Telemedicine

What is telemedicine?

Telemedicine is medicine at a distance. The doctor and patient are not in the same room, but connected by phone, video, chat, app or the exchange of photos and readings. The term covers very different things: an initial assessment by phone of whether you need to see a doctor, a video consultation with your GP, a follow-up check via an app, or remote monitoring of blood sugar or blood pressure readings.

In Swiss health insurance, telemedicine plays two roles:

• As a way of being treated: a doctor authorised in Switzerland advises, examines or treats you at a distance. For basic health insurance, this is a medical service like any other.
• As an insurance model: in the telemedicine model (Telmed), you undertake to contact a telemedicine advice centre before a doctor’s visit. It decides whether self-treatment is enough or where you should go. Well-known advice centres include Medgate and Santé24; the health insurer decides which centre is responsible for your plan.

In a broader sense, telemedicine also includes digital tools that complement treatment at a distance: the e-prescription, which sends the prescription electronically to the pharmacy, and the electronic patient record (EPR), in which treatment documents are stored with your consent.

Health apps without medical treatment, such as symptom checkers or fitness apps, are a different matter. They are not basic health insurance benefits. Some health insurers contribute to such offers through supplementary insurance or bonus programmes; this is governed by the policy conditions.

How it works

Telemedicine consultation with a doctor. You book an appointment by video or phone, for example with your GP practice or with a telemedicine provider with doctors in Switzerland. The doctor bills the service under the applicable outpatient tariff. As after a visit to the practice, the bill goes through your deductible and retention fee. What matters is that the doctor is authorised as a service provider in Switzerland: in basic health insurance, the principle of territoriality applies, so only compulsory benefits provided in Switzerland by authorised service providers are paid for. A video consultation with a doctor abroad is generally not covered, except in an emergency while travelling.

Prescription at a distance. The doctor may only prescribe a medicine if she knows your state of health. This applies whatever the channel. Whether a phone call or video is enough, or whether you need an appointment in the practice, is up to the doctor to decide in each case. The prescription belongs to you: you decide which pharmacy to take it to, and for electronic prescriptions this choice may not be restricted by technical means.

Telemedicine model. Before every doctor’s visit, you call the advice centre or use its app. A medical professional assesses your concern and gives a recommendation: self-treatment, an appointment with your GP, a referral to a specialist or, in urgent cases, going straight to the emergency department. If you follow the recommendation, the health insurer pays for the treatment as in the standard model. If you depart from it without consulting the centre, it may refuse to pay, depending on the plan’s conditions. Legally, the telemedicine model is insurance with restricted choice of service provider, the same principle as gatekeeping in the GP or HMO model.

Switching. You can switch to a telemedicine model at any time. You can only switch back to the standard model at the end of a calendar year, by notifying your health insurer by 30 November.

Legal basis

The Federal Health Insurance Act (KVG) does not use the term telemedicine. It governs benefits by their content, not by the channel. Under Art. 25 para. 2 let. a KVG, basic health insurance covers examinations and treatment by doctors; under Art. 35 KVG, only authorised service providers may bill at the expense of basic health insurance. The FOPH explains on Priminfo that, as a rule, only services in Switzerland are paid for; exceptions for emergencies abroad are governed by Art. 36 KVV.

The telemedicine model is based on Art. 41 para. 4 KVG: with the health insurer’s agreement, insured persons can limit their choice to service providers selected by the health insurer for more cost-effective care; the compulsory benefits remain insured in every case. Art. 62 para. 1 KVG allows a premium discount for this. Art. 99–101 KVV govern joining, leaving and discounts: switching in at any time, switching out only at the end of a calendar year; discounts only for proven cost differences, and at most 20% without five years of experience data.

Art. 26 HMG applies to prescriptions. Under para. 2, a medicine may only be prescribed if the patient’s state of health is known. Under para. 2bis let. b, the prescription belongs to the person for whom it was issued; for electronic prescriptions, the choice of service provider may not be restricted by technical obstacles.

The EPDG governs the electronic patient record. Under Art. 3 EPDG, opening one requires your express consent, which you can withdraw at any time without giving reasons.

Example: telemedicine instead of standard in Zurich

Samira is 34 (born in 1992), lives in the city of Zurich (premium region 1) and is rarely ill. She is considering switching from the standard model to a telemedicine model. The table shows the 2026 monthly premiums of the offers in her municipality, with accident cover. Source: FOPH, health insurance premiums 2026, opendata.swiss.

How much Samira saves with her own health insurer depends on the specific plan; the medians only show the trend. Her entitlement to benefits does not change. What is new is that she has to call or use the app before a doctor’s appointment and follow the recommendation. She can find the current premiums of all plans in her municipality in the premium calculator.

What this means for you

Telemedicine can save you journeys, and the telemedicine model saves premium. But neither suits every situation:

1. Are you rarely ill and mainly need advice? Then an initial assessment by phone is often exactly what you need, and the telemedicine model is an option.
2. Are you having ongoing treatment with several specialists? In the telemedicine model, you need recommendations for each of them. Check in the plan’s conditions how long a recommendation is valid.
3. Would you rather always see the same person? Then a GP model suits you better than Telmed, because a fixed practice is your first point of contact there.
4. Do you use online doctors abroad? Basic health insurance generally does not pay these costs. Ask beforehand where the doctor is authorised.

You can see which health insurers offer which telemedicine plans in the health insurer profiles. The model finder helps you choose between standard, GP, HMO and Telmed. You report a change of model for the next year by 30 November; all dates are listed under Deadlines.

Common mistakes

• Doing something else after the telemedicine call. If you ignore the advice centre’s recommendation without checking back, you risk the health insurer not paying for the treatment.
• Thinking telemedicine is free. A medical consultation by video is a normal service with deductible and retention fee.
• Trying to bill online doctors abroad to basic health insurance. Except in an emergency abroad, the principle of territoriality applies.
• Confusing Telmed and telemedicine. You can use telemedicine in any model. You only get the discount if you choose a telemedicine model with a duty to call first.
• Comparing only the name of the model. In the group “Telmed and other models” in Zurich in 2026, with a CHF 2,500 deductible, there is CHF 173.30 per month between the cheapest and the most expensive offer.

How we calculate the premium examples is explained under How we calculate.