At the mercy of the system... Changing Cantons and continued treatment

Finance, Taxes, Banking, Insurance and Retirement
1
Has anyone out there had experience in moving to a different canton and not being able to continue treatment in the old canton?

Long story short, I moved cantons and had to switch house doctors. The new house doctor refuses to write the referral to continue treatment (for which I need a procedure every 1 to 2 weeks) with the diagnosing/treating doctor. The new doctor feels as though he can do better himself, and referred to writing the referral letter to continue treatment as an "insurance scam." All I want is continuity of care and I'm really happy with the doctor in the old canton. Obviously I can't make any policy changes until the new year and my experience with the insurance company has been horrible thus far, which compounds my frustration.

Anyone have any tips or just wants to vent with similar experiences?

I'm beyond frustrated.

2
Are you on a managed care type insurance policy?

3
meloncollie has hit it spot on. If you have bought medical insurance that is "managed care" or "HMO", then you will be paying lower premiums, but the restriction is that yes, you do need a referral from your new GP (= house doctor), ALWAYS.

However, if you don't have that restriction (and are paying the full premium), you can go straight to the diagnosing/treating doctor (and any other doctor you choose), yourself, without a referral.

One other thing to check with your medical insurance is that you have bought coverage for all cantons.

4
Or just change doctor?

5
We changed from canton Zurich to schaffhausen and kept the same doctor in canton Zurich. No problems with on going care needs.

6

Yes, this is the problem. As when I moved here I wasn't fully informed about the system and followed the guidance of family members who insisted on a particular insurance scheme and it was not fully what I wanted. I am now paying the consequences. A while after I signed up, I got diagnosed with something that requires treatment and am stuck with the "house doctor" model (since that was what was advised), as my old house doctor wrote the referral for the treatment. Now that I have changed Cantons, I can no longer see the diagnosing and treating doctor in the old Canton, since the new house doctor thinks that writing the referral to continue treatment is an insurance scam.

I understand the insurance restrictions - I'm just frustrated and I don't understand how continuing treatment with a diagnosing/treating doctor is an insurance scam? And, more so how an insurance company can dictate one's health care. I've had horrible experiences with doctors and the insurance here and I finally found a Dr. who can help and I actually like - only to have it taken away because I moved my home.

7
Can I ask who your insurance company is?

8
@watericeair

I'd suggest that you change the type of insurance you buy. Very soon is the Magic Date by which you can give notice to your medical insurance company. It happens only once a year. Sorry, I'm not sure by when you have to act, but hope someone else here will tell you.

If you choose this route, you have to be 100% sure that they do, in fact, receive the notice. The formal way to do it is by Registered Letter (in an envelope, registered at the post office, costs about Fr. 6 in addition to the Fr. 1 stamp) and you must keep your copy of that letter AND the receipt of the registered mail transaction at the post office. After you've sent it off, send a mail to the person in charge of you, or your area, and ask for confirmation that they have received it. Print out their confirmation mail and keep it with your letter. That may seem over the top, but there are many tales of woe of people who THOUGHT that they had given notice, but whose medical insurance said they were still "theirs" and kept billing them (and chasing them for payment). It is not easy to just walk away, so make doubly sure you get it right from the start, and in writing.

Since you know you'll be needing treatment, in your case I'd advise insuring OUTSIDE of a HMO /managed care model, called "Freie Arztwahl" (= free choice of doctors) so you do not have to have permission from your Hausarzt, and also "ganze Schweiz" (= for the whole of Switzerland).

That doesn't solve your current problem, I realise that, but it will probably give you a lot more freedom from 01. January 2016 (if your termination notice goes through correctly and on time).

There is, in fact, no solution through your current Hausarzt. He doesn't want to refer because he doesn't believe in it, and he also doesn't have to refer. After all, that's how the insurance company keeps its costs down (and can offer those apparently discount premiums). That's that. Sorry.

For the rest of 2015, you can either:

a) continue to go to the diagnosing doctor but pay the full costs yourself (ask him/her how high they would be), or

b) find a different Hausarzt in your canton. To do this, you might have to pay the costs of the first appointment yourself, since your current Hausarzt will not refer you there, either. Be sure to ask, though, before you leap, how the new doctor deals with referrals.

9
How can I change my insurance plan?

Basic insurance: You can adjust the plan and the franchise every year on 1 January. Please inform us in writing of the change by 30 November.

Bolding done by me.

From here

Recommendation: Do everything by registered mail.

10
I just wanted to say thank you to those who provided the helpful information above, and just listening to me vent. I got caught up in the moving process and forgot to say "thank you."

I did try to switch my insurance models but was denied coverage by the other companies, so I was "forced" to stay with my current provider... I'm now just trying to figure out the best in making it work.

Doesn't ease the frustration and feeling of losing control over my own health, but like everything living in a foreign land, I just have to figure it out, accept it and adapt the best I can!

11
One problem I have found is that even if you have standard model insurance that in theory allows you to go to any doctor you want... It still is only valid with in your canton (unless you have supplementary insurance which not everyone can get). You can go to a doctor in another canton, but they'll only cover the cost of what it costs in your canton. Changing insurance companies or insurance models won't change this.

12
Unless the treatment is deemed essential by your doctor, and NOT available in your current Kanton of residence.

13
yep. enter back at square 1.