Family doctor, HMO or telemedicine?
An alternative model cuts the premium in exchange for one constraint: going through an entry point before any specialist consultation. The reimbursed benefits, meanwhile, do not change one bit.
The standard model
Free choice of doctor, specialists included, with no gatekeeper. It is the most expensive model and, by far, the least chosen today.
The family doctor
You name a primary-care doctor from a list. They become your entry point: every specialist consultation goes through them first, except emergencies and — depending on the insurer — gynaecology and ophthalmology.
This is the most widespread model. The constraint is light if you already have a GP — provided they appear on your chosen insurer’s list.
The HMO practice
You commit to consulting within a network of group practices. The premium cut is usually the largest of the three, but you do not choose your doctor within the practice, and the network has to exist near you.
Telemedicine
You call a medical advice centre before any consultation. They direct you, and sometimes treat you remotely. The constraint is light and the saving real, but the call is compulsory: skipping it can cost you the reimbursement.
What to check before signing
- Is the required doctor or network reachable from where you live?
- Which exceptions does the insurer accept without a prior contact?
- What happens if you consult directly: refusal to reimburse, or a mere warning?
Sophie’s guides
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- Is psychotherapy covered?
- Are medicines covered?
- Is an ambulance covered?
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