How much will these treatments cost?

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

I was looking at this thread explaining health insurance and the basic maths behind it:

https://www.englishforum.ch/insuranc...ne-choose.html

Very useful.

Essentially, other than choosing HMO, GP, and Telehelpline etc. it’s all about your excess. To figure out what excess I should choose, I need to figure out approximately how much my treatments will cost and so, I have the following questions I would really appreciate some answers to:

1) I would like to start seeing a therapist to talk some things over. I have never seen one before and also have no idea how much such visits/treatments would cost. Any idea what insurance approved therapists/psych charge in Zurich?

2) I would also like to get a full allergy test i.e. the one where they scratch your skin with a series of allergens to see which triggers a reaction. Was supposed to get this done in England but left before it was arranged. Got my epipen though thank God! Until this test is done and I have the results, I take antihistamines almost daily so that is another expense. I know how much the antihistamines cost because I have been buying them but have no idea what a doc would charge for the allergy test. The GP in England told me that it’s usually done in a hospital in case the patient reacts badly to one of the allergens and needs emergency treatment. This makes me think it is going to be expensive! Any ideas?

3) Someone I met mentioned something about the year you start an ongoing treatment and how that affects the excess and the rebate on treatment costs in following years. Something along the lines of if you start a treatment in 2017 but do not reach the excess that year, that treatments costs for that issue will not count towards the next years excess and you will continue to pay for those specific treatments yourself with no rebate. This seems a bit strange and unlikely to me but it was a Swiss national that told me this so thought I’d check with you guys.

4) What do you guys think of the HMO system? In fact, if it’s not too personal a question (and forgive me and ignore if it is), what treatment system have you opted for?

Thanks again guys, really appreciate it!

2
Hi Rick,

In general, if you have recurring health issues, going with a cheaper insurance provider with a low franchise/excess might be the best way as healthcare costs are in general rather high here.

A normal GP consultation here costs between 90-150 CHF in central Zürich, and if you're seeing specialists on the regular, you can expect to pay more (I see a specialist every month which costs 200-250 CHF).

1) Be careful with psychotherapists. While usually super helpful, if the therapist is not also an MD or overseen by a psychiatrist in the practice (who will then have to see you occasionally), insurance might not cover it (at least not the basic insurance -- supplemental might). Psychiatrists are covered, but depending on your issue, might not be helpful. Just something to keep in mind (that said, integrated psychiatrist/therapist practices do exist!).

2) Yikes. I have not had this done, but considering the price of other tests (last week 60 CHF for one-item blood test), this might be expensive. Your best bet might be to ask the receptionist beforehand to give you a ballpark estimate.

3) Yes, in my experience. The franchise/excess typically runs for the full year, and that's it. Also, it's not a franchise per ailment, but a general franchise. There might be exceptions to this however. Accidents are covered by a separate insurance (either paid by employer or if un/self-employed paid by yourself as an add-on to health insurance) with no franchise/excess.

4) I had a HMO insurance for years in another country, was definitely not fond of it. For someone who is occasionally sick, but otherwise healthy, it's probably fine to save costs. If, however, you end up going to the doctor often for chronic issues, being able to choose your doctor, go to a specialist without referral and just not worry about it might be worth it.

So to answer your question, I went with Assura with the lowest franchise/excess and free choice of doctor/no referral for specialists. I still pay less per month than many of my colleagues with the highest franchise and a fancier insurance provider!

But Assura is definitely a no-frills, low-cost provider (for example, the doctor sends the bill to you instead of them, and then Assura reimburses you). The customer service is hit and miss, but so far they've always reimbursed me everything they should have and on time, so I'm happy with them so far.

Hope that helps.

3

Can’t help with 1 and 2, but I wish you the best. I had allergy tests done when I was a kid - 103 different things tested for and in those days it wasn’t scratch the skin, it was inject under the skin. I looked like I’d been attacked by a hive of angry bees by the time I finished. Luckily not too allergic to anything and desensitizing worked for me.

  1. What you have is a yearly franchise which can be as low as 300 francs up to 2,500. You choose what you think is best, but if you go for the lower figures then your monthly premiums will be higher. What this means is that you pay directly for whatever your franchise is - so if you choose 300 you pay 300 francs worth of treatment before the insurance starts picking up the bulk of the cost. If you choose 2,500 then that’s what you pay before the insurance kicks in. Then there’s the quote-part where once your franchise is used up you then pay 10% of the next 7,000 francs worth of treatment, i.e. up to 700 a year. At the start of each year the franchise and quote-part go back to zero and you start again. If you use your franchise and quote-part up during the year then any further medical treatment covered by your insurance is free for the rest of that year - and yes you can actually have that happen if you have ongoing treatments that need expensive medications, regular tests and follow-ups with specialists. So choose your franchise carefully, saving on the premiums may not be the best choice if you’re going to need continuing treatment year on year. I don’t know how much antihistamines may cost, but as an example of expensive medication I know that Aubagio tablets for MS cost over 4,000 francs for a 3 month supply. Antihistamines won’t be anyway near that being more commonly prescribed, but you can see how it is possible to clock up the medical costs in some cases.

  2. We just went with the basic standard model and that works fine for us. We choose the doctor we want to be with and so far all the referrals they’ve made have been fine. We didn’t want a high franchise so opted for 500.

As amckayn said also check whether any insurer pays the bills directly or whether you have to pay first and then reclaim it from your insurer. Otherwise you could find yourself badly out of pocket if an emergency comes up that you have to pay for first and then reclaim back.

4
Thank you very much for the info and replies Amckayn and Medea Fleecestealer.

I guess it might be worth having the lower franchise and higher premiums since the monthly doc visits may actually equate to almost most of the monthly premiums.

Once again, your help is very much appreciated!

5
#2 son had the full allergy test done several years ago. I can't remember how much it was (and long enough to probably make it unhelpful if I could), but he had it done at the allergy specialist's office and not a hospital. He did have to lurk in the waiting room for a hour afterwards though in case of any serious reactions.... so take a book!

6
Go speak with your accountant to see if you can afford it or not

7
Just wondering, as I am a tad surprised. If you wanted those tests and therapy- would it not have been a good idea to have them in the UK (NHS) in your own language? Seems strange to come here with a list of treatments 'wished for' ...

even in Switzerland, insurance will not necessarily pay for your 'wishes' if there is no clinical reason for this.

8

They did say they were going to get it done in the UK, but left before it could be arranged.

9
And neither issue seems to be "immediate life threatening" ... so even if OP had tried to get things done before leaving, there's every chance the system didn't turn in time.

yes, the allergy thing is potentially risky....but in NHS-setting-priorities-think, taking a daily anti-histamine and having an epipen solves that

10
Example:

Franchise (excess) set at Fr. 300 per year.

2017

First bill in October 2017: Fr. 200. You pay it all.

Second bill in November 2017: Fr. 50. You pay it all.

No more bills in 2017. That's the end of the 2017 franchise. Books closed.

2018

First bill in January 2018: Fr. 200. You pay it all.

Second bill in February 2018: Fr. 100. You pay it all. That's the end of the 2017 franchise. Of course, the medical insurance can know this only if you make sure they received the bill (even though you have to cover the costs).

Third bill in July 2018: Fr. 300. You pay 10% of the bill = Fr. 30. This is called the Selbstbehalt.

Up till now, you have paid, in 2018: Fr. 300 Franchise, and Fr. 30 Selbstbehalt. Total so far Fr. 330.

Fourth bill in August 2018: Fr. 4000. You pay 10% of the bill = Fr. 400. This is Selbstbehalt.

Up till now, you have paid, in 2018: Fr. 300 Franchise, and Fr. 30 + Fr. 400 Selbstbehalt. Total so far Fr. 730.

Happily, the total costs of Franchise plus Selbstbehalt are limited to max. Fr. 1000 per year.

Fifth bill in September 2018: Fr. 3000. You would ordinarly pay 10% of the bill = Fr. 300, BUT your remaining maximum possible Selbstbehalt is Fr. 1000 - (Fr. 300 + Fr. 30 + Fr. 400) = Fr. 270. You pay only Fr. 270.

Sixth bill in October 2018: Fr. 54000. You pay nothing.

Seventh bill in November 2018: Fr. 2000. You pay nothing.

Sixth bill in December 2018: Fr. 75. You pay nothing.

That's the end of the 2018 Franchise and Selbstbehalt. Books closed.

Books open again on 01.01.2019, and your new Franchise is open again.

If you've filled up your Fr. 1000 by October, and you know that you also, on top of everything else, ought to drag yourself off to another doctor, then there is a financial incentive to get it done before the books close on 31.12. of that year.

The exceptions to this "you pay no more" are:

a) Treatments not covered by the basic insurance (typically alternative medicine concepts),

b) some types of psychotherapy, espcecially if done by a psychologist who happens not to work in conjunction with a psychiatrist (many use this arrangement, called "delegiert"), and

c) Fr. 15 per day hospitalised. This fee is charged for the "hotellerie", i.e. laundry and food which you would ordinarily have had to pay for yourself, had you been at home.

There is often some leeway on a) and b), in that part of the costs may be covered, for example only 75%, or limited to 8 sessions.

There is no exception to c). It is obligatory.

11
Regarding 2)

There are also blood tests available to test for allergy which are more accurate and also give no risk for adverse reaction. A good allergologist will always do either only blood or both.

12
I see only 2 options: either max franchise of CHF 2500 or min franchise of CHF 300. If the annual health cost are low then the max and when high then the max. You can also change this every year so if you in 1st year intend to consult therapists and make the tests you can take the lowest and when your situation changes, your allergies are treated and the health cost are low, change it to the maximum.

HMO gives normally 8-10% discount to the premiums. I initially did not have it as I wanted freely go to any specialist I wanted. Then I needed to see a dermatologist but would have got an appointment like 2 months later. I called my family doctor, told my problem and he arranged me an appointment for the following week at the same dermatologist. Exactly same thing with the gynecologist for a basic checkup; appointment in 3 months, I call my family doctor and he arranges the appointment for the following week. That was the moment I said that if anyway I need to go to the specialist via my family doctor then I want to profit of the discount and took HMO or CareMed as Sanitas calls it. Since I am generally healthy and typically my annual health costs are low, I have the maximum franchise of CHF 2500, with CareMed.

The HMO I think is a good thing for most of the situations. Sometimes I advice my clients to take Compact One where the clients must call the insurance companies medical team first before going to doctor (15% discount), or NetMed where the client has not 1 family doctor but a medical network with multiple family doctors and specialists. The best solution depends of various things like where does the client live, do they have children (how old, how many) and what kind of medical treatment the client typically needs and of course personal preferences.

PM me if you want to chat with me about these issues and I’ll give you my phone number. It costs nothing and you commit to nothing

13
Dear All,

Many thanks for (as usual) the very helpful replies! I have decided to take the 2.5k excess with the family doc/GP option.

Again, very grateful for the help