His doctor urges him to change health insurance

In his apartment in Bienne, Gérald Nicolet has been doubtful since a phone call from his family doctor after work: “As he no longer wanted to spend his weekends doing paperwork to meet the requirements of certain insurers, he recommended that I change insurance,” he summarizes.

“I want to spend more time with my patients and less on paperwork,” his GP told him. According to this practitioner, the administrative burden imposed on medical practices concerns one insurance in particular, whose premiums are among the lowest: Assura.

“Surprised, I asked him very clearly what would happen if I decided to stay at Assura and if I could continue to be followed by his office,” explains Gérald Nicolet. His observation: “I understood from our exchange that this would become problematic.”

His feelings were confirmed in a document where the firm explains that the administrative burden caused by health insurance companies which are not partners of mediX bern continues to increase. It was indicated that from 2027, certain requests from these insurers, in particular confirmations of coverage, will no longer be processed.

The medical practice frequented by Gérald Nicolet recommends that its patients switch to a family doctor model with a mediX bern partner fund this fall in order to reduce the administrative burden weighing on doctors.

“Where does this leave us, the insured?”, asks Gérald Nicolet, sensitive to the approach of his general practitioner. “We choose a fund based on the premiums, the deductible and the model offered. And now, should we also change insurers to be able to keep our family doctor?”, he asks.

In other words: “Are we creating a system in which doctors indirectly select the insurances with which their patients must be affiliated?”, asks the insured person from Bienne.

Through its spokesperson Karin Devalte, Assura immediately points out that “controlling healthcare providers’ invoices is one of the fundamental missions of health insurers”. This control allows, at the Swiss level, a saving of around 10% of costs which, otherwise, “would be borne by the premiums of the insured”.

With greater control, does Assura generate more administrative work than other insurances? Response from its spokesperson: “We apply the same control procedures to all doctors.” In other words: “We do not apply additional or different procedures for doctors from mediX or other networks”.

Do doctors indirectly select the insurance companies with which their patients should be affiliated? “The law on health insurance provides that everyone is free to choose their health insurer,” recalls Karin Devalte, communications manager at Assura.

“Doctors do not have the right to dictate a choice to their patient,” assures Karin Devalte. At Assura, free choice of family doctor is possible in all basic insurance models, with the exception of telemedicine and care network models.

Gérald Nicolet made his choice: he canceled his basic insurance with Assura to switch to Helsana, a mediX partner, saving 143 € on his monthly premium in the process: “I wasn’t going to change doctors, the same one I’ve always had!”