of Helsana Telmed?

The main drawback of Helsana Telmed health insurance is that it is restrictive. In practical terms, this means that policyholders are obliged to approach the independent telemedicine call center before visiting a doctor. They are also required to follow the protocol, i.e. the care pathway, laid down by the teleconsultant. Without this, policyholders cannot benefit from their health insurance cover.

Please note: in an emergency, it is possible to go directly to the hospital or to a healthcare professional. In this case, it is advisable to contact Helsana, as soon as possible, to inform them.

Helsana Telmed: zoom on rates

Health insurance, although compulsory, can represent a certain cost. What is the cost of Helsana Telmed health insurance? Can I benefit from premium reductions? What are the deductibles?

How much does Helsana Telmed health insurance cost?

The cost of health insurance varies according to many factors, including the age of the insured, where he or she lives, and so on. It is therefore not possible to give the cost of Helsana Telmed health insurance here. However, it is important to point out that membership of this solution entitles the insured to a premium reduction of 15% on the basic health insurance rate.

Is it possible to benefit from a premium reduction?

People with low financial resources can benefit from an additional premium reduction. To do this, they should contact the relevant department in their canton. If the person meets the conditions, he or she must then submit a file which will be examined by the cantonal administration within 3 months. If the application is accepted, the canton will inform Helsana directly, which will apply the reduction to the next bill and, if necessary, reimburse any overpayments.

What is the deductible?

Regardless of the plan chosen, benefits are reimbursed after deduction of the statutory co-payment, which includes the deductible, co-payment and co-payment for hospitalization.

The amount of the deductible may vary according to the plan chosen. Some treatments are also subject to a maximum annual reimbursement limit. Once this has been exceeded, it is no longer possible to benefit from reimbursement for this type of service. This is particularly the case for transport, where coverage is limited to 500 Swiss francs per calendar year.