Groupe Mutuel OptiMed

  • Family doctor model

  • Primary care: family doctor

General

General information:

Health insurance model «OptiMed» of the insurance company Groupe Mutuel.

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 Groupe Mutuel.
Pharmacy choice:
You get free choice of pharmacy
Number of policyholders:
A total of 1,053,960 people hold compulsory health insurance policies from Groupe Mutuel.
Additional child-discount:
Not specified.
Administrative costs:
4.1% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).
Administrative costs per policyholder:
CHF 192 (as per the most recent BAG data).

Customer satisfaction

General satisfaction    7.4/10 (Satisfactory)
Helpfulness    7.5/10 (Good)
Billing: flexibility    7.0/10 (Acceptable)
Reimbursement: time frame    7.1/10 (Satisfactory)
Product information    7.0/10 (Acceptable)

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