Health Insurance - first 3 months...once again

Finance, Taxes, Banking, Insurance and Retirement
1
Keeping in mind how much questions have been already stated here about, I need to start the new topic, to get the final question.

case:

I have came in August. At the beginning obviously I ve managed all the things with registration and started to look for health insurance. Meanwhile I ve of course got a letter wich had remind me about this obligation etc.

From the very beginning, I have had valid EHIC card.

In October I chose the insurance, applied for it with a coverage starting from 1st of November (so exactly after 3 months).

Here come the question - what with 3 first months (August, September, October)? Answer seems to be obvious, as it has been thousand times stated - the insurance is backdated and I should pay for 3 months as well.

...but...

(and here comes the real questions

- where exactly it is stated (I mean some legal statements whch said, that I am supposed to pay back for the insurance which covers me (according to the agreement which I have personally signed) from 1st November)

- on the forum I have already read some stories where it is mentioned "someone suggested me not to pay those backdated part" etc. are there any success-stories on that?

- does EHIC card makes here any difference?

- (the best part) what if my insurance company has issued for me backdated-bill only for October (so 1 month back, not 3), should I stand up and say that I will pay for all 3 months?

- any ideas why they did so?

- what if I will not pay the backdated part of the bill? any user-stories on that?

Thank you very much in advance for any help with this case and any input!

2
EHIC has nothing to do with this- once you are registered here as resident. We found out the hard way that insurance is back dated to date of arrival, by Law- even if, as we did, you arrive on the 29th of the month, will be back dated to the first of any month you arrived. Had we known, we would have moved on the 1st of the next month

I really do not think you have the choice about not paying from first month. We here have all had to pay from day 1 of month of arrival- some might have got lucky, but it is the Law.

3

No EHIC card makes no difference. Once you become resident here all insurances become invalid. If you were here as a tourist and had a medical emergency the EHIC would cover you, assuming you hadn’t taken out travel insurance in the first place. But the EHIC wouldn’t cover doctor’s visits, etc, it’s only for emergencies. Once you’re resident here the EHIC from your home country is invalid, though you should get a new EHIC card with your Swiss cover.

As soon as you become a resident by registering with your commune/gemeinde you’re supposed to have mandatory Swiss health insurance so if you registered in August the insurance should be backdated to then. One of the reasons they do so is if you had need of a doctor/hospital before you got your insurance sorted out you could make a back claim to cover the costs. Say you had to see a doctor in September - with no medical cover you would have to pay his bill yourself, but could claim it back once your insurance cover kicks in.

If you’re now landed with a big bill for 3 months that’s your fault. If you’d sorted it out quickly it would have been easier on your pocket.

4
Re-reading your post, if the insurance has backdated only one month- as long as you were truthful about your arrival in August (which does seem bizarre- but they make mistakes too)- then pay for October. But... if the authorities find out later that you deliberately cheated the system by false declaration (eg that you arrived in October)- then please, do not come complaining if you get fines, etc.

It is a bit unfair to ask EF members who have done what is legally required and paid for it- to condone you not doing so, isn't it?

5

Well if you have BUPA international which is not acceptable (childbirth not covered for men), you can ask for an exemption, go through a few appeals & not get back dated. I was here for 6 years before getting health insurance, however it was not a requirement for the first 4 years. It's moving to Zurich city that caused the problem, Urdorf accepted BUPA as they did not wish to argue in English .

6
Well, I do not believe that we are talking about BUPA International in this case, are we?

7
You can perfectly start your insurance 3 months after your arrival (arrival date is mentioned on your residence card). If you directly go to an insurance company office they use to start the insurance on first day of your arrival. If you get insured through an insurance broker (except those working for Groupe Mutuel) they can start your insurance as your choice after four or even five months after your arrival. I work as insurance broker.

8
This sounds like your employer (broker) claims openly and explicitly to help bypassing the law. We know how that ended with the banks.

I think yours is a bogus claim and in all likelihood you're a liar. Who's your employer?

9
Helvetia67- would you care to clarify how you justify this, as it is clearly illegal. Insurance has to be taken within 3 months of arrival, and back dated to the first day of the month of arrival. I am sure you know this perfectly well. Insurance premiums are always calculated on a montly, not daily basis. hence the advice often given here not to arrive and register at the end of a month, as you have to pay for whole month.

10
And apparently in the habit of dodgy dealings. And it would be the client, not you, I suspect, who would get into big trouble over this.

Who do you work for anyway? Just so we can make sure to avoid using them, you understand.

11
Ursmax, Oldie and others. I confirm what I said. There is a agreement between the 64 swiss health insurers. For new residents they agree to start the insurance up to 6 months after the arrival (the arrival is the first day of residence. This date is mentioned on the back of the residence card). It's a sort of "tolerance" for new residents who contract the compulsory insurance trough a broker (or even trough a agent working for the insurance company). As I said situation is different if the new resident directly go to the insurance office. In an insurance office all the insurers would ask to start the insurance on first day of residence.

What I say is only what I know and according my experience. I have insured plenty of new residents to plenty of insurers in my professional life. No one has been insured back to the date of arrival. No one !

For a new resident insurance contract we (we = the brokers or the insurance agents, or the insurers) need to enclose copy of the residence permit. I repeat, on the back of the residence permit the date of arrival is mentioned. The insurance company perfectly see it. And accept to start the insurance up to 6 months after the first day of residence ! I know than only Groupe Mutuel doesn't agree for this. They agree to start the insurance no longuer than 3 months after the arrival (even if they have signed the agreement of the 6 months mentioned hereabove).

In all the cantons are a state health insurance service. They warm the new residents to get an insurance within 3 months. Few weeks (even months!) after the 3 months deadline they use to send a letter to the new resident saying he/she need to show them the proof he is insured. The proof is the insurance policy. They perfectly see than new residents often start their health insurance up to 6 months after the arrival. And nothing else happens.

It's not illegal to start an health insurance few months after the first day of residence. All the 64 swiss health insurers agree for it. The cantonal health insurance services are accepting this situation.

Regards

12
All the official state documents re insurance contradict you. Legally it should make no difference if you go through broker or not. To be honest, this annoys me so much that I shall investigate after Christmas, via 'Bon à Savoir' and 'FRC' legal departments (both Romandie Consumer associations) and a relative in the business.

We were clealy told from all sides we had to be insured from 1st day of month of arrival, and although we arrived on a 29th, had to pay from 1st. The Law is no different for brokers or individuals. My niece organised our Insurance, and she has been working for one of the main insurers for 30+ years- I am sure she would have told us if we could get away for not paying from beginning of month of arrival... and not for months either. The law is the same for all- vraiment.

Could you post a link here showing that the Law does not apply to brokers? Merci. Just find me and post the evidence here.

13
"All the official state documents re insurance contradict you". I... agree. The health insurance law says than resident people must be insured for health. It's means than people must be insured for health immediatly when they become residents. At the first day of residence. But because it takes time for to receive the residence card the law says than the must apply for an health insurance within 3 months. The insurance normally need to start at the first day of arrival (the day of residence in fact).

There is no different law for individuals and brokers (or agents or insurance companies).

But the fact is : 1) if you go to an insurance company office they would ask to start your insurance from the first day of your arrival. 2) if you apply for insurance trough a broker you are often able to start your insurance few months after your first month of residence. 3) the insurance company do what he wants. If they want to start the insurance on the first month of residence (according to the Law and according to the date mentioned on the residence card) they can do it. But they don't do it... The cantonal health insurance services do also what they want. When they see than the health insurance starts 3 or 4 or 5 months after the begining of the residence statut they can say NO. But they never say no if the insurance starts within 6 months...

Interesting information : If the new resident has serious (and costly) medical problems within 6 months after he becomes a resident - but he is still not insured - he can ask to the insurer he wants to start the insurance back to the first day of residence. The same even if he has started his insurance few months after he became a resident.

14
We started making arrangements right away - we arrived August. However it took the agent AGES to sort it all out and it was supposed to start on 1st September but it was well into November before they approved everything (dental for the kids blah blah) and we managed to get it started from 1st October so a month less than we thought....we had been putting 1000CHF away each month as we anticipated paying from the get go but we got a little lucky break. All above board as far as I know.....big company and direct with them so....

15
Evidence please, not blabla (to Hevetia67- show me the Law which states this).

MaybeeSkint, you should have been paying for August too, month of arrival. Insurance should have been in place for basic insurance, and other complimentaries/dental, etc, added later, as they are totally separate anyhow. It does seem unfair that people applying via big companies get preferential treatment in this way, same with pre-exisiting conditions, etc, which are accepted if insured via big company (big clients, big money) or for individuals.

Later edit.

From the official Swiss Government website:

The Law:

832.10

Loi fédérale sur l'assurance-maladie

(LAMal)

du 18 mars 1994 (Etat le 1er mars 2014)

L'Assemblée fédérale de la Confédération suisse,

vu l'art. 34bis de la constitution 1 , 2 vu le message du Conseil fédéral du 6 novembre 1991 3 ,

The Law, part 2:

Titre 2 Assurance obligatoire des soins

Chapitre 1 Obligation de s'assurer

Section 1 Dispositions générales

Art. 3 Personnes tenues de s'assurer

1 Toute personne domiciliée en Suisse doit s'assurer pour les soins en cas de maladie, ou être assurée par son représentant légal, dans les trois mois qui suivent sa prise de domicile ou sa naissance en Suisse.

Translation- each person resident in Switzerland has to insure themselves for health care in case of illness, within 3 months of taking up residence, or birth in Switzerland.

Later edit: and here is the official link about back-dating. Same applies to a baby born at the end of a month, insurance is payable from start of month of birth. so if you are having an elective ceasarian for triples, ask for a beginning of month date

05. My child was born at the end of the month. I registered in Switzerland in the middle of the month. Is the insurer entitled/obliged to charge a premium for the whole month?Yes. Although this question is not explicitly mentioned in the law, it is important to note that premiums for compulsory health insurance are not calculated on a daily but exclusively on a monthly basis and that, in addition, these premiums are payable in advance. Premiums thus have to be paid for the whole month.

06. Within which period do I have to take out insurance, and what are the consequences of delayed registration?You have to take out health insurance within three months of the beginning of compulsory insurance (e.g. of the date you take up residence or give birth to a child in Switzerland). The insurance is then back-dated to the beginning of compulsory insurance. Since expenses are reimbursed retroactively, consequently it is mandatory to pay the premiums retroactively from the beginning of coverage on.

16

Is that to me?!!!

17
There is no law wich states than health insurers and the cantonal health insurance services agree for to start the health insurance within 6 months with no retroactive effect. Just the experience and the facts. It happens like I said ) Let's maybe wait here for testimonials of new residents. You will be surprised I guess )

18
We arrived 25th August. We got on with it right away. We contacted 2 different insurers right away and got the same replies - do YOU work for insurance because it seems like you know more than the people who claim to i.e. Helvetica1967, the man in the Zurich office here and the woman at my current insurer....

19
So what you're saying, basically, is that you can get away with it.

Yes, I agree. I wasn't aware of these things, and didn't take out health insurance for two years after I was first here.

But as a broker, advising clients to take advantage of a lack of sufficient controls is a very different thing.

20
We didn't pay for the month we arrived either. ( son and myself as OH was already living here.)

We registered on October 28th, filled out all the forms for the health insurance during our first week here but we only started paying from December 1st. We got ours directly from the insurer so no broker involved.