Group practice (HMO)
HMO: Das Gruppenpraxis-Modell der obligatorischen Grundversicherung
In der obligatorischen Grundversicherung bieten die Schweizer Krankenkassen neben dem Standard-Tarif auch alternative Versicherungsmodelle an. Diese Modelle schränken die Arztwahl auf bestimmte Ansprechpartner ein, Versicherungsnehmer profitieren dafür von geringeren Prämien. Einer dieser alternativen Tarife ist das Gruppenpraxis-Modell.
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What is an HMO practice?
The abbreviation HMO stands for Health Maintenance Organization, which means "organization for the preservation of health". Several doctors join together to form such an organisation and work together in a group practice. In addition to general practitioners, you will usually also find various specialists and therapists from other disciplines in such practices. The practices operate in a certain catchment area. Your health insurance company will tell you which group practices exist in your area of residence.
The insurance model was originally developed in the USA around 1910. In Switzerland, such practices have existed since the 1990s. The group practices either belong to one health insurance company or conclude contracts with several health insurance companies. Doctors receive a monthly lump sum from the insurance companies for each registered policyholder. This lump sum covers all the medical services used by the insured person. This includes not only treatment by the group doctor himself, but also treatment by specialists, in hospital and other therapeutic measures. The aim of this regulation is to keep the number of external medical services as low as possible.
This is how the group practice model works
If you choose this alternative insurance model, decide to always go to a group practice first in the event of illness. You can choose your practice from a list provided by your health insurance company.
There are certain exceptions for the limited choice of doctor. In emergencies, you may also see another doctor. Gynaecological check-ups and check-ups with an ophthalmologist are also exempt from the group practice requirement. The exact exceptions are specified in the terms and conditions of your health insurance company.
Advantages of the group practice model
Health insurers are rewarding the limited choice of doctor with significantly reduced premiums. With this insurance model you can save up to 25 percent compared to the standard model.
As various doctors and therapists come together in the group practices, you receive a large proportion of your medical care under one roof. This reduces waiting times for referrals and you can be treated in a familiar environment.
Compare the alternative rates offered by Swiss health insurance companies
The high premium savings make the group practice model particularly interesting for young and healthy policyholders. If you would like to benefit from this alternative tariff, please make an insurance comparison with us. We will help you find the health insurance company with the cheapest basic insurance.