HMO, Telmed or family doctor? All the models explained simply
When you compare health insurers, terms like HMO, Telmed or family doctor model keep coming up, and the cheapest tariffs are almost always an alternative model. But what does that mean in practice? And do you really get the same benefits? Here are the answers.
The key point first: basic health insurance benefits are identical by law in every model (KVG Art. 25 to 31). You get exactly the same treatment, medicines and hospital care. The only difference: how you get to see a doctor.
The 5 models at a glance
Standard (free choice of doctor)
How it works: you see any doctor, specialist or hospital you like, without a referral and without notifying anyone first. Maximum freedom.
Advantage: no restrictions, no hassle.
Disadvantage: highest premiums. No coordination. Duplicate tests possible.
Family doctor model
How it works: you choose a regular family doctor from your insurer's list. When you have a health problem, you always go to them first. They refer you to specialists if needed.
Advantage: a trusted person who knows you, coordinated treatment, fewer duplicate tests.
Disadvantage: no going straight to a specialist (except in emergencies). Depending on the insurer, changing family doctor takes some notice.
HMO (group practice)
How it works: you are treated at an HMO group practice. Several doctors from different specialities work there under one roof. The practice coordinates everything, including referrals.
Advantage: highest discount. Everything under one roof, short distances, integrated care.
Disadvantage: treatment only at the assigned practice. Not available in every region (mainly in towns and cities). Less of a personal bond with one doctor.
Telmed (telephone model)
How it works: before every doctor's visit you call a medical helpline (24/7). A specialist advises you and decides whether you need to see a doctor, and if so, which one.
Advantage: good discount. Immediate medical advice, unnecessary doctor's visits are often avoided. Free choice of doctor after the call.
Disadvantage: you have to call before every doctor's visit, even for minor things. Some people find that tiresome.
Pharmacy model
How it works: your regular pharmacy is the first point of contact. The pharmacist assesses whether you need to see a doctor or whether treatment is possible directly at the pharmacy.
Advantage: easy access (no appointment needed), short waiting times, the pharmacist can carry out simple treatments.
Disadvantage: still not widespread, not offered by every insurer.
Comparison at a glance
| Model | First point of contact | Saving | Choice of doctor |
|---|---|---|---|
| Standard | Free | – | Completely free |
| Family doctor | Chosen family doctor | 10 to 15% | Via family doctor |
| HMO | Group practice | 12 to 18% | Within the HMO |
| Telmed | Telephone helpline | 9 to 16% | Free (after the call) |
| Pharmacy | Regular pharmacy | 12 to 17% | Via pharmacy |
Saving compared with the same insurer's standard model, adults, deductible 2'500, with accident cover, 2027 premiums in all premium regions. The range shown is the middle half of tariffs.
New from 2027: the FOPH groups the models differently
From 2027, the FOPH sorts the models in its official premium data into four groups: Standard, Practice (family doctor and HMO), Telemedicine and digital, and Flex. Flex covers models where you choose the first point of contact case by case: family doctor, telephone helpline or pharmacy. Pharmacy models therefore usually come under Flex. In the calculator this group is called ‘Alternative’.
Nothing changes for you: the tariffs have the same names at your insurer as before, only the way they are classified in the statistics is new.
What happens in an emergency?
This is the most common worry, and the answer is clear:
In a genuine emergency, every model allows free choice of doctor and hospital. You can go straight to A&E at any time, without calling first, without your family doctor, without the HMO. This is guaranteed by law.
5 myths about alternative models
‘In an HMO I get worse treatment.’
Wrong. The benefits are identical by law (KVG). Studies even show that coordinated care in HMO practices sometimes leads to better outcomes: fewer duplicate tests, better coordination.
‘Telmed means I get treated over the phone.’
Wrong. It is triage, an initial assessment. If needed, you are referred to a doctor straight away. Often you even get a recommendation for the most suitable specialist.
‘Once I'm in the model, I can't get out.’
Wrong. You can switch every year with effect from 1 January (notice by 30 November). Changing model within the same insurer is often even easier, by form or online.
‘In an emergency I have to call my family doctor first.’
Wrong. In a genuine emergency (accident, life-threatening situation) you can go straight to hospital in every model. No call, no referral.
‘Alternative models are only for young, healthy people.’
Wrong. People with chronic illnesses benefit too: a regular family doctor knows your whole medical history, coordinates treatment and avoids drug interactions. Plus, lower premiums ease the budget.
How popular are the models?
Most insured persons in Switzerland switched long ago:
- approx. 60 to 70% use an alternative model (not standard)
- The family doctor model is the most popular (approx. 30 to 35%)
- Telmed is growing fastest, especially among younger people (approx. 15 to 20%)
- HMO is concentrated regionally, mainly in towns and cities (approx. 10 to 12%)
- Standard keeps falling (now only approx. 30 to 40%)
How do I change model?
- Choose a model: think about which model fits your everyday life
- Compare premiums: use our health insurance calculator, it shows the premiums for each model
- Hand in your cancellation: by 30 November for 1 January (registered mail recommended)
- Sign up with the new insurer or model: every insurer must accept you for basic health insurance (legal obligation to accept)
Combining an alternative model + deductible 2'500 brings the biggest saving. An example from the 2027 premiums: City of Zurich, adults with accident cover. The standard model with a 300 deductible costs CHF 676.90 a month on average across all insurers, the cheapest HMO with a 2'500 deductible CHF 406.80. Difference: around CHF 3'240 a year.
More on the best deductible: Which deductible is best?
Our recommendation
| You are... | Best model | Why |
|---|---|---|
| Young, rarely ill | Telmed or HMO | Highest saving, minimal effort for people who rarely see a doctor |
| You have a family doctor | Family doctor model | You go to your family doctor first anyway, so why not get paid for it? |
| In a town or city | HMO | Biggest discount, widely available in towns and cities |
| In the countryside | Family doctor or Telmed | HMO often not available. Family doctor or Telmed are good alternatives |
| Chronically ill | Family doctor model | Coordinated care, one regular contact |
| Want maximum freedom | Standard | If flexibility matters more to you than money |
Compare all models for your postcode now
Our calculator shows you the cheapest insurers, standard and all alternative models.
Compare premiums →Sources: Health Insurance Act (KVG) Art. 25 to 31 (catalogue of benefits), Federal Office of Public Health (FOPH), 2027 premiums (opendata.swiss) and Statistics on compulsory health insurance. All information without guarantee. Savings vary by canton, age and insurer.