Helsana BeneFit PLUS Telmed

  • Telemedicine model

  • Primary care: telemedicine

  • Telmed recommendations are binding

General

General information:

Health insurance model «BeneFit PLUS Telmed» of the Swiss insurance company Helsana.

Health insurance model:
Telmed model: If you choose a telmed policy, you will have to contact the telemedicine hotline before every doctor visit. Telephone consultation is not required in the event of medical emergencies, gynecological examinations and treatment by eye doctors.
Choice of doctor:
Your choice of doctors is limited by Helsana BeneFit PLUS Telmed requirements.
Medical partner:
Medi24.
Telmed consultation:
Recommendations made during telephonic consultations are binding.
Pharmacy choice:
You get free choice of pharmacy
Payment methods:
18% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
82% of payments are tiers payant, meaning the bills are paid directly by the insurance (Helsana).
Reimbursement:
The average waiting period before tiers garant reimbursement from Helsana is 9 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 Helsana is 119% (according to FOPH data). The minimum ratio required by the FOPH is 100%.
Number of policyholders:
A total of 1,412,757 people hold compulsory health insurance policies from Helsana.
Additional child-discount:
Helsana does not offer additional premium reductions for more than one child.
Administrative costs:
4.5% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).
Administrative costs per policyholder:
CHF 171 (as per the most recent BAG data).

Customer satisfaction

General satisfaction    8.0/10 (Very good)
Helpfulness    7.9/10 (Good)
Billing: flexibility    7.6/10 (Good)
Reimbursement: time frame    7.8/10 (Good)
Product information    7.6/10 (Good)

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