Your benefits
- Flexible choice of first point of contact for health issues (pharmacy, telemedicine, or your family doctor).
- Selected services with no deductible (e.g., generic medications, breast cancer screening).
- Save up to 24% on your premiums.
Pharmacy, telemedicine or family doctor: you decide! Discover the only basic health insurance in Switzerland that actively promotes health prevention and rewards your choices by offering attractive premium discounts and not charging the deductible on certain benefits.
With PrimaFlex, you can benefit from breast cancer screening with no deductible.
You can have a consultation free of charge in our partner pharmacies if the pharmacist considers this advisable.
Decide which first point of contact is best for you on a case-by-case basis:
Requirements for the PrimaFlex model
With an alternative model, you can secure a more favorable premium than with the Standard model. In return, you agree to adhere to the policy rules.
Please note that insured persons who do not follow the rules of their insurance model will still be reimbursed, but will receive reminders explaining how the model works. After two reminders, insured persons will be transferred to the standard model with free choice of doctor, in accordance with the terms and conditions of insurance. This means that they will have greater freedom to choose their own doctor, but the monthly premium will increase accordingly, until the end of the current year.
Emergencies and specific checks
In some cases, you can consult a doctor of your choice or a specialist directly:
You do not pay a deductible for this if the criteria for coverage by basic insurance are met:
The costs of medications prescribed by a doctor and listed in the List of Medicines with Tariff (ALT/LMT) and the Specialties List (SL/LS) are covered.
Complementary medical treatments practiced by a recognized doctor (acupuncture, homeopathy, phytotherapy, traditional Chinese medicine, anthroposophic medicine) are covered.
Medically prescribed spa treatments in Switzerland are reimbursed at CHF 10/day for a maximum of 21 days per calendar year.
For children up to the age of 18, the costs of glasses or lenses are reimbursed up to CHF 180/calendar year. For adults, between CHF 180 and CHF 630 per eye is covered for certain conditions only (as per the List of Products and Items MiGeL).
External and removable devices (e.g., crutches, wigs, hearing aids, etc.) are covered as per the List of Aids and Objects MiGeL).
Standard pregnancy: 7 check-ups and 2 ultrasounds during pregnancy; delivery at home, in a birthing center or hospital and one check-up after the birth are covered.
High-risk pregnancy (as determined by a doctor): All necessary check-ups and ultrasounds are covered.
Lump sum of CHF 150 for antenatal classes offered by a hospital or midwife.
The following are covered:
Costs are covered for conditions of the masticatory system and dental accidents that are treated by a dentist.
Transportation costs are covered at 50% up to a maximum of CHF 500/calendar year.
Rescue costs are covered at 50% up to a maximum of CHF 5,000/calendar year (in Switzerland only).
Services provided by recognized psychologists/psychotherapists are covered when medically prescribed.
Outpatient treatment is covered as per the KVG/LAMal (e.g., doctor’s visits):
Do you have any questions about PrimaFlex? Our specialist advisers are here to help.
Use our online form to ask to be contacted by an insurance specialist.
Contact usYou will receive a call at a time that suits you.
Request a callThis model is an alternative to the standard model of basic insurance. You will receive the same benefits as under the standard model of basic health insurance but will pay a lower premium. In exchange, in the event of a health problem, you undertake to choose a prior approach that suits you best according to your situation:
If you choose to receive advice from our telemedicine partner or in a pharmacy, you will now be free to decide, after having received the advice, on the next steps of your medical treatment during the time window defined by the telemedicine partner or partner pharmacy.
And if you choose to consult your family doctor directly and he refers you to a specialist, you must ask the doctor to issue a brief certificate, also called a "referral voucher" (a simple signed note is sufficient, mentioning the type of specialist recommended and the period of validity of the certificate). You can then send it to us by post or via your online Customer Area (if you prefer, you can also ask your doctor if he agrees to send it directly to us).
Yes, you are exempted from contacting one of the above-mentioned first points of contact in certain special cases (e.g. in case of emergency or for consultations with a gynaecologist, ophthalmologist, etc.). The list of special cases can be found in your special terms and conditions of insurance.
No, you are free to buy your prescription drugs at the pharmacy of your choice (even if it is not a PrimaFlex partner).