| Assura-Basis AGFeminaVitaFLEX · flexibleSavings | Advance-payment discount | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 5.7% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Assura-Basis AGHausspitalFLEX · flexibleFlexible | Advance-payment discountTelemedicine subject to cost-sharingFirst contact: family doctor or telemedicine | - First contact: family doctor or telemedicine centre; further care is routed through Assura-approved institutions and their specialists, subject to contractual exceptions.
- 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 10.4% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - The first consultation through the telemedicine centre is charged to the insured person; ordinary deductible and copayment apply.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official document ↗ |
| Assura-Basis AGPreventoMedFLEX · flexibleFlexible | Advance-payment discountFirst contact: doctor, Medgate or pharmacyReferral required for specialists | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 5.7% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: First contact of your choice: family doctor, Medgate telemedicine centre or partner pharmacy (Amavita, Coop Vitality, Sunstore).
- Current source, not dated 2027: A delegation notice is required for specialist reimbursement; direct access only for emergencies, eye doctors, paediatricians and gynaecologists.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Assura-Basis AGQualiMedFLEX · flexibleSavings | Advance-payment discount | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 13.4% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Avenir Krankenversicherung AGPrimaFlex (flexibles Modell)FLEX · flexibleFlexible | First contact: pharmacy, telemedicine, Ada or doctorTransfer to the standard model2027 benefits not confirmed | - Median premium 11.9% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Mandatory first contact chosen among four: partner pharmacy, telemedicine partner, Ada symptom checker or family doctor.
- Current source, not dated 2027: Repeated breaches of the rules lead to a transfer to the Standard model.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Avenir – official website ↗ |
| CSS KrankenVersicherung AGMultimedFLEX · flexibleFlexible | First contact: Multimed practice, telemedicine or appDirect access for specified services2027 benefits not confirmed | - Median premium 7.6% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: First contact: a Multimed practice, the telemedical advice centre or the Well app symptom checker.
- Current source, not dated 2027: Direct access only to eye doctors, gynaecologists and midwives.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| CSS – official website ↗ |
| Helsana Versicherungen AGHelsana BeneFit PLUS FlexmedFLEX · flexibleFlexible | Insurer-paid partner-pharmacy consultationFamily doctor as first contact | - From January 2027, an in-depth consultation for simple acute complaints at a partner pharmacy is paid by Helsana. Charges for medicines and materials are not specified.
- Median premium 14.2% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Helsana – official website ↗ |
| KPT Krankenkasse AGKPTwin.win - Hausarzt, Telmed und ApothekeFLEX · flexibleDigital | Free medical advice (phone/chat)First contact: pharmacy, Medi24 or doctor | - Free advice from Medi24 medical professionals. Not every billable medical consultation is stated as exempt.
- DoctorChat: medical advice from a doctor via WhatsApp around the clock. Prescriptions, certificates and remote treatment are not free because of this.
- First contact of your choice: partner pharmacy, telemedicine (Medi24) or family doctor; free choice of doctor afterwards.
- Median premium 10% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - KPT confirms ordinary statutory benefits with deductible and copayment for 2027. No pharmacy or telemedicine exemption list was provided.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| KPT – official document ↗ |
| Mutuel Krankenversicherung AGPrimaFlex (flexibles Modell)FLEX · flexibleFlexible | First contact: pharmacy, telemedicine, Ada or doctorTransfer to the standard model2027 benefits not confirmed | - Median premium 10.7% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Mandatory first contact chosen among four: partner pharmacy, telemedicine partner, Ada symptom checker or family doctor.
- Current source, not dated 2027: Repeated breaches of the rules lead to a transfer to the Standard model.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Mutuel – official website ↗ |
| Philos Krankenversicherung AGPrimaFlex (flexibles Modell)FLEX · flexibleFlexible | First contact: pharmacy, telemedicine, Ada or doctorTransfer to the standard model2027 benefits not confirmed | - Median premium 13.6% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Mandatory first contact chosen among four: partner pharmacy, telemedicine partner, Ada symptom checker or family doctor.
- Current source, not dated 2027: Repeated breaches of the rules lead to a transfer to the Standard model.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Philos – official website ↗ |
| SWICA Krankenversicherung AGFavorit MedpharmFLEX · flexibleDigital | Free medical advice (phone/chat)Free symptom checkerFirst contact: pharmacy, santé24 or app | - santé24 advice is free; ordinary telephone charges remain payable. This is not a waiver for medical treatment, prescriptions, certificates or psychotherapy.
- The designated symptom-checking app is free to use. A subsequent doctor consultation does not become free.
- First contact: partner pharmacy, santé24 or symptom checker. Subsequent doctors, hospitals and medicine suppliers must be in the Medpharm directory.
- Median premium 6% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – official document ↗ |
| SWICA Krankenversicherung AGFavorit MultichoiceFLEX · flexibleGuided pathway | Free medical advice (phone/chat)Binding care pathwaySeveral first-contact options | - Advice from santé24 is free; standard telephone charges remain payable. This clause does not confirm a cost-sharing exemption for treatment, medicines or certificates.
- First contact of your choice: partner pharmacy, santé24 or the SymptomCheck app.
- Median premium 11% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Choose a provider from the Multichoice list for treatment, examinations and medicines; recommendations from santé24 are not binding.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – regulations ↗ |
| Sanitas Grundversicherungen AGMultiAccessFLEX · flexibleFlexible | Telemedicine subject to cost-sharingFirst contact: doctor, telemedicine or pharmacyDirect access for specified services | - When enrolling, choose a doctor or practice from the Sanitas list. For a health problem, the first contact may be that doctor, the telemedicine centre or a pharmacy on the MultiAccess list; the agreed treatment plan must be followed.
- Median premium 3.4% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Treatment concluded by the telemedicine centre without referral is billed under statutory tariffs with KVG cost sharing.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – terms ↗ |
| Visana AGCombi CareFLEX · flexibleFlexible | First contact: family doctor or Medi24Generics or biosimilars rule2027 benefits not confirmed | - Median premium 3% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Before booking: your family doctor or Medi24 by phone; referrals must be reported to Medi24.
- Current source, not dated 2027: Generics or biosimilars are required: originals are reimbursed only if no generic exists or for proven medical reasons.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Visana – official website ↗ |
| Vivao Sympany AGflexhelp24FLEX · flexibleFlexible | First contact: Medgate or partner practiceReferral required for specialists2027 benefits not confirmed | - Median premium 14.2% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: For every health problem, first contact with Medgate (app or phone) or a Medgate partner practice.
- Current source, not dated 2027: Most specialists require a referral; first check that a nearby partner practice accepts new patients.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Vivao Sympany – official website ↗ |
| ÖKK Kranken- und Unfallversicherungen AGÖKK CASAMED SELECTFLEX · flexibleGuided pathway | Binding care pathwayEmergency notification ruleDirect access for specified services | - Median premium 10% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Benefits are covered when provided by the provider chosen and authorised under the CASAMED model, or on its referral. No free pharmacy or telemedicine is provided for.
- After an emergency, notify the family doctor, tele-family-doctor or HMO practice of the chosen model within 20 days.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| ÖKK – terms ↗ |
| Aquilana VersicherungenCASAMEDPRAXIS · medical practicePersonal doctor | Free medical advice (phone/chat)Family doctor as first contactAssistance service abroad | - Medgate medical advice in Switzerland is free for Standard and CASAMED. This does not mean medical treatment is free.
- Median premium 9.6% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - First contact: the family-doctor practice. CASAMED is not offered in GE, JU, NE, TI, VD or VS premium region 1; check the practice and municipality.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Aquilana – brochure ↗ |
| Assura-Basis AGGesundheitsnetzPRAXIS · medical practiceSavings | Advance-payment discount | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 12.3% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Assura-Basis AGHausarztPRAXIS · medical practiceSavings | Advance-payment discount | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 11% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Assura-Basis AGPharMedPRAXIS · medical practicePharmacy | Advance-payment discountReferral required for specialistsPartner pharmacyLimited geographical availability | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 13.1% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Medicines must be bought at Assura-recognised pharmacies: elsewhere they are not reimbursed, even on prescription.
- Current source, not dated 2027: Family doctor first; a delegation notice is required for specialist reimbursement.
- Current source, not dated 2027: Available in French-speaking Switzerland and most German-speaking cantons, except AI, AR, OW and NW.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Atupri Gesundheitsversicherung AGHMOPRAXIS · medical practicePersonal doctor | HMO network / health centreEmergency notification ruleDirect access for specified services2027 benefits not confirmed | - Median premium 13.7% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: First contact: the chosen HMO practice, which refers to hospital or specialists if needed.
- Current source, not dated 2027: Within 20 days, report referrals by specialists, follow-ups, second opinions, emergencies and accidents to the HMO practice.
- Current source, not dated 2027: Without prior consultation: preventive gynaecological check-ups, dental care, eye exams for glasses or lenses; later treatment must be reported.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Atupri – official website ↗ |
| Avenir Krankenversicherung AGOptiMed (Ärztenetz)PRAXIS · medical practicePersonal doctor | Family doctor as first contactReferral required for specialists2027 benefits not confirmed | - Median premium 12.5% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Always the declared family doctor first; for adults the doctor must be on an OptiMed list.
- Current source, not dated 2027: When referred to a specialist, a delegation voucher must be sent to Groupe Mutuel.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Avenir – official website ↗ |
| CSS KrankenVersicherung AGGesundheitspraxisversicherungPRAXIS · medical practiceFlexible | Telemedicine subject to cost-sharingFirst contact: HMO practice or telemedical practice | - From 1 January 2027, a telemedical family-doctor practice (Medi24 or Medgate) can also be chosen as the HMO first contact.
- Median premium 11.8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Telemedical doctor consultations are billed like a practice visit: deductible and copayment apply.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| CSS – official website ↗ |
| KPT Krankenkasse AGKPTwin.doc - HausarztPRAXIS · medical practicePersonal doctor | Free medical advice (phone/chat)Family doctor as first contact | - Free advice from Medi24 medical professionals. Not every billable medical consultation is stated as exempt.
- DoctorChat: medical advice from a doctor via WhatsApp around the clock. Prescriptions, certificates and remote treatment are not free because of this.
- Median premium 15% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - A specific family doctor or practice is registered as the first contact.
- KPT confirms ordinary statutory benefits with deductible and copayment for 2027. No pharmacy or telemedicine exemption list was provided.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| KPT – official document ↗ |
| KPT Krankenkasse AGKPTwin.plus - HMO-HausarztPRAXIS · medical practicePersonal doctor | Free medical advice (phone/chat)HMO network / health centre | - Free advice from Medi24 medical professionals. Not every billable medical consultation is stated as exempt.
- DoctorChat: medical advice from a doctor via WhatsApp around the clock. Prescriptions, certificates and remote treatment are not free because of this.
- Median premium 15% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - The selected network practice is the first contact.
- KPT confirms ordinary statutory benefits with deductible and copayment for 2027. No pharmacy or telemedicine exemption list was provided.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| KPT – official document ↗ |
| Krankenkasse Luzerner HinterlandHausmedPRAXIS · medical practicePersonal doctor | Family doctor as first contactEmergency notification rule | - Median premium 5.4% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Choose a doctor from the KKLH list, who coordinates care and referrals, subject to the listed exceptions.
- After an emergency, inform the chosen family doctor as soon as possible with the emergency doctor's report; no fixed number of days is stated.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Krankenkasse Luzerner Hinterland – terms ↗ |
| Mutuel Krankenversicherung AGOptiMed (Ärztenetz)PRAXIS · medical practicePersonal doctor | Family doctor as first contactReferral required for specialists2027 benefits not confirmed | - Median premium 11.7% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Always the declared family doctor first; for adults the doctor must be on an OptiMed list.
- Current source, not dated 2027: When referred to a specialist, a delegation voucher must be sent to Groupe Mutuel.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Mutuel – official website ↗ |
| Philos Krankenversicherung AGOptiMed (Ärztenetz)PRAXIS · medical practicePersonal doctor | Family doctor as first contactReferral required for specialists2027 benefits not confirmed | - Median premium 12.6% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Always the declared family doctor first; for adults the doctor must be on an OptiMed list.
- Current source, not dated 2027: When referred to a specialist, a delegation voucher must be sent to Groupe Mutuel.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Philos – official website ↗ |
| SWICA Krankenversicherung AGFavorit BestcarePRAXIS · medical practiceGuided pathway | Free medical advice (phone/chat)Binding care pathway | - Advice from santé24 is free; standard telephone charges remain payable. This clause does not confirm a cost-sharing exemption for treatment, medicines or certificates.
| - Treatment and examinations require a Bestcare partner practice, including after initial advice via the app, santé24 or a partner pharmacy.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – regulations ↗ |
| SWICA Krankenversicherung AGFavorit CasaPRAXIS · medical practicePersonal doctor | Family doctor as first contactEmergency notification rule | - Median premium 3.1% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - First contact: the chosen Favorit Casa doctor, who coordinates referrals and further treatment.
- After an emergency admission or emergency doctor, inform the Favorit Casa doctor as soon as possible; no fixed number of days is stated.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – official document ↗ |
| SWICA Krankenversicherung AGFavorit MedicaPRAXIS · medical practiceRegular care | HMO network / health centre | | - All treatment and examinations, including gynaecology, eye and paediatric care, must use providers in the Medica directory. Not a conventional family-doctor model.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – official document ↗ |
| SWICA Krankenversicherung AGFavorit SantéPRAXIS · medical practiceGuided pathway | Binding care pathway | - Median premium 8.1% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Treatment and examinations must be provided by the Santé partner practice or through its referral.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – regulations ↗ |
| Sanitas Grundversicherungen AGHausarztmodell 1PRAXIS · medical practicePersonal doctor | Family doctor as first contactDirect access for specified services | - Median premium 4.5% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Choose a coordinating doctor or group practice from the Sanitas list and contact it first; the care plan is binding. The four tariff variants classify the chosen practice and do not create different exemption lists.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – terms ↗ |
| Sanitas Grundversicherungen AGHausarztmodell 2PRAXIS · medical practicePersonal doctor | Family doctor as first contactDirect access for specified services | - Median premium 3.8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Choose a coordinating doctor or group practice from the Sanitas list and contact it first; the care plan is binding. The four tariff variants classify the chosen practice and do not create different exemption lists.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – terms ↗ |
| Sanitas Grundversicherungen AGHausarztmodell 3PRAXIS · medical practicePersonal doctor | Family doctor as first contactDirect access for specified services | - Median premium 3.8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Choose a coordinating doctor or group practice from the Sanitas list and contact it first; the care plan is binding. The four tariff variants classify the chosen practice and do not create different exemption lists.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – terms ↗ |
| Sanitas Grundversicherungen AGHausarztmodell 4PRAXIS · medical practicePersonal doctor | Family doctor as first contactDirect access for specified services | - Median premium 3.8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Choose a coordinating doctor or group practice from the Sanitas list and contact it first; the care plan is binding. The four tariff variants classify the chosen practice and do not create different exemption lists.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – terms ↗ |
| Sumiswalder KrankenkasseHMO plusPRAXIS · medical practiceGuided pathway | Advance-payment discountMandatory first point of contactBinding care pathwayEmergency notification rule | - 1% discount for annual advance payment, on the net premium after any premium reduction.
- Median premium 9.9% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Mandatory first contact as set out in the 2027 model overview. Exemptions and service charges are not specified.
- The treatment plan and referrals are binding; changes or extensions require approval. Partner pharmacies may be visited without prior discussion.
- If reachable, contact the family doctor or telemedicine centre first. After an emergency admission or emergency doctor, report within 30 days with the emergency doctor's report.
- Use the appropriate lower-cost medicines (generics, biosimilars or originals); a higher-cost alternative may not be reimbursed without documented medical necessity.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sumiswalder Krankenkasse – regulations ↗ |
| Sumiswalder KrankenkasseHausarztmodellPRAXIS · medical practiceGuided pathway | Advance-payment discountMandatory first point of contact | - 1% discount for annual advance payment, on the net premium after any premium reduction.
- Median premium 8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Mandatory first contact as set out in the 2027 model overview. Exemptions and service charges are not specified.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sumiswalder Krankenkasse – regulations ↗ |
| Visana AGVIVA - GesundheitsplanPRAXIS · medical practiceGuided pathway | Binding care pathwayEmergency notification ruleGenerics or biosimilars rule2027 benefits not confirmed | - Median premium 14.5% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Always the same personal contact for medical questions, following the agreed treatment plan.
- Current source, not dated 2027: Direct access for gynaecology, dental care and emergencies; urgent care and gynaecological treatment must be reported within 30 days.
- Current source, not dated 2027: Generics and biosimilars must be bought; originals are paid only if no generic exists or for medical reasons.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Visana – official website ↗ |
| ÖKK Kranken- und Unfallversicherungen AGÖKK CASAMED HAUSARZTPRAXIS · medical practiceGuided pathway | Binding care pathwayEmergency notification ruleDirect access for specified services | - Median premium 11.1% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Benefits are covered when provided by the provider chosen and authorised under the CASAMED model, or on its referral. No free pharmacy or telemedicine is provided for.
- After an emergency, notify the family doctor, tele-family-doctor or HMO practice of the chosen model within 20 days.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| ÖKK – terms ↗ |
| ÖKK Kranken- und Unfallversicherungen AGÖKK CASAMED HMOPRAXIS · medical practiceGuided pathway | Binding care pathwayEmergency notification ruleDirect access for specified services | - Median premium 13% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Benefits are covered when provided by the provider chosen and authorised under the CASAMED model, or on its referral. No free pharmacy or telemedicine is provided for.
- After an emergency, notify the family doctor, tele-family-doctor or HMO practice of the chosen model within 20 days.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| ÖKK – terms ↗ |
| Aquilana VersicherungenSMARTMEDTEL_DIG · phone / digitalGuided pathway | Mandatory first point of contactAssistance service abroad | - Median premium 13% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - First contact: the Medgate app or a telephone/video consultation. The price of medical treatment is not stated.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Aquilana – brochure ↗ |
| Assura-Basis AGMediTelTEL_DIG · phone / digitalSavings | Advance-payment discount | - 2% discount for annual or 1% for half-yearly advance payment.
- Median premium 13.8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Assura – official website ↗ |
| Atupri Gesundheitsversicherung AGSmartCareTEL_DIG · phone / digitalGuided pathway | Mandatory first point of contactEmergency notification rulePaid teleconsultation (CHF 50 on average)2027 benefits not confirmed | - Median premium 12.5% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: First step: the online assessment in the Atupri Medgate app, which sets out the checks and next steps.
- Current source, not dated 2027: A medical teleconsultation (chat, phone or video) costs CHF 50 on average.
- Current source, not dated 2027: Referrals, follow-ups, second opinions, emergencies and accidents must be reported within 20 days via the app.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Atupri – official website ↗ |
| CSS KrankenVersicherung AGCallmedTEL_DIG · phone / digitalGuided pathway | Mandatory first point of contactEmergency notification ruleGenerics or biosimilars rule2027 benefits not confirmed | - Median premium 9.8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: Before every doctor's appointment: the telemedical advice centre (058 277 77 77) or the Well app symptom checker.
- Current source, not dated 2027: In an emergency go straight to a doctor; then report it via myCSS or to the telemedical centre within 10 days.
- Current source, not dated 2027: Generic medicines are used; originals instead of generics may cause extra costs.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| CSS – official website ↗ |
| EGK Grundversicherungen AGEGK-TelCareTEL_DIG · phone / digitalDigital | Emergency notification rulePrescription subject to medical assessmentMedical certificate subject to assessment | - Median premium 11% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - After an emergency, notify Medgate as soon as possible and within 10 working days at the latest, as health permits.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| EGK – written reply (not public) · Priminfo ↗ |
| Helsana Versicherungen AGHelsana BeneFit PLUS TelemedTEL_DIG · phone / digitalPharmacy | Insurer-paid partner-pharmacy consultation | - From January 2027, an in-depth consultation for simple acute complaints at a partner pharmacy is paid by Helsana. Charges for medicines and materials are not specified.
- Median premium 15.9% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Helsana – official website ↗ |
| Helsana Versicherungen AGHelsana Premed-24TEL_DIG · phone / digitalPharmacy | Insurer-paid partner-pharmacy consultation | - From January 2027, an in-depth consultation for simple acute complaints at a partner pharmacy is paid by Helsana. Charges for medicines and materials are not specified.
- Median premium 8.9% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Helsana – official website ↗ |
| KPT Krankenkasse AGKPTwin.easy - TelmedTEL_DIG · phone / digitalGuided pathway | Free medical advice (phone/chat)Mail-order pharmacyMandatory first point of contact | - Free advice from Medi24 medical professionals. Not every billable medical consultation is stated as exempt.
- DoctorChat: medical advice from a doctor via WhatsApp around the clock. Prescriptions, certificates and remote treatment are not free because of this.
- Median premium 12.3% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Medi24 is the mandatory first contact.
- KPT confirms ordinary statutory benefits with deductible and copayment for 2027. No pharmacy or telemedicine exemption list was provided.
- Medicines are obtained from the mail-order pharmacy Zur Rose (by post) or directly from the doctor.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| KPT – official document ↗ |
| KPT Krankenkasse AGKPTwin.smart - Hausarzt mit AppTEL_DIG · phone / digitalGuided pathway | Free medical advice (phone/chat)Mandatory first point of contact | - Free advice from Medi24 medical professionals. Not every billable medical consultation is stated as exempt.
- DoctorChat: medical advice from a doctor via WhatsApp around the clock. Prescriptions, certificates and remote treatment are not free because of this.
- Median premium 17.6% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - First step: the symptom checker in the Well app, which shows the next step; you can follow its recommendation or see your own family doctor.
- KPT confirms ordinary statutory benefits with deductible and copayment for 2027. No pharmacy or telemedicine exemption list was provided.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| KPT – official document ↗ |
| Krankenkasse Luzerner HinterlandTelmedTEL_DIG · phone / digitalGuided pathway | Mandatory first point of contactEmergency notification ruleDirect access for specified services | - Median premium 6.4% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Contact Medi24 before arranging a treatment appointment; any further referral or follow-up needs a new call and treatment window.
- After an emergency, notify Medi24 as soon as possible and within 20 days at the latest.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Krankenkasse Luzerner Hinterland – terms ↗ |
| SWICA Krankenversicherung AGFavorit StartTEL_DIG · phone / digitalDigital | Free medical advice (phone/chat)Free symptom checkerMandatory first point of contact | - santé24 advice is free; ordinary telephone charges remain payable. This is not a waiver for medical treatment, prescriptions, certificates or psychotherapy.
- The designated symptom-checking app is free to use. A subsequent doctor consultation does not become free.
- Median premium 14.5% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - From age 17 the first contact is the SymptomCheck app. Up to age 16, without a suitable device or during an app outage, call santé24.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – official document ↗ |
| SWICA Krankenversicherung AGFavorit TelmedTEL_DIG · phone / digitalDigital | Free medical advice (phone/chat)Same-case follow-up without a new contactFree symptom checkerMandatory first point of contact | - santé24 advice is free; ordinary telephone charges remain payable. This is not a waiver for medical treatment, prescriptions, certificates or psychotherapy.
- The designated symptom-checking app is free to use. A subsequent doctor consultation does not become free.
- After a santé24 consultation, no new telephone advice is needed for follow-up consultations or treatment of the same case within six months. Not for a new problem.
| - First contact with santé24 or the app is compulsory; the recommendations that follow are non-binding. Hospital admissions and post-emergency follow-up still require coordination.
- Paediatric visits without prior contact only until the 16th birthday; after that, contact with santé24 or the app is required.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| SWICA – official document ↗ |
| Sanitas Grundversicherungen AGTelMed BasicTEL_DIG · phone / digitalGuided pathway | Telemedicine subject to cost-sharingMandatory first point of contactEmergency notification ruleDirect access for specified services | - Median premium 5.1% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - If the telemedicine centre concludes treatment without referral, statutory tariffs apply with KVG deductible and copayment.
- Contact the designated telemedicine centre before any treatment and follow its care plan, subject to the contractual exceptions.
- In an emergency, contact an initial provider first if reasonable; otherwise notify the telemedicine centre within 14 days of emergency treatment starting.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – terms ↗ |
| Sanitas Grundversicherungen AGTelMed PlusTEL_DIG · phone / digitalRegular care | Free medical advice (phone/chat)Free initial partner-pharmacy consultationPrevention exempt from cost-sharing | - Medical consultations through the designated telemedicine centre carry neither deductible nor copayment. Telephone/internet charges and unrelated treatment are excluded.
- Only the initial consultation at a pharmacy on the Sanitas partner list carries neither deductible nor copayment. Medicines, materials and later consultations are not included.
- Vaccinations covered by basic insurance (Art. 12a KLV): no deductible or copayment.
- Preventive gynaecological check-up (Art. 12e(b) KLV): no deductible or copayment where the conditions are met.
- Preventive mammography (Art. 12d(d) and 12e(c) KLV): no deductible or copayment where the conditions are met.
| - In an emergency, contact an initial provider first if reasonable; otherwise notify the telemedicine centre within 14 days of emergency treatment starting.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sanitas – official document ↗ |
| Sumiswalder Krankenkassesumis24TelmedTEL_DIG · phone / digitalGuided pathway | Advance-payment discountMandatory first point of contact | - 1% discount for annual advance payment, on the net premium after any premium reduction.
- Median premium 8% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Mandatory first contact as set out in the 2027 model overview. Exemptions and service charges are not specified.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Sumiswalder Krankenkasse – regulations ↗ |
| Vivao Sympany AGcallmed 24TEL_DIG · phone / digitalGuided pathway | Mandatory first point of contact2027 benefits not confirmed | - Median premium 12.3% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Current source, not dated 2027: You always contact Medgate first; Medgate refers to a practice only when needed and its treatment plan is binding.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| Vivao Sympany – official website ↗ |
| ÖKK Kranken- und Unfallversicherungen AGÖKK CASAMED 24TEL_DIG · phone / digitalGuided pathway | Binding care pathwayEmergency notification ruleDirect access for specified services | - Median premium 9.4% below the same insurer's Standard model (Priminfo 2027 data, like-for-like; indicative).
| - Benefits are covered when provided by the provider chosen and authorised under the CASAMED model, or on its referral. No free pharmacy or telemedicine is provided for.
- After an emergency, notify the family doctor, tele-family-doctor or HMO practice of the chosen model within 20 days.
- Outside the agreed pathway the insurer may refuse to pay (Art. 41(4) KVG).
| ÖKK – terms ↗ |
| Aquilana VersicherungenStandardStandard · free choiceDigital | Free medical advice (phone/chat)Assistance service abroad | - Medgate medical advice in Switzerland is free for Standard and CASAMED. This does not mean medical treatment is free.
| | Aquilana – brochure ↗ |
| Assura-Basis AGStandardStandard · free choiceSavings | Advance-payment discount | - 2% discount for annual or 1% for half-yearly advance payment.
| | Assura – official website ↗ |
| KPT Krankenkasse AGStandardStandard · free choiceDigital | Free medical advice (phone/chat) | - Free advice from Medi24 medical professionals. Not every billable medical consultation is stated as exempt.
- DoctorChat: medical advice from a doctor via WhatsApp around the clock. Prescriptions, certificates and remote treatment are not free because of this.
| - KPT confirms ordinary statutory benefits with deductible and copayment for 2027. No pharmacy or telemedicine exemption list was provided.
| KPT – official document ↗ |
| SWICA Krankenversicherung AGStandardStandard · free choiceFreedom of choice | Free choice of provider | - The 2027 general terms confirm coverage of statutory KVG benefits.
| - Deductible and copayment apply under the general terms and statutory provisions.
| SWICA – regulations ↗ |
| Sumiswalder KrankenkasseStandardStandard · free choiceSavings | Advance-payment discount | - 1% discount for annual advance payment, on the net premium after any premium reduction.
| | Sumiswalder Krankenkasse – regulations ↗ |
| All insurersStandard / free choice of doctorStandard · free choiceFreedom of choice | Free choice of doctorTelemedicine cost to verify | - Direct access and the widest choice.
| - Usually a higher premium.
| FOPH ↗ |
