Does any of the forum members have this insurance method ? Did you encounter any problems with it ?
On paper it looks very reasonable - but it's the real life experience that counts.
I was offered the option of Telmed - calling the 24hr helpline before visiting the doctor.
Are you referring to the option offered by Swica? That is the only one I am familiar with.
Thanks for your reply. It doesn't have to be by Swica - I beleive most Health insurance companies offer it (maybe under a different name)
My colleague uses Telmed it with SanSan and recommended it to me. To be honest, getting a doctor's appointment is difficult enough on the day I am ill and I didn't want to let someone else decide if I should see a doctor or not. My husband hasn't seen a doctor in 2 years and was still against having to call up a hotline before he could book to see a doctor.
I Have The Same With Groupe Mutuel, I Should Get In Touch These Days...i Will Let You Know... The Point For Me Is That I Have No Idea About Where To Go..as A Doctor I Mean.. Does Anyone Has A Good Doctor To Suggest ? (better If He Talks Some Italian...)
I always visit the HMO practice in Neustadt Passage in Zug. Look on www.doctor.ch for the closest one to you or your workplace.
Hello
Telmed is easy. You only need to phone and says : "I am sick. I have an appointment with my doctor."
Regards
Alexandre
We have Innova and use it. The service is called Medgate and is used by several swiss insurers. For us, it reduces our premium and it's fairly innocuous. I see my doctor at least every 3 or 4 months, am middle aged and have a few chronic issues. I'm from the US and have always had private insurance, to give you a sense of my perspective. Here, I feel like I have a lot of choice in what I do with my health care, too.
When we call Medgate, there are two choices... one is for medical advice (you're sick) and two is to announce an appointment.
For medical advice, a doctor usually calls back within an hour. If it's anything at all they always tell us to go to the doctor and usually give 3 doctor's appointments over the next three months for the same issue. If it's an emergency, you can call them within 3 days, and tell them you went. Also if you say that you think you really need to see your doctor, they tend to listen to that. And, they speak English.
For existing or recurrent conditions, or if my family doctor has recommended another physician, I make an appointment, call them and tell them I'd like to see the doctor for x and this is my appointment. They give me 3 appointments over the next quarter (ending March, June, October, December), and I can have more if I ask. If I had something really chronic, and had to go every week, it might be more inconvenient, but I don't know, and if I had a serious procedure or surgery I might not be so pleased. But so far, so good.
The advice that the doctor gives (and can give) is really very minimal. As an example for how this might work, if you have a urinary tract infection without fever or pain, and it's the first one you've had in a while, the doctor faxes a prescription for antibiotics to your chosen apothek, and then tells you to vist your doctor for a control in a week or so. If you have a recurrent UTI they tell you to go to the doctor right off the bat, so you learn to just make the appointment and tell them rather than request advice, that works just fine with them.
I used to have a Telmed option from Sansan and it worked exactly like AlexB said. Phone them up, tell the nurse you have a problem/are unwell, and they tell you to go see a doctor.
So far as I understand, the main motivations behind insurers setting up a Telmed system are:
1. To minimise the occurrence of people visiting doctors for trivial matters (e.g. toothaches, in which case you should visit the dentist!). (Note: people go to the doctor for teeth problems more than you'd think!)
2. To reduce the occurrence of people visiting the ER for non-emergency problems (e.g. my throat is really sore).
3. To ensure that patients visit a GP for initial consultations as opposed to making an appointment on their own to see a specialist, which is (a) expensive and (b) normally not necessary.
They will pretty much always advise you to seek medical treatment if you are ill, and if you have a chronic condition there are no problems with this. It's just that they try to control things a bit more to minimise the number of 'unnecessary' trips to the doctor's office or the ER.
Heather
I have a telmed system and have been really happy with it. The other thing that was pointed out to me by both the insurers, underlined in my policy and the one time i called the service is that I have to make the phone call but i do not have to follow the advice.
I checked when I registered that there would be somebody English speaking always available on the phone and they said yes.
When you choose Telmed and you call every time you have a problem, do they just tell you to see a general practitioner if the problem is serious or do they send you to a specialist? Is your choice of general practitioners or specialists limited in this case? Thanks.
I Telmed combined with free choice of doctors, so no need to go to a GP first.
I've both met and heard of GP's trying not to send one to a specialist in spite sound indications to do do.
I have Telmed with Group Mutuel. I can see anyone I like. I don't even have to call them before hand but they prefer it if I do (they said if I don't too often they won't want me as a client, but they'll still pay).
I wasn't impressed with the TELMED service. I thought it would be more than it was. I thought they'd actually give medical advice over the phone. I also thought they send you to a specific doctor.
I've only used them once but now that I know the limitation, it's perfect....just not what I expected.
Thanks for the responses in this thread - i have signed up to Telmed as it was the cheapest option at the time, but I havent used it yet and was worried as to my lack of fluent foreign languages...! But now I know they can speak english that is a weight off my mind.
Also, I havent gone so far as to register with a doctor yet, should the time come when i have to phone telmed - should i already be registered with someone or can i phone up any doctors surgery and request an appointment (registering with them at the same time?)
The HMO option is very good as you can always see the same doctor.
For me, Telmed was the second most premium/expensive option. I wanted to avoid having a list of doctors I could go to. With telmed you can (or at least I can) choose anyone I like which is excellent. The phone call before takes about 30 seconds - "I am sick, I need to go to a doctor" - "Thank you for informing us, I'll put a note on the system" But yeah, you rarely get someone who speaks English with my service.
Although I haven't subscribed to a Telmed option, I think my insurance is also associated with Medgate and we tried to call this number once but couldn't get through! Is that something to consider when going for this option?
We've not had problems getting connected, although if you're calling to announce an appointment (which is what we usually do), you now have to ask for an English speaking person, and that can take 5 minutes or so. Sometimes I have bumbled through in my bad German, but there are English speaking people, just may just have to ask. I find it's best to call them between 9-11 or 2-4, for non emergent situations.
For the doctor to call back, you may wait for a while if you call at night, and during flu season. In the US I used to direct the data folks in a nurse triage call center, and during cold and flu season people often had to wait for more than an hour for a return call - it's the nature of the beast.
I've had to call them when I had a respiratory infection, for example, but I always say that I have "X" some pre-existing condition (which is true), and they turf me off to my own doctor. Also if you have a fever, they don't really want to give much advice. You still have to wait for the doctor to call, and if it's taking too long, call them back.
But they're not real gatekeepers... I always make the appointment and then call them to announce the appointment. And in case of an emergency even they tell you to deal with it first, then call them.
If you have a chronic condition and need lots of appointments, they will open up a window at a facility. FOr example, I can see my oncologist as much as I like in 2011 without calling. Any other doctor in the same facility, all I need to do is to just call them and tell them I have an appointment and they'll give me 3 more in the same facility (doesn't matter which doctor, which I learned today).
For us, it saves a boatload of cash on our health insurance, and it's kept our premiums from rapid increases. And I think that different people have different peceptions about choice in health care - for me, I don't like the HMO or GP option because of the network restrictions. But I rely on my hausarzt and frauenartz for referrals, so what's the difference? Probably none.
I also think it's a good idea for everyone to have a primary care doc, no matter how young and healthy you are. It's sooo much easier to get into the system if you need future care. But then, that's my own experience talking, and my past career as a health care administrator.
But like everything, YMMV.
I read the literature but decided not to go for it.
However, based on the above posts it would seem to be a good solution for most people.