Helsana BeneFit PLUS - Hausarzt 14%
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Family doctor model
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Primary care: family doctor
General
General information:
Health insurance model «Helsana BeneFit PLUS - Hausarzt 14%» of the insurance company Helsana.
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 Helsana doctor list.
Medical partner:
Argomed, Ärztenetz Nordwest, Ärztenetzwerk Thurgau, Beodocs, Centramed, Doccare, Docnet, DOXnet, Grisomed, Hapmed, HARESO, HAV Schwyz, HAV-SH, Hawa, Igomed, localmed, Medbase, mediX limmimed, mediX luzern, mediX säntis, mediX winterthur, MedNet Biel-Bienne, mednetbern, PizolCare, Réseau de Soins Neuchâtelois, Réseau Delta, RhyMed, Seelandnet, xundart, zimdoc, zmed, Zolamed, Zürcher Gesundheitsnetz.
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).
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 130% (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 provides additional premium reductions from the third child onwards.
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).
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