BeneFit PLUS Flexmed

If you have a health problem, use the digital symptom checker in the Compassana app for an initial assessment. You will then be given a choice between a GP on our Flexmed doctor list, the Telemedicine Centre (0800 88 40 40) or a Helsana partner pharmacy. You can choose the option that is best for you, receive medical support around the clock and benefit from an attractive premium discount.

  • Choose between your GP and the Telemedicine Centre and plan your course of treatment. The general practitioner and group practices you can choose from can be found in the premium calculator.
  • Quick help with health complaints at a Helsana partner pharmacy – free of charge, no appointment required
  • A fast and straightforward digital initial assessment using the AI-based, medically recognised symptom checker.
  • All of your health documents are in one place in the Compassana app, which you can share with a trusted medical professional.
Find your GP or HMO group practice

To benefit from this insurance model, you must select a doctor or a group practice (HMO) from the following list.

What is Compassana?

The Compassana app is a digital service for your health. The app lets you access your documents, such as medical reports, laboratory results and prescriptions, at any time. For example, for specialist appointments, hospital admissions or when changing doctors. Your data is always secure, and you can share it only with trusted medical personnel. 

In-depth consultation at Helsana partner pharmacies

Does your eye burn, your ear hurt or your skin itch? Our partner pharmacies will be at your service throughout Switzerland from 2026 – even without an appointment. You will receive rapid treatment for simple, acute complaints – in a separate consultation room if necessary. We will cover the costs for you. You do not pay any deductible or excess.

How BeneFit PLUS Flexmed works

Before you consult your chosen GP, telemedicine provider or Helsana partner pharmacy in the event of new acute symptoms, you should first use the Compassana app’s digital symptom checker (except for emergencies). Based on an expert assessment and recommendation, the app can help you decide how to proceed. Use of the symptom checker is only mandatory for adults. Children under the age of 18 may not use the symptom checker.

You can consult either your chosen Flexmed GP practice or Flexmed group practice or the Telemedicine Centre (0800 88 40 40) about your resulting treatment plan, or take advantage of a free, in-depth consultation in a Helsana partner pharmacy*. To plan further treatment (e.g. consultation with a specialist), consult the Telemedicine Centre or your GP.

  • Illness or accident
  • Use the symptom checker in the Compassana app for an initial assessment
  • GP or Telemedicine Centre or Helsana partner pharmacy*
  • Further treatment

* From 2026. You will not be in breach of your obligations if you take advantage of an in-depth consultation from a pharmacy. The in-depth consultation will only be carried out if the pharmacist considers it necessary. The costs for an in-depth consultation are paid by Helsana (excluding additional costs such as medication or other benefits) – you do not pay any deductible or excess. If the partner pharmacy has not been able to conclusively resolve your health problem, proceed as usual in accordance with your basic insurance model and coordinate your next steps with the Telemedicine Centre or your GP.

Helsana partner pharmacies

Emergency: In an emergency, always go directly to an emergency doctor or a hospital. 

  • Emergency
  • Emergency doctor or hospital
  • Flexmed GP practice or the Telemedicine Centre

Important: After receiving treatment, let your GP or the Telemedicine Centre know about the consultation. This information allows them to optimise your further treatment.

You must carry out the following one-time steps

  1. Download the myHelsana app and complete the registration
  2. Download the Compassana app
  3. Sign in to the Compassana app using your myHelsana login details

Whenever you have an acute medical concern, first use the symptom checker in the Compassana app for an initial assessment.

Insured benefits

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 a stay, care and treatment in a general ward (multi-bed room).

Choice of hospital

You enjoy free choice among all the hospitals in Switzerland that are included on the cantonal hospital lists (“listed hospitals”) but receive no more than the costs up to the rate of your canton of residence. 

Exceptions

  • If you need to find a hospital outside of the canton for medical reasons. 
  • If an out-of-canton hospital is on the hospital list for your canton of residence.

Hospital stays

If you have opted for an alternative insurance model, you will only receive these benefits subject to the following conditions:

  • BeneFit PLUS General Practitioner: if the hospital stay has been prescribed by your GP or group practice.
  • BeneFit PLUS Telemedicine: if the hospital stay has been prescribed by a doctor at the telemedicine centre.
  • BeneFit PLUS Flexmed: your hospital stay is ordered by your GP practice, your group practice or a doctor at the Centre for Telemedicine.
  • PREMED-24: if you have called the advice hotline and received non-binding health advice before the hospital stay.

In an emergency, you will receive the respective social tariff schedule in the EU/EFTA country. In all other countries, we will cover a maximum of twice the amount insured in Switzerland. 

Emergency treatment abroad (inpatient and outpatient)

The Agreement on the free movement of persons (AFMP) ensures that you have access to the same public healthcare services (doctors, pharmacies, hospitals and ambulances) within EU/EFTA/UK as the residents of the respective country. In the event of a medical emergency, you will therefore receive costs equivalent to the social tariff in the country of temporary residence.

In all other countries, you receive the costs of outpatient and inpatient emergency treatment up to twice the amount that would be covered by basic insurance in Switzerland (tariff in your canton of residence).

Take your insurance card with you when you travel and always have it on you. The uniformly designed back of the card is valid as a European Health Insurance Card and is recognised within EU/EFTA/UK.

You receive 50% of the costs for transport, up to CHF 500 per calendar year. We will reimburse 50% of the costs for rescue operations, up to CHF 5,000 per calendar year.

Transport

Overall, you receive 50% of the costs of planned transportation to a medical facility for medically necessary treatment, up to CHF 500 per calendar year.

Requirement

You choose a recognised mode of transport, such as a Spitex vehicle, a wheelchair-accessible taxi, a disability vehicle or an ambulance.

Rescue

You receive 50% of the costs of rescue operations in Switzerland, up to CHF 5,000 per calendar year.

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 40%.

Specialities list (SL)

You receive the costs according to the tariff of the recognised specialist for the whole of Switzerland.

You receive the costs according to the tariff of the recognised specialist for the whole of Switzerland for treatment by federally certified doctors, chiropractors and medical support staff, such as physiotherapists, occupational therapists, nurses, midwives, speech therapists, etc.

Requirements

The treatment is prescribed by a doctor and listed in the benefits catalogue of the basic insurance.

Health Care Benefits Ordinance (KLV)

You receive the costs according to the tariff of the recognised specialist for the whole of Switzerland.

You receive contributions towards the costs of the following types of complementary medicine:

  • Anthroposophic medicine
  • Classical homoeopathy
  • Phytotherapy
  • Pharmacotherapy within traditional Chinese medicine (TCM)
  • Acupuncture

The costs are reimbursed according to the tariff of the recognised specialist for the whole of Switzerland.

Requirement

Your doctor holds a recognised certificate of competence awarded by the Swiss Medical Association (FMH) for these methods.

You receive the costs for certain preventive examinations and measures.

You receive the costs related to specific examinations for the early detection of illnesses and preventive measures that are prescribed or carried out by a doctor (e.g. isolated vaccinations).

The costs of a gynaecological check-up are covered for women every three years. The costs of mammograms are covered subject to certain conditions.

We would be happy to provide you with information on which examinations are covered by basic insurance in a phone call.

You receive the costs of medically prescribed aids and apparatus up to the maximum amount specified by law.

You receive the costs of medically prescribed aids and apparatus, such as crutches, blood glucose meters, inhalation/respiratory therapy equipment and compression stockings, up to the maximum amount specified by law.

Requirements

The medical aids are listed in the aids and equipment list and obtained from an authorised provider.

Medical aids and equipment list

You receive the costs of examinations and birth preparation measures. 

Check-ups and ultrasound examinations

  • During a normal pregnancy, you are entitled to seven check-ups to be carried out by a doctor or by a midwife.
  • We will also reimburse you for two ultrasound examinations carried out by a doctor.
  • For a high-risk pregnancy, you will receive the costs of all necessary check-ups and ultrasound examinations.

Breastfeeding guidance                                                      

  • You receive three sessions of breastfeeding guidance from a midwife or specially trained nurse.

Preparing for the birth

You receive CHF 150 per calendar year for

  • birth preparation courses run by the midwife for individuals or groups

or

  • a consultation with the midwife on the birth, planning and organisation of the postnatal period at home as well as preparations for breastfeeding.

Home birth

For a home birth, you receive the costs in accordance with the applicable tariff or contract of the midwife.

Hospital stays

If you have opted for an alternative insurance model, you will only receive these benefits subject to the following conditions:

  • BeneFit PLUS General Practitioner: if the hospital stay has been prescribed by your GP or group practice.
  • BeneFit PLUS Telemedicine: if the hospital stay has been prescribed by a doctor at the telemedicine centre.
  • PREMED-24: if you have called the advice hotline and received non-binding health advice before the hospital stay.

You receive the costs of a stay in a general ward (multi-bed room), care and treatment in accordance with the standard rate in your canton of residence.

Exceptions

  • If you need to find a hospital outside of the canton for medical reasons. 
  • If an out-of-canton hospital is on the hospital list for your canton of residence.

You receive contributions towards the costs for care at home (Spitex) and in a nursing home.

Spitex

With care at home, the care specialist determines your expected care needs in terms of time required. We cover this cost based on the corresponding amount in Swiss francs specified by law. This is subject to the condition that Spitex (home nursing) is medically prescribed and that the chosen Spitex organisation or care specialist is qualified and recognised.

Nursing home

You receive the costs according to the applicable tariff for care services in a nursing home. The tariff is based on the level of care needed, as determined on your admission.

We cannot assume boarding costs (room and board at the nursing home) under basic insurance.

You receive CHF 10 per day for balneotherapy at recognised therapeutic spas in Switzerland.

You receive CHF 10 per day for up to 21 days per calendar year for balneotherapy at recognised therapeutic spas in Switzerland.

Requirements

  • The spa treatment is medically certified as necessary.
  • The spa treatment is prescribed to you by a doctor.
  • The spa treatment is carried out at a recognised therapeutic spa.

Downloads

Frequently asked questions

Under the Federal 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. 

  • You can enjoy the highest flexibility and decide whether to consult your Flexmed GP or group practice, or the Telemedicine Centre (0800 88 40 40), on a case-by-case basis
  • Your GP or the Telemedicine Centre coordinate your treatment 
  • This allows you to benefit from an attractive premium discount 
  • You have access to a medical contact person around the clock and from any location 
  • Thanks to the integrated care provided by Compassana, you are connected to your various points of contact and can coordinate your treatment together 
  • A fast and straightforward digital initial assessment using the AI-based, medically recognised symptom checker 
  • All of your health documents are in one place in the Compassana app, which you can share with a trusted medical professional 
  • Online appointment booking and secure messaging with your trusted medical professional 

The R designations stand for different discount levels. R1 corresponds to the highest and R4 to the lowest discount level. Every doctor is assigned an R level. The doctor selected by you and your place of residence will have a bearing on your premium level. When selecting a doctor, the premium calculator will show you the potential premium discount. 

When you take out the insurance, select your GP or group practice from our Flexmed doctor list. You then need to download – initially and only once – both the myHelsana and the Compassana apps, register, and while registering in the Compassana app agree to the sharing of personal data as well as data regarding contracts and medications. Under “Activate insurance guide”, you also need to link the Compassana app to your basic insurance model so that your point(s) of contact will be displayed based on your insurance model. 
Each adult in a family with BeneFit PLUS Flexmed must have their own Compassana smartphone access.

 

If you experience new, acute symptoms, you must use the Compassana app’s symptom checker before consulting your GP or group practice. If you would then like to receive medical assistance, you must consult your chosen GP or group practice – or the Telemedicine Centre. 

You do not need to use the symptom checker in the following cases: 

  • In emergencies 
  • For children under the age of 18 
  • For non-acute medical concerns. 

 

If the Compassana app or the symptom checker are not working, for example because of a system outage, you may consult your GP or group practice or the Telemedicine Centre directly. 

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 face-to-face consultation with you if this is necessary. If you need general medical treatment, this must be provided by the GP you selected when you took out BeneFit PLUS Flexmed. 

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Other models under basic 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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