Quality Physical Education (QPE) is crucial, yet its delivery at the primary level is often challenged by generalist teachers’ inadequate preparedness, a deficit that collaborative tandem teaching can address. This study compared the perceived preparedness of 618 generalist teachers with varied tandem teaching experience in Slovakia and North Macedonia, examining differences linked to the structural model type. Data were collected via a questionnaire assessing self-perceived preparedness across 11 PE domains and the need for continuous professional development. A Chi-square test compared responses between the Slovakian model (rotational sports coaches, co-teaching 1 of 3 weekly lessons) and the North Macedonian model (consistent PE teachers, co-teaching all 3 weekly lessons). Generalist teachers in both countries reported overall high preparedness, but a significant deficiency was identified in working with children with diverse learning needs (p < 0.01). North Macedonian teachers, who experience a long-term partnership with a dedicated PE teacher in all weekly PE lessons, reported being significantly better prepared across most domains (e.g., selection of equipment, p = 0.000) than Slovakian teachers, who utilize short, rotational partnerships in 1 of 3 weekly lessons. The findings suggest that the structure of the tandem teaching model is a key factor in enhancing generalist teachers’ preparedness and professional growth in QPE.