On November 20, the Federal Council adopted modifications to the health insurance ordinance (OAMal). One will concern some of the policyholders. Those who have chosen as an option, in the basic insurance, the free choice of doctor and pharmacy.
This is the most expensive model. If, in 2011, half of the insured opted for a free choice of doctor, the high amount of the premium and the other options introduced by the funds, less expensive, but with more or less significant restrictions on choice, have changed the situation. . According to figures from 2021, that year there were only one in four policyholders with such a contract.
On the other hand, as with all other models, once the option is chosen, it is impossible to change it until the following year. From January 1, 2025, this will change. People with a free choice of doctor can opt at any time during the year for a more restrictive but less expensive model, provided they stay with the same insurer. “This modification is particularly suitable for policyholders whose financial means have evolved and who seek to reduce the cost of their premiums,” justifies the Federal Council.
Another modification of the OAMal, when packages have been negotiated by pricing partners for certain outpatient treatments, laboratory analyzes can now be included in these packages and will no longer be billed separately.
Finally, insurers will be required to communicate to the cantons the amount of compensation payments in the event of a voluntary reduction in reserves.
