Standard model – freedom to choose your own doctor
Under the traditional model of mandatory basic insurance, you are at all times free to choose your own doctor.
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The advantages for you
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Free choice of doctor throughout Switzerland.
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Make an appointment directly to see a specialist.
- Medical advice is available 24/7 on 058 277 77 77.
- CSS clients can find fantastic offers in the enjoy365 Health Shop and use the active365 app for free.
How the standard model works
Do you like to decide for yourself which doctor or specialist you want to see? Then the standard model is the right form of insurance for you.
What should you do in the event of illness?
Under the standard model, you can choose which medical practice to go to for treatment or see a specialist directly. There is no need for you to inform your health insurer.
How much will the premium cost each month?
Premiums depend on where you live, your age and what deductible you choose.
What you need to know about the standard model
The standard model gives you access to basic outpatient and inpatient medical care in the event of illness, accident and maternity.
Special treatment
If you need chiropractic treatment, you can contact a recognised practitioner directly. A doctor's prescription is required for nutrition therapy, speech therapy, physiotherapy, occupational therapy and other forms of therapy.
You can go to any gynaecologist for screenings and routine consultations during pregnancy. Because basic insurance pays important maternity benefits.
What to do in an emergency
In an emergency, you can go straight to the doctor’s practice of your choosing. If they cannot be reached, you can contact their locum or the emergency service.
What are the rules?
If you need to spend time in hospital, choose the general ward and a recognised clinic that features on the cantonal list of hospitals. That way, there will be no limit to either the amount or duration of the cost coverage.
What does ‘standard model’ mean?
The standard model is the basic version of mandatory basic insurance, and comes with a free choice of doctor. All general health insurance companies offer this model. You pay less in premiums under alternative models like family doctor, HMO, Telmed and Multimed. But there are a few rules that you have to follow.
Basic insurance benefits
Overview of benefits
Outpatient treatment / classical medicine
Cost coverage according to the tariff, throughout Switzerland, for treatment by recognised doctors, chiropractors, dieticians, midwives, speech therapists, physiotherapists, ergotherapists, nurses and nursing auxiliaries
Outpatient treatment / alternative medicine
Acupuncture, anthroposophic medicine, Chinese medicine, homeopathy and phytotherapy: Cost coverage according to the tariff, throughout Switzerland, for treatment by recognised doctors with an FMH qualification in the respective field of complementary medicine
Hospitalisation
Cost coverage without limit to sum or duration in the general ward (hospital/acute-care hospital) in accordance with the current cantonal hospital list
Health promotion / prevention
As stipulated in article 12 of the Health Insurance Benefits Ordinance
Abroad
Cost coverage in the general ward in emergencies for outpatient or inpatient treatment, up to a maximum of twice the tariff of the canton of residence in Switzerland. The special provisions in force under the bilateral agreements apply in the case of EU countries (incl. Iceland, the Principality of Liechtenstein and Norway). Insurance cover abroad
Medication
Medically prescribed medication on the Federal Office of Public Health (BAG) «New list of generic medicine with differentiated retention fees for original preparations and generic medicines», the drug formulary or the Specialty List
Spa treatments / recovery cures
Spa treatments: CHF 10 per day, 21 days per year, plus the cost of medical treatment
Recovery cures: The cost of medical treatment only
Maternity / breastfeeding
7 check-ups during pregnancy and one following the birth, 2 ultrasound examinations for a normal pregnancy, home birth or hospital birth, maximum CHF 150 for antenatal courses, maximum 3 sessions of breastfeeding advice. Maternity benefits under basic insurance
Aids
Contributions to aids in accordance with the aids and appliances list
Preventive examinations / vaccinations
Contributions to preventive health measures e.g. vaccination of children, preventive gynaecological examinations, etc.
Transport and rescue costs in Switzerland
Cost of transport: 50% of costs, max. CHF 500 per calendar year
Rescue costs: 50% of costs, max. CHF 5,000 per calendar year
Spectacle lenses / contact lenses
Up to age 18: CHF 180 per year, on a doctor’s prescription
Home care / care in a nursing home
Cost coverage for medically prescribed examinations, treatment and nursing care by recognised Spitex organisations at home or in nursing homes
Dental treatment
Cost coverage for severe jaw disease or if treatment becomes necessary because of a serious general illness. Primary treatment of dental accidents (if accident cover included)
Psychotherapy
Cost coverage for psychotherapy with a doctor
Frequently asked questions
Then we recommend an alternative form of basic insurance such as the Telmed, Multimed, HMO or family doctor model. You enjoy the exact same benefits while saving on premiums.
Instead of opting for the regular deductible (CHF 300), adults and children can increase the deductible and pay lower premiums in return.
Save the number 058 277 77 77 to obtain free medical advice. If you contact other telemedicine service providers or use apps other than Well or myCSS, you will be billed for their services.
Basic insurance provides benefits for alternative medicine if treatment is provided by a recognised doctor with relevant training in acupuncture, anthroposophic medicine, homeopathy or phytotherapy.
How to save on premiums
Premiums depend on where you live, your age and what deductible you choose.
