With the HMO model PRAXMED, you first visit an HMO doctor or an HMO practice (see general practitioner directory) if you have any health concerns. The HMO doctor knows your medical history and the best course of action for your treatment. Together with you, he will determine the treatment and, if necessary, refer you to a specialist or to a hospital.
PRAXMED is a basic insurance model. A HMO group practice is always your first point of contact for all health-related questions.
Exceptions prove the rule. In following cases your family doctor is not your first point of contact:
As well as a visit by the following specialists:
Out-patient treatment by specialists, chiropractors and medical support staff (nurses, physiotherapists etc.), as long as it is referred by a family doctor / full coverage at the place of residence or work
Emergency illness during a stay abroad, coverage of costs at double the amount of the canton of residence.
Spa treatments prescribed by a doctor in a recognized spa/ medical treatments, drugs and therapies according to the rate of place of residence of CHF 10.– per day, up to 21 days per year for accommodation expenses.
When prescribed by a doctor, nursing care at home, in accordance with cantonal home care(Spitex) contracts.
In accordance with regulations concerning aids and materials
Statutory mandatory benefits in accordance with KLV
Medicines prescribed by the doctor covered by the insurance, full coverage
Stay, doctor and therapy costs according to the rate / contribution to nursing costs in accordance with nursing home fees
Statutory mandatory benefits
Stay and treatment in an acute care hospital with reference from a family doctor/ full coverage on the general ward of the hospital in the canton of residence (in accordance with the hospital list)
Bis zum 18. Lebensjahr 180.- pro Jahr
Medically necessary emergency transport / rescue / 50%, up to CHF 500.– per year for transport costs / 50%, up to CHF 5'000.– per year for rescue and recovery costs
Damage to teeth caused by an accident / full coverage
Severe disease of the masticatory system / full coverage
up to 14 %