Assura PlusMed

Multiple: Family doctor/hmo/telemedicine
Primary care: Family doctor/hmo/telemedicine
Attention: No free choice of specialists!

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General

General information:

Health insurance model «PlusMed» of the Swiss insurance company Assura.

Attention: The choice of specialists can no longer be determined by you or your family doctor. Instead, the company Better Doc decides which specialists you can be referred to.

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:

Medgate.

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).