In the event of a health problem, always first contact a general practitioner on our Flexmed doctor list or the Telemedicine Centre: 0800 88 40 40. This means that you can choose the access to medical help that is best for you and benefit from an attractive premium discount.
To benefit from this insurance model, you must select a doctor or a group practice (HMO) from the following list.
Your GP, your HMO group practice or the Telemedicine Centre is your first port of call. After an initial assessment, the selected contact person will explain to you which treatment is appropriate. If necessary, you will be referred for further treatment to a specialist or hospital.
Emergency: in an emergency, go directly to an emergency doctor or a hospital.
Remember: After receiving treatment, let your GP or the Telemedicine Centre know about the consultation. This information ensures that further treatment can be optimised.
The benefits are the same for all basic insurance models. With the Flexmed model, we will reimburse you the following benefits after deduction of the statutory co-payment (deductible/excess/hospital cost contribution).
You receive the costs of medically prescribed medication on the specialities list.
If several pharmaceuticals are listed with the same combination of active ingredients, the excess can amount to 20%.
Under the Swiss Health Insurance Act (KVG), health insurance is compulsory for anyone living in Switzerland. It provides basic medical care in the event of illness, accidents and maternity.
The scope of benefits it covers is regulated by law. This means you receive exactly the same benefits from every health insurer in Switzerland.
Yes, but only for certain illnesses. The healthcare professional or doctor at the Telemedicine Centre will be happy to discuss this with you.
Yes. If necessary, the Telemedicine Centre will request the advice of a paediatrician.
When taking out the Flexmed model, you have to select a doctor or HMO group practice from our list of doctors as your main contact. If your current GP is on our list of doctors, you can continue to be treated by them.
If not, you can use our general practitioner search to find a practice that’s compatible with the Flexmed model. In the event of a medical concern, you can choose between the defined practice and the Telemedicine Centre.
If you have taken out the statutory BASIS standard option with the deductible of CHF 300 with us, you can switch to this alternative insurance model on the first of any month and take advantage of its benefits.
Contact us if you would like to change your current insurance.
You cannot switch insurance model during the year. You can switch as of 1 January. Contact us if you would like to change your current insurance.
With BeneFit PLUS Flexmed, you have the freedom to consult your selected GP or the Telemedicine Centre. In the event of a telemedicine consultation, the medical professional will discuss a real consultation with you if this is necessary. If you need general medical treatment, this must take place at the doctor’s office you selected when you took out BeneFit PLUS Flexmed.
From the first GP visit or following a referral from the healthcare professional or doctor at the Telemedicine Centre. Calls are free of charge to you.
In general, yes. But not for the following examinations:
All persons resident in Switzerland can opt for this model. When taking out the BeneFit PLUS Flexmed model, you are asked to select a GP. You can use our general practitioner search to find out whether a GP is available where you live or in the vicinity.
Furthermore, taking out this model is conditional on your willingness to share your health and benefit data with Helsana and any first points of contact.
In the event of an illness or treatment, Helsana or your selected cooperation partner may recommend measures and health programmes aimed at improving quality and reducing costs. This will allow you to benefit from measures aimed at boosting health or recovery that are tailored to your specific needs, while at the same time positively impacting your healthcare costs.
Calls to the Telemedicine Centre are generally free of charge, but Helsana advises you to check this with your phone company.
In an emergency, you can go directly to a hospital or emergency doctor. Following emergency treatment, however, you must inform your general practitioner or the Telemedicine Centre about the emergency consultation.
The treatment plan covers all the phases of medical care until your complete recovery.
The responsibilities are essentially the same when you are abroad. For any treatment, consult with your GP or the Telemedicine Centre beforehand.
Helsana is entitled to exclude you from the BeneFit PLUS Flexmed model if you don’t adhere to your insurance conditions or to the treatment plan discussed with your general practitioner or HMO group practice or the Telemedicine Centre. If you violate these obligations, you may be transferred to a basic insurance model.
Adults aged 18 and over can either select the statutory minimum deductible of CHF 300 or one of five optional deductibles between CHF 500 and CHF 2,500. The higher your deductible, the lower your basic insurance premium.
There is no minimum deductible for children. However, by choosing the optional deductible of CHF 500 for them, you can save on their premium too.
Still not sure which deductible would be best for you? We would be happy to help. Call us on 0844 80 81 82.
For cross-border commuters from EU/EFTA countries, the statutory annual deductible for adults is also CHF 300 a year and there is no annual deductible for children up to the age of 18. However, cross-border commuters cannot be offered optional deductibles, i.e. they cannot opt for a higher deductible in return for a reduction in premium.
You can terminate the insurance on 31 December of each year and switch to another health insurance company in Switzerland, provided that you have no outstanding premium invoices. There is a one-month notice period. Notice of termination must reach us by no later than the last working day in November.
You can increase or decrease your deductible on 1 January of the following calendar year. The following deadlines apply:
Please note that notification of change must reach us by no later than the last working day before the respective date.
Those whose income and assets justify financial support are entitled to a premium reduction (PR). The premium reduction differs from canton to canton. This often needs to be requested by the policyholder in order for it to take effect. It is therefore worth asking the competent office in your canton of residence whether you are entitled to financial support for your health insurance.
Helsana offers basic insurance as a standard version as well as four alternative models. The benefits are the same for all models.
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