Swica FAVORIT SANTE
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HMO model
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Primary care: HMO center
General
General information:
Health insurance model «FAVORIT SANTE» of the Swiss insurance company Swica.
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 Swica.
Medical partner:
Centramed, Medbase, MedNet Biel-Bienne, Monvia, PizolCare, Sanacare.
Pharmacy choice:
You get free choice of pharmacy
Payment methods:
11.6% of payments are made using the tiers garant payment method, in which you pay and claim reimbursement.
88.3% of payments are tiers payant, meaning the bills are paid directly by the insurance (Swica).
88.3% of payments are tiers payant, meaning the bills are paid directly by the insurance (Swica).
Reimbursement:
The average waiting period before tiers garant reimbursement from Swica is 2.3 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 Swica is 138% (according to FOPH data). The minimum ratio required by the FOPH is 100%.
Number of policyholders:
A total of 754,833 people hold compulsory health insurance policies from Swica.
Additional child-discount:
Swica provides additional premium reductions from the third child onwards.
Administrative costs:
5.1% (ratio of adminstrative costs to risk-adjusted premiums as per BAG data).
Administrative costs per policyholder:
CHF 184 (as per the most recent BAG data).
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