Standard model

What is the standard model?

The standard model is basic health insurance in its original form, with no restriction on your choice of doctor. The law calls it “standard health insurance” (ordentliche Krankenpflegeversicherung). For outpatient treatment, you can choose any doctor, therapist or practice that is approved to bill basic insurance and suitable for your condition, including specialists, without asking anyone first.

Alongside the standard model, insurers offer special types of insurance. With these, you give up part of your free choice and get a lower premium in return. The best known are the GP model, the HMO and the Telmed model with an initial consultation by phone.

Important: the standard model does not offer more benefits. The benefits required by law are covered in the same way in every model. The free choice of hospital for inpatient treatment among listed hospitals also follows the same rules in basic insurance. The only differences are the route to treatment and the price.

How it works

In the standard model, you do not need a referral or an initial call. You book an appointment directly, show your health insurance card, and the bill goes to the insurer or to you. The deductible (Franchise) and the retention fee (Selbstbehalt) apply as in every model.

Because the insurer has no influence on the treatment route, the standard model premium is the reference against which all other models are measured. The insurer may only offer models with a restricted choice at a lower price if the savings result from the restricted choice or from the remuneration of service providers, not from a healthier pool of insured persons. Without five years of claims data, the discount may be at most 20% of the standard premium.

The standard model has an advantage when it comes to deadlines. With the standard deductible of CHF 300, you can change insurer not only at the end of the year but also at the end of June, with three months’ notice, i.e. your notice of cancellation must be received by 31 March. If you have an optional deductible or a special type of insurance, you can only switch at the end of the year. The dates are listed under deadlines.

The ordinance treats a change of model asymmetrically: you can switch from the standard model to a model with a restricted choice at any time. You can only go back to the standard model or to another model at the end of a calendar year.

Legal basis

Art. 41 para. 1 KVG gives you free choice, for outpatient treatment, among approved service providers suitable for your condition; the insurer pays according to the tariff of the provider you choose. Art. 41 para. 4 KVG allows you to restrict this choice in agreement with the insurer; the benefits required by law remain covered in every case. Art. 62 para. 1 KVG allows lower premiums for such models.

Art. 99 of the Health Insurance Ordinance (KVV) refers to the standard model as “standard health insurance”, alongside which insurers may offer models with a restricted choice. Art. 100 para. 2 KVV allows you to switch from the standard model to a restricted model at any time, and para. 3 allows a switch to another type only at the end of the year. Art. 101 paras. 2 and 3 KVV set out when discounts are permitted. Changing insurer is governed by Art. 7 paras. 1 and 2 of the Federal Health Insurance Act (KVG); Art. 94 para. 2 and Art. 100 para. 3 KVV limit it to the end of the year for optional deductibles and special models.

Example: premiums 2026 in Zurich by model

Premiums 2026, city of Zurich (region 1), adults born in 1992, with accident cover; source FOPH. The table shows the cheapest and the median monthly premium for each group of models.

What this means for you

Ask yourself three questions before choosing the standard model:

1. How often do you go straight to specialists? If you regularly need different specialists without a GP as a hub, that speaks for the standard model.
2. Are you prepared to follow rules? In special models, you risk benefit cuts if you go straight to a doctor without a referral or an initial call.
3. Do you want flexibility to switch? Only the standard model with a CHF 300 deductible also allows a switch at the end of June.

You can compare the premiums for your municipality and your age in the premium calculator. The model finder works out which model suits the way you use healthcare. You will find the insurers and their offers under health insurers.

Common mistakes

• Thinking the standard model is the better insurance. The benefits are the same in all models.
• Staying in the standard model out of habit. If you hardly use the free choice, you pay the extra for nothing. Check every year whether another model suits you.
• Switching to a special model and ignoring the rules. If you go straight to a specialist without a referral, you risk the insurer not paying.
• Planning a mid-year switch with an optional deductible. Switching at the end of June is only possible in the standard model with the standard deductible.

We explain how we compare premiums under how we calculate.