According to my therapist, that's not allowed either. But as Melloncollie pointed out, the higher prices listed would suggest otherwise.
Could be a kantonal thing. I'll ask him to clarify at my next appointment.
We thought we had a very solid insurance coverage. We opted for every member of our family to have their free choice of doctor, worldwide coverage for medical treatment abroad, and private accident insurance. All within the same insurance company. Two children under the age of 18.
As mentioned earlier, daughter tore her ACL and had the reconstruction done in the U.S. We communicated back and forth with our Swiss insurance agency and their emergency department dealing with cases abroad. We were asked to have a prescription from the US doctor for the PT done before and after the operation. We got that and I sent the prescription, which prescribed PT for one year 2-3 times a week depending on her progress. She had about 3 sessions in the US before we returned home. We wrote the insurance that we would like to continue her PT once we returned to Switzerland, but were going to try and keep the doctor in the US since he was the one who operated on her.
The doctors in the US stressed to us how important it is for her to do her PT exercises and to find a competent physical therapist right away. The physical therapy afterwards was vital for her recovery. Once we arrived back to Switzerland I called several PTs in the area and were told it would be a month before she would be able to get in. As she is a member of a Swiss national team, we were able to get into a place in about 10 days after arrival. She went 2 times a week for about 30-45 min depending on what the physical therapist recommended.
Last week I got a call from the hospital saying that the insurance would not cover the costs of her physical therapy, as the prescription was from a US doctor. I need a Swiss doctor's prescription. I called the insurance agency to get it clarified and was told that if she was going to have PT in Switzerland, she would have to have a prescription from a Swiss doctor. I was confused, as I thought I paid for a plan that allowed us free choice of a doctor. She has private accident insurance, and this surgery was a result of an accident, she should be considered private. I was told no. She is only considered private worldwide but not in Switzerland. Correct me if I am wrong but I thought Switzerland was part of the world too? Apparently not. As she is a student, physical therapy costs, in Switzerland, come from basic health insurance coverage and the other supplementary insurances she has, do not apply, so I am told. I asked to get this in writing, and they refused. They just sent back the bill stating I am responsible of the costs. Does anybody know the rules?
She had an appointment with a Swiss doctor today and he prescribed PT. He said he was not allowed to back date a prescription. So now we have to cover 3.5 months of PT bills out of pocket.
I wrote to the emergency center several times telling them what our plans were. Not one person mentioned anything about having to have a Swiss doctor's prescription, if she wanted to continue PT in Switzerland. If she continued her PT in the US, it would, of course, be covered.
Is this common knowledge?
I write this in hopes that someone doesn't make the same mistake. Beware.
I don’t know if your daughter has been seen by the Sports Clinic in the Hirslanden https://www.sportclinic.ch/de/661/Hi…Standort=19246
I found Dr Borovac very helpful and open.
Yes, I think it is common knowledge. The idea that a doctor from one country would have any authority to prescribe treatments in another country just doesn't gel, for me. At least, across the various countries in which I've lived and travelled, and people in my immediate circle, I can't think of an instance where this would have worked, not even when - as in your daughter's case - a part of the treatment was started in one country and then continued in another.
Certainly, specifically for Switzerland, as far as I've seen it, the authority always rests with the doctor working in Switzerland , and reports from doctors from abroad are at worst largely ignored by treating doctors or hold no value with insurers, and at best are noted as relevant for insurers covering only emergency treatment abroad and are sometimes welcomed by the locally treating doctors as a potentially useful part of the information they will regard when making their own decisions and prescriptions .
I'm very sorry you've experienced this misunderstanding, and that it's going to cost you quite a lot. Thank you for having taken the time to write your post to warn others not to make the same mistake.
And here's hoping that your daughter makes a full recovery!
Thank you so much for your insight, and well wishes. You always explain things so well.
I guess I just thought that it is normal after this type of operation to receive PT, and the insurance wouldn't question it, especially since we have all these supplementary insurances on top of it. It did not make sense to me that I would have to make an appointment with another doctor just to get a prescription, when the insurance company already requested and approved the prescription in the US. I thought it to be a waste of a doctor's visit. My mistake. But that does not change the fact that she needed to have physical therapy after this type of operation (it is done that way here in Switzerland as well), and the company is aware of it, but still wants me to pay the bill. I thought of it like medicine. Surely if you are on heart pills and lost your pills while on vacation, you could get your prescription refilled without having to go through a complete evaluation of your heart to confirm you do have a heart problem and require these pills. You could just get a prescription from a doctor (based on your doctors prescription) and that's it.
To make an appointment, get x-rays, and the works just to get a prescription seems like a waste of money. Live and learn.
And the explanation that global coverage excludes Switzerland to me is ridiculous . The policy states "accident insurance for global private cover supplementary to compulsory health or accident insurance, free choice of doctor and hospital, one-bedroom and first-class additional accident benefits". For those benefits to stop as soon as she returns to Switzerland to me seems absurd.