Go straight to a doctor with the HMO model
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Under the HMO model, you consult a member of the Visana network of doctors or a group practice of your choice.
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Single point of contact for all medical issues.
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Your general practitioner oversees all of your treatment and refers you to specialists or hospitals as needed.
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A group practice brings together specialists in various medical disciplines. You benefit from easy access to a broad range of medical services.
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Free, round-the-clock telemedical advice with Medi24 and the Well health app.
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Includes health legal protection insurance.
You can get medical advice at any time of the day or night by calling Medi24 on 0800 633 225.
If you opt to join Managed Care, you are helping to keep health costs under control. As a result, you benefit from lower premiums. But we can only give you lower premiums if you follow a few rules. You will find details here.
Managed Care discounts
If you choose to pay your premium every six months, you will get a discount of 1%. This rises to 2% if you pay annually.
By always contacting the general practitioner you have chosen from the Visana network of doctors or your chosen group practice first, you are actively helping to reduce health costs and avoid duplication during treatment. In return, Visana offers you a model-based discount on your basic insurance premium.
If you work for the same employer for more than eight hours a week, you are insured against non-occupational as well as occupational accidents. This means you can exclude accidents from your basic insurance.
Basic insurance offers selectable deductibles in addition to the standard annual deductible of CHF 300. People aged 19 and over who are insured with Visana can choose a deductible of CHF 500, CHF 1,000, CHF 1,500, CHF 2,000 or CHF 2,500. The higher the deductible chosen, the greater the discount. By choosing the right insurance model and deductible for their needs, policyholders can calculate their premium in such a way that they can manage their annual total cost contribution risk.
Is the HMO Managed Care model right for you?
This basic insurance model is suitable for you if you:
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want to be treated by the same, trusted general practitioner in a network of doctors or group practice;
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attach importance to efficient treatment without duplicate examinations;
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want access to a broad range of medical services in a network of doctors or group practice;
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don’t like telephone consultations but prefer face-to-face contact.
How the HMO Managed Care model works
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If you have health problems or want to make an appointment for treatment or an examination, you always contact either your general practitioner from the Visana network of doctors or your group practice first.
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You get treatment from your general practitioner or a doctor at your group practice. If needed, your doctor can consult other experts from the network or within the group practice.
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If necessary, your general practitioner will refer you to a hospital, specialist or other service provider.
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You can upload reimbursement receipts and invoices quickly and easily using the myVisana app or the portal.
Exceptions and obligations
Always consult your Managed Care doctor or your chosen group practice whenever you have a medical concern. You can only consult other service providers (particularly specialists) if you have a referral from your doctor. However, you do not have to report the referral because Visana receives automatic notification of it from the Managed Care doctor.
You can consult a specialist directly in the following circumstances:
- Outpatient eye examinations and optical aids
- Maternity
- Preliminary gynaecological examinations and treatment
- Dental treatment
- Emergencies
You must inform your doctor or group practice of emergencies at the earliest possible opportunity.
Managed Care gives you a single point of contact for all medical issues, attractive premiums and round-the-clock advice. We can only provide these advantages if you comply with the obligations set out above. If you fail to follow your Managed Care treatment pathway by going straight to a specialist, for example, we will take the following action:
The first time you fail to follow your Managed Care clinical pathway, we will send you a written reminder of your obligations. The second and third times, we reserve the right to reduce the benefits we pay by 50% or 100% respectively. The fourth time, we will transfer you from Managed Care to ordinary basic insurance.
Your advantages with Managed Care
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Single point of contact for all medical concerns
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Access to a network of doctors for efficient and well-coordinated treatment
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Attractive premiums, thanks to your obligations in an alternative insurance model
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Free telemedical advice over the phone or from DoctorChat via Well app– around the clock
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Health legal protection insurance included
We will be happy to take the time to explain the advantages of the various models to you at no obligation.
Useful services for you
Cleverly insured, optimally supported. These services assist you:
You can easily upload invoices and reimbursement receipts via the myVisana app or myVisana customer portal.
With ‘Emergency-Finder’, you are optimally equipped in critical medical situations. This app helps you to assess your symptoms correctly and shows you the nearest emergency ward in real time, along with its current capacity.
The cost-free service is available in the City of Bern and the surrounding metropolitan area.
See at a glance which benefits your basic insurance covers and what additional advantages our top-up insurance models offer.
Insurance that complements this product
Frequently asked questions about the HMO model
HMO stands for “health maintenance organisation”. If you specified a group practice when taking out your Managed Care insurance, you are looked after by a fixed team of doctors. Treatment is efficiently organised and tailored to your needs.
A network of doctors is a group comprising several affiliated doctors. Mutual exchange and the shared use of infrastructure (diagnostic equipment, laboratories etc.) enable a network of doctors to offer high-quality care at lower cost.
Group practices combine general medicine, internal medicine and basic gynaecological care under one roof. This facilitates a mutual exchange of expertise and makes it easier to obtain a second opinion.
The HMO basic insurance model Managed Care offers the following advantages:
- Lower premiums
- Coordinated treatment, provided by a well-established team of doctors
- Efficient medical care with fewer redundancies
- Short distances between different medical departments within a single practice
- Effective prevention, due to long-term care
In the HMO model Managed Care, you choose either a fixed group practice with several doctors, or a doctor from the Visana network of doctors. Your treatment is organised by the team at the HMO practice, and doctors from the network can support each other.
In the general practitioner model Med Direct, you choose a GP as your first point of contact. This person coordinates all your medical care. If you are referred to a specialist, you must notify Visana; in the HMO Managed Care model, this happens automatically.
Both models offer lower premiums than, for example, the traditional insurance model. In the HMO Managed Care model, your care is more centralised, while in the general-practitioner model Med Direct, it is more personalised.
In an emergency, you can go straight to an out-of-hours practice or a hospital. However, you must inform your doctor or group practice as soon as possible afterwards.
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Conditions of insurance
Overview of benefits
Fact sheets
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