Why is your health insurance involved? And what are the 120 CHF for, is that a deductible and if so what for/by which party?
That sounds very much like 3rd party insurance case.
I've also been with Swica for over 10 years, no problems with them at all, including very minor surgeries and a more major one.
They've never messed up anything.
We have had major issues with Swica this year. First year with a major claim but impossible to get a clear response on what is covered. Spoke with multiple people who gave different responses. 3 people promised to phone back with the answer to whether a particular piece of equipment was covered but no-one did. When we managed to get through to the same person, they insisted they had responded and we were lying.
Eventually we had confirmation that all care was been covered under accident insurance, for which we have full private worldwide coverage. On day of operation, we were informed it was only covered on basic insurance. We tried without success to get this clarified in writing on at least 8 separate occasions.
Months later, we still get invoices from them, sometimes multiple in a month. These are confusing (eg bill of 400 split into 245 on one insurance, the remainder on another, 15% deductible). It seems the bill for the surgery itself has still not been settled. It is going to be near impossible to work out if correct amount is reimbursed.
The way invoices have been dealt with is annoying but no more than this. It means we are more likely to move to CSS, where we find the online system more user-friendly and people actually seem to respond to enquiries within 48 hours. However, the main reason we will change insurance is the attitude of the staff at a stressful time.
For Basel, I would recommend CSS over Swica (no experience with other companies)
I am considering to change to SWICA from next year, do you need to pay invoices in advance? I did not find this information
No. Swica pays, sends you an invoice for the deductable.
If you have not used your deductable, Swica pays, then sends you the bill.
ie, you only have to pay swica.
That entirely depends on the doctor's contract with swica.
Some doctors can send the bill directly to the insurance and it works as you described. Some can't and they send the bill to the patient.
After nearly 6 years dealing with Swiss health insurance companies as a doctor and subsequently in pharma I can say it's all swings and roundabouts really - none really stands out. Swica do tend to be more focused on prevention than the other companies so, as someone already mentioned, if you're keen on the gym it may save you a few hundred CHF.
But it‘s useful to know that you usually can send in the doctor‘s bill for reimbursement and get the money back from Swica in about 2-3 weeks so you can pay the bill on time.
We‘ve had Swica for two years. I like that they do everything in English and they‘ve paid everything expected. I had a knee replaced in February and once I paid my franchise and chf 700, i pay pretty much nothing the rest of the year - except for insurance.
I had viva care before this and one thing I liked better with viva care was more informative statements and Bills. I know I can ask Swica for more detail, i‘m Just lazy.
Other than that, I have no complaints.
The preventive stuff though..... that’s only if you have supplemental, right?
I'm with swica for about 5 years now. Very easy, smooth and yes: Efficient.
I don't understand what you mean by more informative statements and bills? The bill comes from the doctor, if they bill swica directly they (the doctor) send you a copy of the bill. Those things are usually very, very detailed. LOL. If they don't do that, you should demand it (and make them take note that you want this all the time). This is normal procedure, you're not asking for anything special.
And what do you mean by statements? As they expect your doctor to provide you with the copy of the bill they only state who billed them when, how much for, how much franchise you got left to pay and the 10% deduction up to yearly 700.00 = the amount they pay or want from you. That's normal. I don't remember having it differently done by other KKs.
You’re talking about the Statement from the doctor. Rückforderung or something. That’s detailed, although if SWICA processes it first what I get is not very detailed.
This year, I had many bills from Winterthur kantonal Spital - preop, surgery, hospital stay, post surgical and physical therapy for both knees. Everything was paid ... and in fact yes, I paid my franchise (chf 300) and the 10% of 7000 (chf 700) so everything else is covered, no problem.
I would like to know what the bills are for - I have no idea which one was pre op or Physio, and how the hospital stay/surgery breaks down. Perhaps it‘s professional curiosity as I used to work in a hospital. But also, i‘d Like to know what I‘m being charged for even if I owe 0. and of course maybe there are errors.
I thought visana was more detailed but maybe I just had more Rückforderung.
The current package of healthcare cost reforms being discussed in parliament will likely include a new law that detailed, easily understood summaries of costs are provided by the insurance company. The idea is that everyone sees and appreciates the eye watering cost of it all. Not sure it’ll make much of a difference here but could be revolutionary in the British NHS.
That's exactly what I said: A copy of the bill that goes to the insurance must be sent to you (how else could you control it, find major errors). If the supplier of the medical care (who ever, hospital, doctor, physiotherapist) does not send you that double, they're in the wrong.
However, with me and my medics it works that way, so I have all the details and there is no need for swica to list them all again.
Well then, Swica is doing it wrong. I get copies of bills that Swica paid. Included on the bill is the doctor responsible for arranging for the service, the date of service and the amount charged. Also included is how much Swica paid and what I owe. No further details. I assure you, this is all I see. So I can guess at the service based on date but sometimes I have had multiple services on the same day. I don‘t know what is included in the bill.
All my hospital encounters as well as my preop and postoperative visit to my Hausärztin are presented in this manner. On one hand, the cost is so reasonable - Less than chf10k for 4 days in hospital, one new knee is quite reasonable. On the other hand, I am curious.
We have the same with Group Mutuel, it infuriates me as I’d to know how much each thing cost. There is no detailed breakdown at all.
They will provide copies of the bills if you ask for them but they don’t routinely send them.
I was with Assura but I see that for 2019 their premium is not much cheaper anymore.
Do SWICA have a good English speaking TELMED line? I cannot find much information about it. But I'm not satisfied with the English speaking doctor in my area either. His attitude is 'I can speak some English when I have to'. I don't know how to find a good GP anyway.
I‘ve had good experiences with the Swica telmed line. Good English, all very polite and helpful. I also have a good GP. In both Belp and Winterthur, i picked the nearest gp practice to my house and lucked out. Got good GPs in both cases. Dumb luck. But I also ask all my doctors if they are comfortable speaking English and most are.
I decided to reply, in case this could be relevant to anyone else.
The doctors from SWICA Sante 24 line (aka TELMED) speak perfect English. They are professional and I was always more than happy after the talks to them (well, except for one case when they rushed me in panic, and another case when they strictly told me off for not dialing them correctly).
The general - central - helpline is perfect in English as well.
But please beware that for some of questions you can be forwarded to the local office. Also, all your requests via contact form online will be sent there as well. I am attached to Lausanne office and it is worse than horrible. They speak no English, and none of my requests that were sent online has been ever responded (I was eventually calling the helpline, sometimes it happened after waiting for several weeks for their response).
Hopefully, if the person is attached to a local office in the German canton, then it is way better.
Hi everyone! It's the end of November and insurances are a hot topic so I started digging more into it and the more I read, the more confused I am
I just switched my basic health insurance to SWICA. Never had any serious disease (knocking on wood) but I start thinking that as I am getting older it makes sense to buy some additional coverage next year. And here is my confusion:
Let's say I have basic insurance only (franchise 2500 CHF) and in 5 years I get a very serious disease (like cancer) that requires lots of medicaments and treatments. Do I pay everything until 2500 CHF, and then 10% of everything above? Or such things are not covered by a basic insurance at all?
The confusion comes from the fact that my agent offered me additional insurance Completa TOP to cover things that are not covered in the basic insurance. But this insurance only comes into action when the franchise will be already used. So even if I had to get treatments that are covered by this insurance, they will be firstly covered from 2500 CHF above.
And here we come to the moment of enlightment in my 8 years in Switzerland, as my whole life here I was sure that whatever happens to me, I need to pay my franchise and then everything above that is necessary will be covered by the basic insurance if the doctor will prescribe it.
I would be grateful for some insights from your side, as I asked 2 SWICA employees and each of them has a different opinion on that, that are contradictory. I read 40 pages about insurances in Switzerland, but that didn't help either.
Here is what the Completa Top covers:
https://www.swica.ch/en/private/insu...#leistungen333
If you got seriously ill you would pay 2500 plus 10% of anything after but only to a max of 700 CHF. So your max payout is 3200.
Regarding getting onto the complementary insurance, depending on your age it may be too late already as many companies make it very hard after one turns 40. Again the old story of how insurance works - one cannot get it when one needs it only but should be paid ongoing just in case
I think.. it doesn't matter to your costs what illness you have been diagnosed as having. It's just your postcode that makes a difference to your costs.
I thought.. you pay your premium, then use up the 'deductible' and then, if you're still paying, you have to pay 10% of SWICA's costs. But, I think, that 10% is capped (so of course.. more serious illness.. more expensive treatment.. but there is a limit)
Most of those SWICA 'extras' are about treatment outside of Switzerland (or 'luxuries' like if you get a bed in your own room in a hospital)