Flex model: several first points of contact
In the flex model you can choose between several first points of contact, for example your GP practice or a telemedicine service. You decide case by case where to start, but you must always go through one of these. In Zurich in 2027, the median monthly premium for adults with a CHF 300 deductible in the flex model was CHF 597.00, and CHF 677.00 in the standard model (median, FOPH data).
How the Flex model works
The FOPH describes the tariff type “FLEX” as a model with several first points of contact to choose from. It remains insurance with restricted choice of service provider (Art. 41 para. 4 KVG): you only go directly to a specialist with a referral or under an exception.
Up to 2026 the FOPH does not list flex tariffs as a separate type; they are included in the tariff type “HAM” (GP) or “DIV” (other models). From the 2027 premiums there is a separate tariff type “FLEX”.
Do not confuse them: “Flex hospital insurance” is supplementary insurance under the Insurance Contract Act, in which you choose the hospital ward before each admission. It has nothing to do with the flex model of basic health insurance.
What you pay compared with the standard model
Compared with the standard model of the same insurer, a tariff of this model is 11.0 to 15.8% cheaper on median (depending on city and deductible, premiums 2027).
| City | Standard (free choice of physicians) | GP/HMO | Telemedicine/digital | Flex |
|---|---|---|---|---|
| Zurich (ZH) | CHF 677.00 | CHF 598.42−11.6 % | CHF 597.05−11.8 % | CHF 597.00−11.8 % |
| Bern (BE) | CHF 699.75 | CHF 617.95−11.7 % | CHF 622.95−11.0 % | CHF 603.30−13.8 % |
| Lausanne (VD) | CHF 720.80 | CHF 637.60−11.5 % | CHF 639.00−11.3 % | CHF 624.30−13.4 % |
| Lugano (TI) | CHF 764.00 | CHF 684.40−10.4 % | CHF 689.55−9.7 % | CHF 687.45−10.0 % |
| City | Standard (free choice of physicians) | GP/HMO | Telemedicine/digital | Flex |
|---|---|---|---|---|
| Zurich (ZH) | CHF 549.75 | CHF 470.45−14.4 % | CHF 471.50−14.2 % | CHF 472.20−14.1 % |
| Bern (BE) | CHF 571.45 | CHF 490.10−14.2 % | CHF 494.60−13.4 % | CHF 475.00−16.9 % |
| Lausanne (VD) | CHF 592.50 | CHF 512.00−13.6 % | CHF 511.00−13.8 % | CHF 496.00−16.3 % |
| Lugano (TI) | CHF 635.70 | CHF 556.10−12.5 % | CHF 561.40−11.7 % | CHF 562.50−11.5 % |
Our own calculation: median of all tariffs per model in the city municipality (premium region 1), percentage compared with the median of the standard model. “Telemedicine and other models” is the FOPH tariff type “DIV” up to 2026; besides telemedicine it also includes other models. Source: FOPH, health insurance premiums 2027, as at 15.10.2026, opendata.swiss. Methodology: How we calculate.
What do I need to do before seeing a doctor?
Most insured people are in a model like this: in 2024, according to the FOPH, 79.8% of adults and 83.1% of children. If you do not know the rules, you risk your insurer not paying for a treatment.
Flex · Emergency
In an emergency you go straight to the nearest emergency department or call 144, without a referral and without calling first. Many tariffs require you to inform the first point of contact you chose afterwards within a deadline. How long that deadline is depends on the insurance conditions.
Important: The insurance conditions of your tariff are binding. You will find them in your policy or on your insurer’s website. The rule above describes what many tariffs provide, not your contract.
Legal basis: Art. 41 para. 4 KVG
Suits you if …
- you want to call one time and go to the practice another, depending on the complaint
- you travel a lot but want to keep a practice as a point of contact
Watch out for
- Even with several points of contact: without the required route, no costs are covered.
- Each insurer sets out which points of contact are allowed differently in its insurance conditions.
More in the glossary
Frequently asked questions
What is a flex model in basic health insurance?
An insurance model in which you choose between several first points of contact before each case, such as a GP practice or telemedicine. The FOPH lists it as a separate tariff type “FLEX” from the 2027 premiums.
How much cheaper is the flex model?
That depends on the insurer, where you live and your deductible. Since the 2027 premiums the FOPH lists flex tariffs as a separate tariff type “FLEX”, so the tables above show the median per city and deductible directly from FOPH data. Up to 2026 flex tariffs were included in “HAM” or “DIV” and could not be evaluated separately.
What happens if I do not follow the rules of the model?
If you see a doctor without following the required route, the insurer does not have to pay for that treatment (Art. 41 para. 4 KVG). Many insurance conditions also provide for exclusion from the model after repeated breaches. Emergencies are always exempt.
When can I change my model?
You can switch from the standard model to a model with restricted choice at any time. Returning to the standard model or switching to another model is only possible at the end of a calendar year; your notice must reach the insurer one month in advance, i.e. by 30 November (Art. 100 KVV, Art. 7 KVG).
Sources
- Federal Health Insurance Act (KVG), Art. 41Art. 41 KVGfedlex.admin.ch
- Health Insurance Ordinance (KVV), Art. 99–101aArt. 99–101a KVVfedlex.admin.ch
- FOPH: Health insurance, special types of insurancebag.admin.ch
- FOPH: health insurance premiums, opendata.swissopendata.swiss
- FOPH: Statistics on compulsory health insurance 2024, tables T 7.08 and T 7.09 (as at 22.05.2025)bag.admin.ch
Calculation based on the 2027 premiums approved by the FOPH, as at 15.10.2026, source: FOPH, health insurance premiums, opendata.swiss. Only the insurer’s quote or policy is binding. The model descriptions and rules are general information, not individual advice; your insurer’s insurance conditions are binding. Methodology: How we calculate.