Visana Managed Care

Multiple: Family doctor/hmo
Primary care: Family doctor/hmo

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General

General information:

Health insurance model «Managed Care» of the insurance company Visana.

Health insurance model:

HMO model: As an HMO policy holder, you are required to get medical consultation from a doctor at an eligible HMO center before receiving further treatment. Your HMO center may then refer you to specialists, therapists or hospitals. A primary consultation from an HMO center is not necessary in the event of medical emergencies, gynecological examinations and treatments by eye doctors.

Choice of doctor:

Your choice of general practitioners is limited to doctors at HMO health centers which partner with Visana.

Medical partner:

Argomed, Ärztenetz Nordwest, Ärztenetzwerk Thurgau, Beodocs, Doccare, Docnet, Grisomed, Hapmed, HARESO, HAV Schwyz, HAV-SH, Igomed, iNetz, localmed, Luganocare, Medbase, Medi24, MediX, mediX limmimed, mediX luzern, mediX säntis, mediX winterthur, MedNet Biel-Bienne, mednetbern, Monvia, PizolCare, Réseau de Soins Neuchâtelois, Réseau Delta, RhyMed, Sanacare, Seelandnet, xundart, zimdoc, zmed, Zolamed, Zürcher Gesundheitsnetz.

Pharmacy choice:

You get free choice of pharmacy

Payment methods:

20% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
80% of payments are tiers payant, meaning the bills are paid directly by the insurance (Visana).

Reimbursement:

The average waiting period before tiers garant reimbursement from Visana is 8 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 Visana is 202% (according to FOPH data). The minimum ratio required by the FOPH is 100%.

Number of policyholders:

A total of 498,455 people hold compulsory health insurance policies from Visana.

Additional child-discount:

Visana provides additional premium reductions from the third child onwards.

Administrative costs:

4.4% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).

Administrative costs per policyholder:

CHF 199 (as per the most recent BAG data).