I hope you can help me. Having seen a severely unwell friend be stuck with a poor health insurance policy I have decided to upgrade from general to semi private cover. my insurer (Sanitas) insists on a 9 month "Carenzfrist" (block, I guess) before I can start to use the cover. For the next 9 months I am only covered by the general insurance. However, they require me to pay already from the beginning - i.e. for 9 months I need to pay for semi private health insurance which would not apply to me during that time.
Seems really unfair and crazy to pay all that money for 9 Months. I don't mind waiting but already having to pay?! Am I overreacting? I don't see why I should give them money for nothing for those 9 months.
Would be grateful to hear if this is normal or not.
Without this waiting period it would all be a bit too easy......
A semi-private policy will get you slightly better conditions for a room, but most hospitals here have a 4 bed per room policy and many 2 or 3 per room.
Health care is fairly similar, you may need to go via your family doctor to get a referral but you can ask him for a referral to almost any specialist you want.
Sure the cliniques are nice, shiny, good views, nice restaurant food, but all this you pay for and it doesn't really touch health care. Any major emergency in a clinique and you usually get transferred to a University hospital where medical facilities are better.
Quite often with a General policy, you can end up with your own room anyway, depending on how full the hospital is or the severity/infectiousness of your illness.
Obviously you can't count on it. I guess with semi-private, if capacity was overloaded, you may end up having to share anyway.
That is quite common for insurances otherwise everyone would only sign up when needed.
For example with our dental, we paid the first 3 months and where unable to use it and then we have an 18 months waiting period for any major reconstruction.
I find that fair and to be honest depending what age you are, you should consider yourself lucky they take you in all together.
I love my semi private insurance in that I can choose my doctor and when I had an operation this year, I picked and new exactly who was going to operate me - versus getting the doc in charge when University Hospital had a free slot. Its not about the room, its about choosing the doctor you are happy with and for me this is really worth it.
So I would just suck it up - you could have paid for years and not used it (most of us do, its how insurance makes their money) and then be happy to have it if you want it.
thanks all - to clarify, I am not asking if Half Private is worth it. I'm asking about the "block period" (Carenzfrist) of 9 months. I just find it bonkers to pay for 9 months (about 100chf per month) for literally nothing before I am allowed to actually make use of the half private benefits. I don't mind the wait, it's the paying-for-nothing I am annoyed by. (thanks Kri for your comments)
You must be a woman. The 9 month period is there to prevent that pregnant women quickly change to a private or semi-private insurance and cost the insurance a lot of money for the birth.
Note that you don’t necessarily need full semiprivate insurance to get this benefit. Most insurance companies have a supplementary hospital coverage plan that allows you free choice of Doctor and the freedom to decide at the time of treatment for general, semi-private or private care at preset levels of cost participation. If all you are looking for is free choice of doctor, this might be a cheaper alternative to the other plans.
Note that in my recent experience at a major cantonal hospital that I knew exactly who were about to operate on me without exercising any special option to choose. The surgery was scheduled for when my chief surgeon was available, not the other way around, so no administrative surprises. I also found that it was relatively easy to have my choice of doctor, provided I was asking for a recommendation of the other staff around, rather than just requesting a particular ‘rank’. As I advanced from one speciality to another, I found asking the previous doctor to recommend the colleague they would prefer if the situation was reversed and they were looking for a doctor with a short list of characteristics that were important to me.
In my case I researched and knew what to look for. In the end it's also about feeling comfortable and confident with a doctor. Not elective surgery at all unfortunately. And I was happy I was comfortable with the doctor and knew I would see them again for my check ups etc. When compared to Unispital where I was clearly told it would depend whoever was available and also for the follow up, for me it was really a different experience.
No idea - could check later. However being able to choose the hospital means you have a wider array of doctors available given they typically are linked with a couple only.
To be very clear, I am by no means advocating that one needs semi private insurance in CH to get a really good treatment. This is not the case at all. I am sharing why it's worth it to me personally and this is a different things all together.
Again the block period is normal as otherwise everyone will just switch when wanted. You will likely pay many more months and never use the service in your lifetime. I did that for about 20 years in fact (well used it for the pregnancies but nothing else). If it's not worth it to you to have semi private then don't accept this condition.
i guess the question is: "there is a waiting period to prevent abuse by signing up to higher care only when the need arises. why can i not just sign a contract which says, ok, i will have the insurance in 9 months time and will start paying premiums then?"
Choosing the doctor is what makes it worth it. The private bed stuff is just whether you are that type of person, i dont give a toss. But if you need surgery, particularly things like joint or ligament surgery, then getting the best in the business because you are paying a bit more can be a life changing outcome.
Because the insurance wants to make a little money in view of you using it when you sign up later in life etc.
The reality should be that you sign up and not expect to use it so this should not bother you. If you already have an expectation to use it then the insurance model would fail.