They communicate in writing in English and have been flexible and helpful when required.
I've used them for 15 years and have had no issues.
We have the telmed model - no complaints. To be clear, we have the telmed version where you do not have to follow the advice, but you have to call for new appointments.
First question - no. You are only covered for emergencies in EU countries.
Second question - usually it’s canton specific I believe, but may depend on the model of cover you choose. For this I’m talking general coverage. If you have an emergency and are admitted to hospital in Vaud for example you should be covered. But visiting a doctor or specialist in Vaud probably not, unless you get permission from your insurer.
Actually, you have it backwards. For non-emergency hospitalization outside your kanton of residence, you have to have permission from your insurer. In many cases, if the service is less expensive outside your kanton, it might not even be a problem. If more expensive, you could be asked to pay the difference. If it's a service not available in your kanton of residence, you can go outside, no problem.
Outpatient procedures, visits to doctors are generally covered outside your kanton. For example, my oncologist and gynecologist are both in Bern and I live in Zurich. I get my mammogram and bone density in Bern. No problem with coverage. I have only basic.
But, like everything else, check and make sure, inform your isurerer.
Thanks. I ́m checking but it seems to be only one type of TELMED. I will ask the guy from Nacora.
Favorit telemed is the one we have
Only 280?
How did you find it?
I am trying to look for an affordable health insurance. Comparis.ch gives me SWICA which is at 303.
I looked up KPT CPT, it was 345
Check out the date of that post. Although many prices don't move that much in Switzerland, health insurance certainly does.
Oops. thanks.
I am a bit disappointed by SWICA Lausanne. I am new but have been here since Oct 9. I went to their office in Dec and they said they were busy. They kept my information on a paper with detailed notes of my needs and promised to call me back. Still nothing today...
Should I go to them again?
their damn phone is always going to auto-voice message....
You're talking about swica FAVOURITE TELMED.
I wonder, if this model allows you to visit a specialist without consulting a GP first? Such important info should be hidden in small print, but so far I haven't found any.
It only says "free choice of doctors" for favourite telmed, however it doesn't say whether under term "doctor" it's meant a specialist or a GP.
Any doctor, specialist included. I continue to see my oncologist in Bern without referral from my GP, and I made an appointment with an orthopedic surgeon in Winterthur last year. He did my knee replacement four weeks ago.
As far as SWICA is concerned, as long as i inform them of the appointment, they are fine. However some physicians require referral from another physician independent of insurance.
Also, if you have an issue requiring repeated appointments, SWICA (and other insurers with telmed models) may open a “window” for that issue so that during the year, all appointments for the same issue at the same facility are permitted. So everything involving my left knee at kantonal Spital Winterthur is allowed in 2018. It’s easy enough to call, however.
Great, so direct visits of specialists are included as well (for comparison: Helsana's telmed with free choice of doctors apparently excludes direct visits of specialists. If you do this, you breach the contract and they assign you to standard model).
Huh. Did not know that. Thanks.
I didn't notice anyone mentioning a key aspect in the question - if you are arriving new to Switzerland, it is probably the best option to take the insurer of your husband's company, especially if you consider complementary insurance.
Most of the insurers will request you to fill in a medical questionnaire and based on it, they will exclude from complementary coverage your current issues / potential issues or even they will simply refuse you a complementary insurance which is quite useful (dental is the most important in my opinion). There is high probability that your husband's company I assume quite big multinational) has a special contract with SWICA according to which any new hire from abroad gets a full coverage without exceptions for him(her)self and his/her family.
I suggest you check this aspect before taking any decision.
Btw. I am with SWICA for 2 years and never had special issues. I am rather satisfied. My company had contracts with CSS and Groupe Mutuel before and both were top as well. I believe that you get also a slightly different service level if you are under a company contract and you have a dedicated/separated Customer Service team.
That’s assuming it’s your husband with the big company job, and the company is contracted to offer complimentary plans. Neither is always the case.
My husband works for one of the kantonal universities, so no company contract.
Helsana's premed24 is in the same tier as swica's favorite telmed.
and then under FAQ section for PREMED-24 model:
THE DETAILS.
Actually no, I am wrong. Apparently you can go directly to specialist, but have to call the first, as in all telemed models.
I have given up with SWICA as seemingly every time we have needed anything, it has been problem after problem to deal with even everyday requests.
Even dealing with the boss - it’s always terrible. Nice guy but just ineffective.
The final straw is a claim for 300chf - a Neighbour is completely accepting full fault - and but SWICA are putting us in the position to claim 120chf of this amount from the 3rd parties insurance, despite this not being an excess or anything. They tell us it’s normal. But having paid a decent lump to insure the family each month I expect them to claim back this and deal with the paperwork for me - well they are for 180chf so what’s the difference? Has anyone experienced that? Is that even correct?
So moved to Sanitas and already we are seeing the benefit - they are now paying for 50% of a hospital upgrade to full private for a birth, something SWICA don’t do. So the insurance has paid for itself for the next couple of years.
Thanks Sanitas
Adios to disorganized SWICA
Uh... huh.
Why would your health insurance pay at all for something where your neighbor is at fault? Are you talking about an optional accident insurance or something?
In no case will an insurance company make claims on your behalf to another insurer. In Switzerland, you’re expected to take responsibility for yourself.
I’ve been a happy Swica customer for twelve years. No complaints, and not anything like disorganized (which adjective, by the way, doesn’t actually apply as you’ve told the story). I suspect you just haven’t understood your contracts.
Maybe I was not explaining very well - true.
The Neighbour admitted full fault, provided their insurance info for a small claim, Swica are now invoicing us 120chf and telling us we must claim that back from the 3rd party/their insurance.
It took Swica 1 entire year to pay my dentist for their work. He was not too impressed either.
I was with them a long time too - paying premiums happily - till I needed anything that worked.
I disagree. With a car accident for instance insurers usually deal directly with one another, the drivers don't need to deal with the other's insurance at all.