An alternative insurance model to suit your needs

Pharmacy, telemedicine or family doctor: you decide! Discover the only basic health insurance in Switzerland that actively promotes health prevention and rewards your choices by offering attractive premium discounts and not charging the deductible on certain benefits.

Your benefits

  • Flexible choice of first point of contact for health issues (pharmacy, telemedicine, or your family doctor).
  • Selected services with no deductible (e.g., generic medications, breast cancer screening).
  • Save up to 24% on your premiums.

Exclusive services

Breast cancer screening

With PrimaFlex, you can benefit from breast cancer screening with no deductible.

  • Contactez notre partenaire de télémédecine au 0800 852 852.
  • Vous bénéficiez d’un entretien-conseil et de recommandations d’examen(s) à effectuer si nécessaire et ce, quel que soit votre âge ou votre canton de domicile.
  • Vous êtes libre de choisir si vous souhaitez effectuer les examens recommandés.

Services from our partner pharmacies

You can have a consultation free of charge in our partner pharmacies if the pharmacist considers this advisable.

  • Detailed discussion and selected diagnostic investigations (e.g., an ear test).
  • Diabetes testing to determine your personal risk.
  • Cardiovascular testing to assess your risk of cardiovascular disease.

How the PrimaFlex model works

Benefits covered under the KVG/LAMal

  • In Switzerland: Throughout Switzerland, the costs of a hospital stay in the general ward of a listed hospital are covered up to the amount of the tariff in the insured person’s canton of residence.
  • Outside Switzerland: In the event of an emergency in the EU/EFTA/UK on presentation of the insurance card: The costs of hospitalization are covered up to the amount that the visited country would have paid for its residents. Outside of the EU/EFTA/UK, the costs of hospitalization are covered up to 90%of what the treatment would have cost in the canton of residence in Switzerland.

The costs of medications prescribed by a doctor and listed in the List of Medicines with Tariff (ALT/LMT) and the Specialties List (SL/LS) are covered.

Complementary medical treatments practiced by a recognized doctor (acupuncture, homeopathy, phytotherapy, traditional Chinese medicine, anthroposophic medicine) are covered.

Medically prescribed spa treatments in Switzerland are reimbursed at CHF 10/day for a maximum of 21 days per calendar year.

For children up to the age of 18, the costs of glasses or lenses are reimbursed up to CHF 180/calendar year. For adults, between CHF 180 and CHF 630 per eye is covered for certain conditions only (as per the List of Products and Items MiGeL).

External and removable devices (e.g., crutches, wigs, hearing aids, etc.) are covered as per the List of Aids and Objects MiGeL).

Standard pregnancy: 7 check-ups and 2 ultrasounds during pregnancy; delivery at home, in a birthing center or hospital and one check-up after the birth are covered.

High-risk pregnancy (as determined by a doctor): All necessary check-ups and ultrasounds are covered.

Lump sum of CHF 150 for antenatal classes offered by a hospital or midwife.

The following are covered:

  • Investigations for the early detection of diseases (e.g., breast cancer screening) in certain risk groups or through cantonal screening programs in accordance with the KVG/LAMal.
  • Recommended vaccinations and vaccinations administered to groups at increased risk of complications or exposure to certain diseases.
  • Nutritional advice and courses as per the special cases under the KVG/LAMal.
  • Gynecological check-ups: one examination/calendar year in the first two years, then one examination every 3 years.

Costs are covered for conditions of the masticatory system and dental accidents that are treated by a dentist.

Transportation costs are covered at 50% up to a maximum of CHF 500/calendar year.
Rescue costs are covered at 50% up to a maximum of CHF 5,000/calendar year (in Switzerland only).

Services provided by recognized psychologists/psychotherapists are covered when medically prescribed.

Outpatient treatment is covered as per the KVG/LAMal (e.g., doctor’s visits):

  • In Switzerland: 100%
  • Outside Switzerland: In the event of an emergency in the EU/EFTA/UK and on presentation of the insurance card, the costs are covered up to the amount that the country in which the person is located would have paid for its residents. Outside the EU/EFTA/UK, the costs are covered up to twice the treatment cost in the canton of residence in Switzerland.

Ask for advice

Do you have any questions about PrimaFlex? Our specialist advisers are here to help.

Frequently asked questions

This model is an alternative to the standard model of basic insurance. You will receive the same benefits as under the standard model of basic health insurance but will pay a lower premium. In exchange, in the event of a health problem, you undertake to choose a prior approach that suits you best according to your situation:

  • contact our telemedicine partner on 0800 852 852 for an advice session
  • visit one of our partner pharmacies for an advice session
  • consult your family doctor directly if you wish, provided you have given us the doctor’s details beforehand.

If you choose to receive advice from our telemedicine partner or in a pharmacy, you will now be free to decide, after having received the advice, on the next steps of your medical treatment during the time window defined by the telemedicine partner or partner pharmacy.

And if you choose to consult your family doctor directly and he refers you to a specialist, you must ask the doctor to issue a brief certificate, also called a "referral voucher" (a simple signed note is sufficient, mentioning the type of specialist recommended and the period of validity of the certificate). You can then send it to us by post or via your online Customer Area (if you prefer, you can also ask your doctor if he agrees to send it directly to us).

Yes, you are exempted from contacting one of the above-mentioned first points of contact in certain special cases (e.g. in case of emergency or for consultations with a gynaecologist, ophthalmologist, etc.). The list of special cases can be found in your special terms and conditions of insurance.

No, you are free to buy your prescription drugs at the pharmacy of your choice (even if it is not a PrimaFlex partner).

See all FAQs
Groupe Mutuel

Rue des Cèdres 5 Case postale, 1919 Martigny    |    +41 0848.803.111