Premium discount: 7% to 10%
Contact your family doctor
first for medical advice
Family Doctor
Excellent care: With Family Doctor, your family doctor is always your first point of contact.
Key benefits
Who is Family Doctor suitable for?
Family Doctor is ideal for anyone who wants individual care from a trusted family doctor. In return, you benefit from a discount on your premium.
How Family Doctor works
Step 1
Choose a family doctor practice from the Sanitas list. Inform us of your choice, for example online via the Sanitas Portal.
Step 2
If you are ill or require medical advice, always contact your family doctor first. If your family doctor is on holiday, contact their deputy.
Step 3
Your family doctor practice draws up a treatment plan with you. Please inform your family doctor practice of any follow-up checks and referrals to other doctors.
In hospital
For a hospital stay, choose the general ward and a recognised clinic on the cantonal hospital list.
In an emergency
In an emergency, you do not have to go to your family doctor first, but can go directly to an emergency doctor or to the emergency room of a hospital. Your family doctor will take care of any follow-up treatment and check-ups.
Exceptions
In the following cases, you can see a specialist directly: Gynaecological treatment, maternity examinations (including childbirth), visits to a dentist, periodic eye tests, vaccinations and paediatric treatment for children up to end of the year in which they turn 7.
Overview of benefits
All the basic insurance models offer the same benefits. We reimburse you for the following benefits after the statutory cost shares (deductible, copayment, hospital cost contribution) have been deducted.
Sanitas may waive the cost share (deductible or copayment) in full or in part for certain benefits. You can find an overview of the corresponding benefits here.
Grundversicherung | |
|---|---|
| Inland | Behandlung durch Ärzte, Chiropraktiker sowie ärztlich verordnete Therapien durch andere Medizinalpersonen |
| EU/EFTA (bei Notfällen) | Behandlung gemäss bilateralen Abkommen (Personenfreizügigkeit) |
| Übriges Ausland (bei Notfällen) | Max doppelter Beitrag der Kosten gemäss Tarif am Wohnort. |
Sofern von Ärzten durchgeführt: Akupunktur, anthroposophische Medizin, Homöopathie, Phytotherapie, Traditionelle Chinesische Medizin (TCM) gemäss gesetzlichen Bestimmungen | |
Hilfsmittel gemäss Mittel und Gegenständeliste (MiGeL) | |
Medikamente der Arzneimittel und Spezialitätenliste | |
Vorsorgemassnahmen, z.B. Entwicklungskontrollen beim Kind, gynäkologische Vorsorgeuntersuchungen (alle 3 Jahre), bestimmte Impfungen | |
Kontrolluntersuchungen durch Ärzte oder Hebammen, CHF 150.– für Geburtsvorbereitungskurs, Stillberatung | |
Behandlung durch Ärzte | |
| Bis 18. Altersjahr | CHF 180.– |
| Badekuren Inland | CHF 10.–/Tag, max. 21 Tage in anerkannten Heilbädern der Schweiz |
| Transport | 50%, max. CHF 500.– |
| Rettung | 50%, max. CHF 5000.– |
| Inland | Allgemeine Abteilung in Listenspitälern, max. Tarif des Wohnkantons |
| EU/EFTA (bei Notfällen) | Aufenthalt, Pflege und Behandlung gemäss bilateralen Abkommen (Personenfreizügigkeit) |
| Übriges Ausland (bei Notfällen) | Max. doppelter Betrag der Kosten gemäss Tarif im Wohnkanton |
The amounts listed are for maximum benefits and, unless specified otherwise, are valid for each calendar year. Decisive for the service orientation are exclusively the KVG, the associated regulations as well as the AVB and ZB of Sanitas.
Downloads
Frequently asked questions
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What should I do in an emergency?
In an emergency, you can go directly to an emergency doctor or to the emergency room of a hospital. Your family doctor will take care of any follow-up treatment and check-ups.
In case of minor emergencies, it is advisable to contact your family doctor first. If they are not available, go to an emergency doctor.
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Family doctor model: Is my family doctor recognised in the list of doctors?
In just a few clicks, our doctor locator shows you all doctors, medical practices and health centres that are compatible with our basic insurance models and which are accepting patients.
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Can I go straight to an ophthalmologist without a referral?
For regular eye tests, you don’t need a referral from your family doctor. You can make an appointment directly with your ophthalmologist.
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What should I do if I would like to consult a specialist?
Contact your family doctor. They will first examine you and initiate the necessary treatments. If you need to see a specialist, your family doctor will refer you to them.
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What happens if I don’t go to my family doctor first?
If you go to a specialist without seeing your family doctor first, you will receive a reminder of the rules for your chosen model. If it happens a second time, you will receive a final warning, and the third time you will be transferred to the Basic (Free choice of doctor) basic insurance model .
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Why is a range given for the premium discount?
The specified range for the premium discount (Family Doctor: X% to Y%) takes the different premium regions into account. How much you save depends on where you live.
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What does HMO stand for?
The alternative basic insurance model HMO stands for “health maintenance organisation”. This is usually a group practice with family doctors, specialists and therapists working closely together. All the doctors and therapists within this network have access to your medical records. This means that there are no information gaps and you receive the best possible treatment. If you are insured under an HMO model, you always contact your HMO practice first for medical queries.
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Which doctors are included in the health network?
Our doctor locator provides an overview. You can enter the desired location of the practice and the postcode here. Use the “Family Doctor” filter to ensure that only medical specialists available for the Family Doctor model are shown.
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Can I change doctor or group practice?
Yes, that’s possible. To do so, choose another doctor or group practice from the list (see doctor locator).
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Why does the Family Doctor basic insurance model offer different discounts?
Sanitas offers four discount variants for the Family Doctor basic insurance model. Sanitas wants its customers to be able to participate more transparently in the cost savings generated by the different networks of physicians. You benefit from different discounts depending on the family doctor or group practice you choose. The handy doctor locator shows you quickly and easily which discount variant your medical contact is assigned to.
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Who decides which discount my family doctor receives?
Your family doctor or group practice may be affiliated with a network of physicians. The network of physicians and Sanitas have concluded contracts with the aim of promoting medical quality and saving costs. These cost savings are achieved through efficient treatment options and effective coordination, for example by avoiding unnecessary treatments. This influences your premium discount. Sanitas calculates these discounts each year based on the cost savings achieved by the networks of physicians. To assign the networks of physicians to a specific discount variant, the costs savings of the previous year are taken into account. In other words, each network of physicians is assigned to a discount variant based on the cost savings it has achieved. If your family doctor isn’t part of a network of physicians, you receive the lowest discount.
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I do not want a lower discount. What can I do?
If you’d like a higher discount on your Family Doctor model, you have the following option: Choose a family doctor or group practice assigned to a higher discount variant. In our handy doctor locator, you can check which discount variant a practice is assigned to. However, if you want to remain with your current family doctor, the specified discount applies.
