Care pathways with visible rules
Educational comparison of Swiss basic insurance models
Compare first contacts and general constraints side by side. No profile is collected and no model is ranked.
No prices · no recommendation
Models to display
No prices · no recommendation
General comparison
| Criterion | Standard modelThe model imposes no alternative coordinating point. | Family doctor modelThe chosen family doctor is the first contact. | HMO modelThe HMO centre or its general practitioner is the first point of care. | Telemedicine modelA remote medical service is contacted first. |
|---|---|---|---|---|
| Required first contact | No family doctor, HMO centre or telemedicine service is imposed as the first contact. | You first consult the designated family doctor about a health concern. | You first contact the designated HMO centre or group-practice general practitioner. | You first contact the telephone or digital consultation service stated by the model. |
| Choice and scope | The FOPH describes it as free choice of doctor within statutory reimbursement rules. | Choice is limited to the doctor or network accepted by the model. | Care is organised within the stated HMO centre or network. | Next steps follow the contractual service’s directions and rules. |
| Care coordination | You organise the pathway directly with the professionals consulted. | The family doctor coordinates treatment and refers when needed. | The HMO coordinates treatment and specialist referral where needed. | Medical staff advise and coordinate further treatment when needed. |
| Before a specialist | No model-specific prior referral by a designated coordinator; reimbursement rules still require checking. | You generally go through the family doctor first; exceptions are set by the terms. | You generally go through the HMO first; any direct access is governed by the terms. | Remote contact generally comes before other steps; exceptions vary by contract. |
| Check in the contract | Check recognised providers, hospital rules, accident cover and administrative procedures. | Check the doctor list, exceptions, emergencies, referral procedure and consequences of not following the pathway. | Check the centre address, network, hours, emergencies, exceptions and consequences of not following the pathway. | Check channels, hours, whether directions are binding, emergencies, exceptions and consequences of not following the pathway. |
What this table cannot determine
- No price, premium difference or saving.
- No insurer, network, practice or service availability in your area.
- No personal recommendation, reimbursement guarantee or assessment of consequences if a pathway is not followed.
- Emergencies, exceptions, direct access, mandatory channels and possible consequences depend on the selected model’s terms.
How to read the comparison
The FOPH describes Standard as the free-choice-of-doctor model. Statutory reimbursement and recognised-provider rules still apply.
In alternative models, the first contact generally coordinates the next steps. Before enrolling, check the full terms, first contact, network, exceptions and emergency procedure.