Miffed About Health Care Finance

I don't completely understand the differences, although I suppose if you can, it's important to have a doctor who will refer you to other doctors. I asked my frauenarzt about this last year before i went in for surgery and she said that if you already had a doctor, or if you were referred to a specific doctor, you would be treated by that doctor regardless of your coverage.

I did read something on the hospital website that was consistent with what meloncollie said above, so that's why I asked. Also, when I was referred to my oncologist, I asked him if I would be treated any differently than a patient who had private or semi private and he told me that I would not.

I've not seen any difference in my treatment for breast cancer based on the fact that I had only the basic coverage, except that when I had surgery, I was in the 4-person room (though there were only two of us there). If I'd been hospitalized later on because of infection risk during chemo, I probably would have been in a private room (they really do have to isolate you).

I've probably incurred somewhere between CHF 50K and 75K in health care costs this year, of which I've paid CHF 300, plus CHF 700, and a few hundred more for the odd thing that's not covered, in addition to our premiums. A bone density test, a flu shot, weird stuff. Radiation alone was 18K, but I didn't pay for any of it. I guess it just depends on your illness, too - but more stuff was covered than in the US, and for less money. There was never a question about any of the drugs I received, some of which are rather pricey.

I've not had any trouble with my insurer either, and that's a big reason why I'm not switching, despite the fact that we're going to have at least a 10% increase in our premium once we move to Zurich. Maybe I'll change next year, I don't know. I know that all insurers have to offer the same coverage, but it seems that there are subtle differences in the "customer service/billing" component and I don't have a lot of patience for that crap, especially in German.

One big reason why I would not even consider living in Schwyz was the lack of specialists, although starting in 2012, the basic insurance does allow you to get coverage outside your canton.

Medicine found “too expensive” in Switzerland

Swissinfo EN

I'm freelance.

Yep, we really must change this year too. They are as you say, a horrible company.

Then I believe you pay for your own accident cover.

Oh, I know.

You still have the franchise though. With company provided accident insurance you pay no franchise.

I receive the bill, with 30 days to pay. Send the bill to the insurer, and the reimbursement is normally in my account before the payment leaves it.

This is under basic cover.

I'm also with Swica. Not the cheapest, but the service has been good for the last ten years. Changing to another insurer would save me a few tens of francs a month and given the stories here, not worth the hassle.

Exactly - this is how we operate with Innova. And their service has been good for the last 4 years, so I am reluctant to switch to save .

Hate to put a dampener on it but most insurance companies need you to give notice of termination three months in advance and that's just once a year, which means notice normally has to be given at the end of September otherwise you are stuck with it for another year.

Check your policy because there's a slim chance it could be different but most are like that.

You have to have send your new company and old company letters by the end of this month if you want to change.

I am saving 30chf per month by moving!

For the basic cover:

What they are citing here is Art. 7 Abs 1 of the Swiss "healthcare law", which gives you the right to change at some points during the year, but only if you have the standard model (no higher deductible etc.)

But when it comes to changing your insurer at the end of the year, Art. 7 Abs. 2 applies, which gives you the right to change your insurer up to the end of the month prior to the month at the end of which the change of the premium takes effect. (bad translation, I know)

This means that (almost*) everyone can cancel their contract until the end of november.

*you can not change if you haven't paid your premiums.

Make sure that the letter arrives before the 30th, as what counts is not the date you posted it, but the date it arrives (which has to be a working day).

So glad I'm not the only one having problems with insurance companies and medical billing. I don't remember who said it, but it's true... coming up with "scratch" is the problem. Most of my money still goes to pay off US debts rather than being set aside. It would be nice to live more like a Swiss person!

I had a nice discussion with my insurer this morning. 1500CHF in invoices vanished before my eyes... ahhhhh what a relief. It turned out that I had gotten bad advice from the previous contact I had at the insurer who told me to pay everything and then get reimbursed. The person I talked to today just told me to send her a scanned copy of everything and that they would pay them all and then bill me for my excess (10%).

So now the rest of the medical debt is suddenly more manageable. Makes me wonder if I shouldn't lower my deductable for next year though.

My monthly premium is a bit high (something over 400chf) BUT I have lowest possible deductible on my basic cover. My hubby has more of a premium cover but with higher deductible, so his monthly premium comes out about the same as mine.

We did get into trouble this year though when he had to see a doctor about (possibly) torn minuscus and his bills started climbing. So, "Swiss" way to set aside money or not, not every Swiss person lives this way (oh, how I wish ) - getting a sudden bill of 1000chf is a bit of a choker.

I'm seriously in favor of paying (slightly) higher amount monthly, even as it adds up and maybe makes you wonder at the rationale, rather than having to face sudden expenses that set you back.

I'm considering a zero deductable if it keeps my monthly premium still within manageable limits. If I'm paying 100CHF in Rx per month and my premium only increases 100CHF then it might be worth it!

Why don't you "self insure" the deductable? Divide it by 12 and put this money aside every month. Then at the end of the year if you haven't claimed ... kerching!

In principle yes, but watch out!!!

Lets say, you play football, as you try to reach the ball - you twist your ankle.

Accident, right?

No.

They called it nowadays "normal movement of a body" and therefore its not an accident; it is Illness! If however, there would be a molehill that stopped your "normal movement" - then it is an accident. tricky, hey!

A friend of mine stud up to rash, high blood pressure kicks in, dizzy, end of story:Hospital with head injury - Illness and not accident as the reason was his blood pressure that caused the dizziness.

Lesson learned: You better get your story right!

BTW, if you employed, it doesn't matter it at work or home. It's the NBU and BU that pays for it anyway - (Nichtbetriebsunfall [at home] or Betriebsunfall [at work]). If you self employed (or without job/ or house wife), then add the accident insurance on your health insurance. For me at CSS it's 12.50 per month. As self employed 142.- per year, NBU and BU - but without salary coverage (Taggeld).

Deductible: I stay with the 300.- For me the lower premium isn't so much cheaper. If I go only once a year to the doctor, its paid already. And as old grizzled you can bet on it

Pregnancy: CSS paid everything, no 10% ether for child birth (KS Luzern).

Even with a complicated delivery (Previa totalis). Child care for the first days by IV. 100% coverage (we then just moved back to CH/2010).

No complaints on the CSS, for us here in Aargau the cheapest. Fast payment and the 300.- they charge during the year part wise, so your first bill isn't all yours! My premium ends up (male, fifties/2012) at 242.-

As it goes for the medical bills, outraged. Back in the Caribbean, a French or Dutch doctor charges for a consultancy USD 25.- without insurance / Free with insurance! If you ask about your swollen finger AND your furuncle then it's 50.- / fair enough.

Here, my son has a broken belly button, 4minutes by the doctor (2 hours in waiting room), result, he is with 2 years too young for surgery; bill = 250.-

2 pages bill, the best one is the paragraph children below years +10.- per minute!

As it goes for private insurance or not, I warned my mother, not to use her private coverage in a hospital at Zurich. Well, she did not listen.

In my experience from Zug (Baar) and Luzern, you better stay general. Have your doctor treat you as private, but stay general? Why?

The same nurses cover both floors. 60 patience in general and 8 in private.

5 nurses, Guess where they are all time? Where the majority of the work is!

So if you ring, they will be there in minutes, no one will be there in the private station, you can ring 30 minutes and more. Same goes for food, general gets it first (warm), private late (cold). So, you have been warned

which is totally separate from health (illness) cover. You need to be insured for both a/ illness b/ accidents. Adding 'accident' cover to your health insurance is actually a very reasonable 'add-on' apart 30CHF in our case I think. Just not worth being without.

From AngloInfo website:

Health insurance

All residents of Switzerland regardless of their age are subject to the health insurance law (KVG in German). Under this legislation everyone has to take out obligatory health insurance for basic medical treatment, drugs and cover for inpatient treatment in a general hospital ward.

Citizens of other countries who remain in Switzerland for more than three months or settle there are also subject to this condition. Health insurance must be taken out within three months of entering Switzerland; newborn babies also need to be insured within this period.

All health insurers provide the same benefits under the obligatory insurance plans, but not for the same premiums, so it is recommended to compare the premiums offered and change insurance if necessary.

Those requiring more than just basic treatment will need to take out supplementary insurance to cover the cost, for example for a private ward or for dental treatment, both of which, in contrast to some other countries, are not covered by obligatory insurance.

Accident insurance

Employers are obliged to insure their employees against occupational and non-occupational accidents. Employers pay the premuims for occupational accidents; employees pay those (maximum two percent of their wages) for non-occupational accidents. Children and individuals who are not gainfully employed can get accident cover included in their health insurance or take out separate accident insurance

I find it all very confusing.

If you have what I would call an "accident" -- e.g. you fall down the side of a mountain while skiing and tear your ACL -- then it should be an accident, right?

But as we have just learned, in CH, this is actually an "illness". Even if you have accident insurance through your employer (as required) your employer will deny that it was an accident because they don't want to pay for it and have to report that one of their employees had an accident!

At least that's how I understand it.

So no... you're actually sick from lack of drinking real Swiss milk, and your weak cartilage gave out causing you to lose balance and fall out of your bindings. But it makes sense. Why should the employer pay for an off-work accident? But it's still an accident, not an illness.

or is it an illness not an accident?

How is this classified? And who pays? I'm still confused.

Sorry for not limiting my quote, but the interface is slow on an iPhone.

Anyway, your example, while it may well have gone down that way, is inaccurate. I also twisted my ankle while doing sports, and it was covered 100% by my accident insurance.

Your employer doesn't pay, your work accident insurance (that both you and your employer pay for) pays.

I have hurt myself skiing, SUVA paid.

Hurt myself on my motorcycle, SUVA paid.

Tom