Availability of appointments

Finance, Taxes, Banking, Insurance and Retirement
1
Hi folk,

I am choosing health insurance at the moment, and some of the supplementary options (typically in the hospital part) offer "fast track appointments" or "up to 5 day appointments" and things like that.

From your experience, how impactful is that?

In other words, let us assume I do NOT take that, and use the regular, non fast, track. How long would I typically wait for an appointment?

Alternatively, those of you who did take something like this, how quickly do you get appointments?

I am talking mainly about outpatient or day treatments, not just meeting a specialist. For example: MRI, colonoscopy, knee surgery, Mirena, etc.

2
I don't think you would wait very long for any of those in normal times. I don't think I ever waited longer than a week or so to see a specialist & that was with basic insurance. It's depends of the diary of your selected surgeon assuming you are choosing if you are having an operation.

3
Obviously it would depend where you live, but for an MRI, I've never had to wait more than a day or two.

4
I’ve never waited more than a couple of days for appointments for any of the above.

Edited to add: Yes I did have to wait a couple of weeks for a PET/CT scan that needed some exotic radioactive fluid that had a a half-life of just a few hours. But in the end everything worked like (Swiss) clockwork. I doubt that could have been expedited by throwing money at it.

5
It depends.

My experience is that emergencies are handled quickly. Routine things can take quite some time. Urgent but not emergency, all over the ball park.

Much depends where you live. Urban areas are better served with health care providers so one likely can get seen sooner than in exurban or rural areas where there are fewer providers.

So with that said, here are my experiences in the Höfe area, where, based on your other threads, you might end up.

Be aware that there is a shortage of GPs who are taking new patients. Get on the books with anyone you can, even if you have to go a bit farther afield, then later start looking for someone who best meets your individual criteria.

FYI, I was told that closing the practice to new patients is one way that GPs are trying to provide care in a timely manner.

To see my GP, who only works part time (which is becoming more common among GPs these days), the worst wait was 6 weeks. On the other hand, I have been able to get a same day appointment in an urgent situation. My typical wait to see the GP is two weeks.

I go to a group practice which has some of the 'bells and whistles' in house - but the things you list are generally provided by specialist practices in this area.

There are private imaging centers in Pfäffikon SZ and in Einsiedeln where MRIs are done. (Einsiedeln hospital does not have MRI capability, not sure about Lachen or Schwyz.) You would need a GP referral, but once you have that my experience has been that appointments at both imaging centers can be made quickly, usually within a week.

A routine screening colonoscopy is likely a 4-6 months wait. Again, seeing a gastroenterologist usually requires a GP referral.

An urgent colonoscopy/gastroendoscopy can be done at either local hospital, wait times will depend on the degree of urgency. There are also a couple of private Gastro practices.

I am currently waiting for a 'semi-urgent' appointment. I had decided to have it done out here because I don't fancy trekking into Zürich Unispital right now. It was recommended that I have it done within 'a few weeks' but it's now been six weeks, still waiting for the appointment letter from the gastroenterologist. I don't know if the delay is due to the specialist's schedule or because my GP has not yet done the paperwork.

Speaking of Unispital, where more complicated things are referred, my experience wiht outpatient consultations: After being referred by the GP, I waited one month to receive the appointment letter from the hospital, another month for the appointment itself, a third month for the report to get back to my GP. Again, urgent but not emergency.

BC, or any visit to the gynecologist: Here is where the shortage is evident. Again, go with any gynecologist who has open books. A female gynecologist who is willing to consult in English and is open to new patients can be tough to find. Routine gyne appointments, non pregnancy related, take 4-6 months; typically I make next year's screening appointment when I am leaving this year's.

Pregnancy related appointment are altogether different and take priority. You can generally be seen quickly.

Non-routine urgent apppointments are generally available quickly, although your gynecologist might send you to the hospital instead due to availability.

Knee surgery... no idea. Be aware that kee surgery, and others typically done outpatient elsewhere are more often done inpatient here. A friend recently had knee surgery done - 3 days in the hospital followed by 10 days in a rehab clinic.

This however likely is changing as costs rise, there is more and more discussion of surgeries now done inpatient moving to outpatient.

Although everyone likes to think differently, I have seen private insurance make a difference in the speed with which you get a specialist appointment. I once got an appointment unexpectedly quickly - only to be called back and told that there was a mix-up, given that I only have basic insurance the wait would be longer. Only one anecdote, make of that what you will.

I only have basic insurance because I had a prexisting condition when we moved here, I didn't qualify for supplemental insurance. If you qualify I would strongly recommend getting it.

As with everything in Switzerland, YMMV.

6
In Basel I've never had to wait more than about a couple of weeks, except like someone else for a PET scan which was comparatively a shambles. To me (from the UK) this is quick. If you're worried about something though it might not be quick enough.

Supplementary insurance can also get you private room, 'better'food and access to senior doctors rather than a university student (not that the senior doctors necessarily know more)

Screening colonoscopies are not at all urgent but if you need one because of unusual symptoms again in Basel about two weeks.

Next day MRIs are unusual unless you have a known serious pre-existing condition or it's an emergency or you live in an area where no-one else is sick and all the medical staff are sitting around doing nothing.

7
If the doctors think it's an emergency, you will not wait long.

You will wait long if they just want to check something, and that can be unnerving.

But I also never heard of these insurances types and wonder how much the hospital's would care.

K

8
Thank you everyone for your replies!

Which location?

Where?

Thank you very much for the detailed response.

Is there an option to opt to outpatient where possible? Honestly I do not like staying in hospitals unless strictly necessary, so unless my life is at risk or I require specialised on going treatment, I would likely prefer outpatient.

So you believe that private hospital insurance (or is just supplementary enouch) is beneficial for getting appointments faster or more easily even when not related to inpatient treatment, correct?

Thank regarding the recommendation to look for doctors soon, that's a good point, I will get on with that.

Also, let's say I am in Hofe, can I get treatments in Zurich, or does it have to be Hofe?

Why do you say that you strongly recommend supplementary insurance? Do you mean only regular suplementary or also hospital cover? What did you experience that in your opinion could be different?

I am comparing to a private insurance in the UK, which was usually very quick, but also very picky about what they cover and what not. When I was covered it was usually a few days wait at most. When I was not, I was effed.

9
In my case I’ve had treatments near to Nyon and across the border in Geneva.

10
In over 35 years I’ve had one treatment that the insurance didn’t cover on the basic. They didn’t cover it on the supplemental either.

11
I imagine that would be up to your doctors to decide. Also whether the hospital has the flexibility to do so. (Asking for things to be done a different way is often a hiding to nowhere. You can, and should, ask, but be prepared for 'No'.)

From my own experience of having a gallbladder removed - an operation that is largely done outpatient in the US, done and dusted in a few hours - I was shocked when the doctor said to plan for 5 days in the hospital. I told him this was outpatient in the US, and his head almost exploded. I bargained him down to two days in the hospital, which ended up being almost three because there was no doctor available to sign me out.

And. at least at the little local hospital, never plan an operation on a Friday. There is only a skeleton staff over weekends, chances are you won't see a doctor, so the chance of being released on a weekend is small.

But as in my earlier post, there have been rumblings about moving more procedures to outpatient in order to cut costs. So who knows what will become the norm in the future.

I wouldn't necessarily say that, as I don't have private insurance myself. All I have is the one anecdote of being told my insurance type meant a longer wait. Is that the norm? Who knows.

Yes you can. The thing that most governs who I can see is my GP's willingness to make a referral. I have traditional insurance, meaning theoretically I don't need a GP recommendation from an insurance standpoint. But in reality, most of the specialists I have seen will not see a self-referred patient. It's a matter of managing their schedules, they want to make sure that you actualy have a problem worthy of their time - and that's a GP referral.

Some insurance plans require referrals within a defined network. But even when you don't have that type of plan often one's GP has a sort of a loose network of colleagues who have a relationship with the practice, those are the people you might get sent to first.

For me the issue is access to a level of care that I have not been able to get with basic insurance. And that argely centers around diagnosis expertise, not treatment once a diagnosis is made. As Landers mentioned, at the hospital technically private insurance gets you seen by the Chefarzt, semi-private by the Oberarzt, and basic insurance by junior doctors. That has indeed been my experience at the local hospitals - but if you read around this topic in the forum you will find that other posters have been able to see someone more senior even with basic insurance. As you will get sick of hearing as you settle in here, YMMV.

One get around has been to pay privately, outside the insurance system, if you can't access the level of care needed through basic. That might be a financially better move, as private insurance is expensive. A few decades of unused private premiums will likely be more than the 5, 10, or 20K you'd need to shell out yourself if you go private on your own.

If the motivation for private is simply a private room, at Einsiedeln this is relatively inexpensive. CHF 200 per night on the general ward floor, CHF 400 per night on the private floor. Does not change your access to care, though. But then, most of your hospital care is provided by the nurses (and thank doG for them!), not doctors.

Each hospital handles upgrades differently, as I understand it. For instance, I believe that at Unispital you have to upgrade the whole kit and caboodle, which comes with a hefty price tag.

There is also a flex option with most insurers, where you pay a smaller premium to give you the option of upgrading a hospital stay. You will pay something out of pocket for that stay, but the amount is fixed. Last time I looked, many years ago, the out of pocket additional expense with this flex upgrade options was something like 4K.

The best argument for getting private now is that the likelihood of qualifying later in life diminishes quickly. If you can get it now, I would. YMMV.

I may have my gripes with the Swiss medical system, but cost is not one of them. But then, I'm an American, used to paying outrageous amounts. At least here medical bankruptcy is not really a thing. Thank doG.

Good luck wading through all the choices and learning to navigate the system.

12
The waiting times I've experienced in Basel have been minimal compared to the UK. If I email my gynaecologist I get an appointment within 10-14 days, the examination is comprehensive and includes smear, any bloods she might want to take to send to the lab, a scan and breast check. I've been referred for 2 minor procedures by her that were done in hospital within a fortnight.

Last December I had a mammogram appointment within a week of contacting the hospital and the result 5 days later. I would usually wait up to 6 weeks for the result back in Scotland.

I needed to see an ENT specialist in 2017 due to a hearing problem with both ears, went to Medix Toujours on the Monday evening, they sent a referral letter out, I had a phonecall from a clinic the following day and an appointment for a hearing test on the Thursday morning.

13
That is in line with standard healthcare in CH in my experience over 20 years of residence

14
Getting a mammogram result quickly is very important for me as I've had BC 14 years ago. When I've had to wait 6 weeks I've been a nervous wreck.

My sister retired to Scotland after 10 years in Saudi, a couple of years back she had to have a bone spur removed from the side of her big toe as it was affecting her being able to walk properly. The NHS refused to do it saying it was like a bunion, cosmetic (and I can assure you bunions aren't as I have one on my left foot). She had to pay upwards of 3.5k to have it done privately at a Spire hospital in Edinburgh by a Consultant from our local NHS hospital. She kept paying NI the entire time she was working in Saudi and couldn't access the NHS when she needed it. As she's single with no children she had worked without a break since 1969. However, as an example, had she been very fat she would have been offered bariatric surgery!

15
The wine at Bethesda is awful and expensive. It's not worth the extra.

I've had three non-urgent MRIs - one next day, two within two days. In Basel. When it was an emergency, both MRI and CAT within about four hours! (I'm fine now, thanks for asking)

16
A lot will depends on local conditions. My son has basic insurance and he recently had a doctors appointment at 3:00pm, where he was told he needed an MRI. The hospital called the next morning and he had it the day after.

On the other had a colleague had been paying for private insurance for years and it was only when he was admitted to his local hospital he discovered they don’t offer private rooms!

17
I see. Thank you everyone. It seems that the overwhelming experience is that even without hospital insurance treatment is fairly quick.

18
I've also not heard of appointments being expedited because of private insurance... but it may be the case.

Here's my advice about the extras (called "Zusatzversicherungen" in German):

First, find out whether any pre-exiting conditions you might have would exclude you from any of these extras, and if so, from which of them.

Second, find out what each module would cost you.

Third, if you can afford the extras (and granted, many people cannot!), buy them all, at least to start with.

They include such modules as: Free choice of doctors (no obligation on your part, to see your/their GP first). Free choice of treatment in all cantons. Private (as opposed to "general" and "semi-private"). Medications not on the standard medication list. Alternative therapies. Options for prevention. Options for long-term care. Option for legal assistance due to matters of health. Medical insurance while travelling. Repatriation. Lump sums in case of disability or death.

Of those, for ease of life in Switzerland, and more especially if you might be living rurally, I'd say those first two are important.

Then, once you've settled in, and found your way around, and met several doctors, as you meet more people and as you receive your first medical bills, you will come to understand, more and more, what the differences are.

I say this because many newcomers are uncertain about this aspect. This forum is a good place to learn, but it will, in the end, be up to your particular set of circumstances. I've seen others working hard, researching many aspects of their new lives in Switzerland thoroughly, and then suddenly realising that they could take this particular pressure off their shoulders by settling it immediately, with a certain sum (being the cost of these extras, for the first insurance period). Then this item can be postponed, pushed further down on the busy list, and leave room for researching something else.

Once you've been here for a while, and if you then decide that you don't want to spend the extra, it is very easy to cancel any part of the bundle at the end of the calendar year.

You might also find something useful in this thread:

https://www.englishforum.ch/insuranc...insurance.html

19
You always have hospital insurance as part of the basic insurance.

You just don't have access to a private room and unlimited treatment options without supplementary insurance (semi-private or private room while in hospital.

As previously stated some hospitals can't give you a private room.

Some hospitals (like Triemlispital in Zürich) provide semi-private rooms to the basically insured as they no longer have wards with more than 2 patients per room. (upgrading to private is approx 1000CHF per day).

I also have a personal semi-private coverage anecdote being instrumental in me getting a diagnosis I needed PDQ at the time. YMMV.

20
This is an interesting approach to take, which resonates.

I plan to do this with supplementary insurance in general, the only part I am unsure about is the private hospital. Because if I count both myself and my wife, this ends up being nearly 450 CHF per month extra cost on top of everything else (totalling medical at around 1,600 CHF per month for both).

That's quite expensive. My private medical in the UK cost a lot less than that.

With the alternative being a flexi model, where I can decide if I want private ward or not and cost a small fraction of that.

But I understand what you are saying. If I take it now, worst case I lose an annual cost of insurance. If I don't take it now, I probably won't be able to take it later as I don't qualify for supplementary and now I am exempt from a questionarrie for my first insurance.