BeneFit PLUS General Practitioner

In the event of a health problem, your first port of call is always your GP or HMO group practice. You benefit from the optimum coordination of your treatment and can save 10%, 12%, 15% or 17% on your premiums, depending on the service provider.

  • One contact point for all requests
  • Discount of 10%, 12%, 15% or 17% on your insurance premium (depending on the service provider)

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Your premium

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Find your GP or HMO group practice

The list of doctors includes all doctors and group practices (HMOs) that are part of the BeneFit PLUS General Practitioner insurance model.

How BeneFit PLUS General Practitioner works

Whether treatment, referral to a specialist or admission to hospital: your GP or HMO group practice is your first port of call.

  • Illness or accident
  • GP or HMO group practice
  • Further treatment

Exception: in an emergency, always go directly to an emergency doctor or a hospital.

  • Emergency
  • Emergency doctor or hospital
  • GP or HMO group practice

Good to know

If you choose a Medbase general practitioner in the BeneFit PLUS model, you can receive medical support and advice anywhere in German-speaking Switzerland in Medbase medical centres or Medbase pharmacies. This will save you time and offers you greater flexibility. Enter "Medbase" in the general practitioner search and select a Medbase medical centre near you.

Insured benefits

The benefits are the same for all basic insurance models. With the General Practitioner 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).

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. 

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.

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%.

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.

You receive the costs for certain preventive examinations and measures.

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

You receive the costs of examinations and birth preparation measures. 

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

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

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Frequently asked questions

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.

  • Your GP or HMO group practice knows your medical history in detail and determines the best-possible medical treatment for you in consideration of any particular conditions and medications.
  • You have only one contact person who is your trusted practitioner.
  • You are referred as and when needed, so avoid unnecessary examinations.
  • Depending on the service provider, you receive a discount of 10%, 12%, 15% or 17% on your basic insurance premium. Please see our list of doctors for your actual premium discount. The reduced premium is calculated on the basis of the premium that you would pay while living in your current place of residence, in your current age group, with a standard deductible of CHF 300 and no special insurance model.
  • The doctors treating you are in ongoing dialogue, which increases certainty and saves time and money.

When taking out the General Practitioner 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.

When you opt for the BeneFit PLUS General Practitioner model, you agree to always first go to your selected GP or HMO group practice in the event of a health problem. If you require a specialist, the referral is made by your GP or HMO group practice.

If you consult a specialist directly, without having been referred, you are breaching your obligations under the General Practitioner model. As a result, Helsana may switch you to the standard model of basic insurance. This means you not only lose your insurance under the General Practitioner model but also your discount on the basic insurance premium.

There are several ways of saving on your premium for basic insurance.

Tips for saving on basic insurance premiums

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Other models under basic insurance

Helsana offers basic insurance as a standard version as well as three alternative models. The benefits are the same for all models.

Calculate premium

Please select your gender
Please enter a date of birth between 25.09.1900 and yesterday
Please enter your postcode or place of residence

BASIS

You have a free choice of doctor at all times.

BeneFit PLUS Telmed

The telemedicine centre advises on health problems.

PREMED-24

Call the medical advice hotline before any visit to the doctor.

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