Assura Hausarzt-Modell

  • Family doctor model

  • Primary care: family doctor

General

General information:

Health insurance model «Hausarzt Modell» of the Swiss insurance company Assura.

Health insurance model:
Family doctor model: When you use a family doctor policy, you are required to visit your relevant family doctor first. Your doctor may then refer you to specialists, therapists or hospitals. A primary consultation from your doctor is not necessary in the event of medical emergencies, gynecological examinations and treatments by eye doctors.
Choice of doctor:
Your choice of family doctor is limited to just one doctor from the Assura doctor list.
Medical partner:
Not specified.
Pharmacy choice:
You get free choice of pharmacy
Payment methods:
64% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
36% of payments are tiers payant, meaning the bills are paid directly by the insurance (Assura).
Reimbursement:
The average waiting period before tiers garant reimbursement from Assura is 14 days.
Financial reserves:
The solvency ratio shows how available financial reserves compare to Federal Office of Public Health (FOPH) minimum reserve requirements. The solvency ratio of Assura is 88% (according to FOPH data). The minimum ratio required by the FOPH is 100%.
Number of policyholders:
A total of 804,064 people hold compulsory health insurance policies from Assura.
Additional child-discount:
Assura provides additional premium reductions from the second child onwards.
Administrative costs:
6.9% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).
Administrative costs per policyholder:
CHF 218 (as per the most recent BAG data).

Customer satisfaction

General satisfaction    7.1/10 (Satisfactory)
Helpfulness    7.2/10 (Satisfactory)
Billing: flexibility    6.9/10 (Acceptable)
Reimbursement: time frame    6.8/10 (Acceptable)
Product information    7.3/10 (Satisfactory)

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