Swiss health insurance models explained: Telmed vs HMO vs standard

Every resident of Switzerland must hold basic health insurance under the KVG (LAMal in French, LAMal/KVG on your paperwork). The federal law defines the entire benefit catalogue: which treatments are reimbursed, which medicines are on the approved list, the annual franchise (deductible) options, the 10% co-insurance you pay above the deductible up to CHF 700 a year for adults, and the daily hospital contribution.

That means the phrase "better insurance" is mostly meaningless for basic cover. A CHF 620 premium and a CHF 380 premium in the same commune buy the same medical treatment. The difference comes from three levers you control:

• Your deductible (franchise): CHF 300 to CHF 2,500 for adults. Higher deductible, lower premium.
• Your care model: how you are allowed to reach a doctor. This guide.
• Your insurer: administrative costs and regional risk pools vary, so approved premiums differ by more than 30% inside the same commune.

Premiums also vary by canton and by premium region within a canton — Geneva and Basel-Stadt are structurally expensive, inner-Switzerland cantons cheap. Our canton index shows the 2026 spread, and the deductible guide works through the break-even maths on the franchise choice.

A few models blur the lines. "Multimed", "Casamed", "Callmed" and similar branded products are usually a hybrid: a Telmed hotline plus a restricted list of doctors and hospitals. They can be excellent value, but read the doctor list before signing — the restriction is real, and going outside it can leave you paying a share of the bill yourself.

What Telmed is actually like

You call a 24/7 medical hotline — in English at most large insurers — describe the problem, and a nurse or doctor either treats it over the phone or issues a referral, which is logged automatically. In practice most calls take ten minutes and the referral is to the doctor you asked for. The friction appears when you need a same-day appointment on a Monday morning, or when the hotline's language coverage is thinner than the brochure suggests. Ask about English service hours before you commit.

What HMO is actually like

You are assigned to a specific group practice. All routine care runs through it, including referrals to specialists and hospitals within the network. When the centre is a five-minute tram ride from home, HMO is the best deal in Swiss health insurance. When you move across the city, or the centre has a three-week waiting list, it becomes the reason people abandon the model in November. Check the practice location and its opening hours on a map before you choose.

Insurers must publish their approved premiums for the following year by the end of October, and they must notify you of your new premium at the same time. That gives you roughly four weeks to act. The mechanics:

1. Read the October letter properly. It states your 2027 premium, your current deductible and your current model. Most people who overpay do so because they never opened this envelope.
2. Compare on Priminfo. The Federal Office of Public Health portal (priminfo.admin.ch) lists every approved premium for your commune, filterable by model, deductible and age group. It shows insurers that pay no brokerage and therefore never appear on comparison sites.
3. Decide model first, then insurer. If your current insurer's HMO or Telmed price is competitive, a model change is a single form and leaves your supplementary policies alone.
4. Get acceptance in writing before cancelling. For basic insurance acceptance is guaranteed, but you want the confirmation on paper before you burn the old policy.
5. Cancel by registered post so it arrives by 30 November. Not postmarked — arrived. Registered post gives you proof. Email cancellations are accepted by some insurers and rejected by others; do not gamble on it.
6. Verify the January invoice. Check the model, deductible and premium on the first bill of the new year, and update the standing order in your bank app.

Two warnings. First, do not cancel supplementary insurance (dental, private hospital ward, glasses, alternative medicine) in the same breath — those policies can refuse you on health grounds, and cancelling before the new one is signed can leave you uninsured for life on that product. Second, if you are behind on premium payments, an insurer can block the switch until arrears are cleared.

Finally, check whether you qualify for a premium subsidy (Prämienverbilligung / subside). Every canton reduces premiums for lower and middle incomes, thresholds are more generous than most expats assume — a single earner under roughly CHF 50,000–60,000 or a family under CHF 90,000–100,000 often qualifies — and in several cantons you have to apply rather than be found. Details on your canton page and in our health insurance guide.

• Young, healthy, rarely see a doctor: Telmed or HMO, CHF 2,500 deductible. Lowest possible cost.
• Family with small children: family-doctor model, moderate deductible. Children's premiums are separate and much lower, and paediatric visits are usually exempt from the gatekeeper rule anyway.
• Chronic condition, regular specialists: standard or family doctor, CHF 300 deductible. You will hit the deductible every year, so the low franchise wins.
• Pregnant or planning: maternity care is exempt from deductible and co-insurance, but switch to a low deductible before conception for the surrounding care.
• About to move commune or canton: a move can change your premium region and, with HMO, break your network. Telmed travels better.

For the wider picture — how the system works, what it costs a household and how it compares with what you left behind — see our Swiss healthcare system explainer and the deductibles and models deep dive.