I ... er ... have a friend who hasn't paid their krankenkasse despite being in the country for a while; is this foolhardy behaviour? and what happens if it is not paid indefinately?
When they find out they'll make him pay for all the months he didn't pay, so he may as well confess.
By the way - I guess you meant to say health insurance rather than Krankenkasse didn't you? I'll change the subject line to assist those who will search for the information at some point in future.
Did your, er, friend ever sign up with a health insurance plan?
What permit does your friend have?
The government will assign you a health insurance plan if you didn't get one for yourself - and it could be very expensive.
If your friend signed up for one and just never paid the premium, wait for the official collection notice from the local government offices (the government acts as a collection agency for things like this) and it will be full of fees and demands for immediate payment.
They take their health insurance here very, very seriously. Very dangerous to go without!
From what I remember you have up to 3 months grace period to get your health insurance sorted. After that it becomes compulsory and they send you a reminder letter. I was also late getting mine sorted out - no back payments necessary, you just pay for the date when it starts (i.e. 1st day of 4th month).
Also, if you have private cover from another country (e.g. Bupa in the UK) that you wish to stick with, it can also be arranged (some friends of mine did this). But it can be complicated as you have to convince the swiss authorities it's equal to the minimum swiss cover and it can be a lot of hassle when it comes to claiming bills and arranging payments from your insurer for treatment.
Was bupa approved? The thing is if one person manages to convince a certain authority, then others can also take the same path since the hard work already done. This has to be done on a canton by canton basis - so if Zurich takes bupa, then others can too!
You were lucky that you didn't have to back-pay the insurance. The logic is that they would have covered you from the day you arrived, so they usually make you pay from that date of "theoretical cover"
Yes, bupa was approved, but the process was a lot of hard work, and also depends on the exact level of coverage you have. This was in Basel-stadt. (Incidentally, my friends are now thinking of going swiss to save further head aches, when getting treatment approved etc... )
I just went to a broker and got it from the 1st of that month. Admittedly I was only a week or so late. I didn't think you were automatically covered during that time, but more like a tourist - your responsibility.
I also have a ...er....friend who, for the first six months of being here, didn't have health insurance because he was unemployed. When he finally got a job he got health insurance. A month later, he came down with a severe migraine, low tolerance for bright light, unable to keep down solids and occasionally fainting.
After x-rays, two catscans (with and without contrast media), and finally a spinal tap (scary), the diagnosis was menangitis. Another week in hospital with MRIs, ECGs and god knows how many other tests with 3-letter acronyms, I... umm I mean he was released. That would have been mega expensive without insurance.
I don't think the permit would be a problem, you'd simply get a bill. If the bill wasn't paid then you'd go on the register and they'd eventually come and take away your possessions to pay the bill - standard debt collecting practice. Those of us living here know that we either dispute a bill within 30 days, or we pay it - those are the only two choices
With respect to BUPA this used to be possible with BUPA international gold but the Swiss in conjunction with the EU closed that loophole and if you are employed then you MUST have a Swiss health insurance. Mark correctly guessed that if you do not then you will be charged as if you had as soon as you register with one. Ie if you fill in the form for Groupe Mutuel (Mutual Group) then they will bill you for the difference between your alien permit entry date and the start date of your health insurance. If you do not register one within 6 months then the local town hall will allocate you one...
Thats interesting, my husband came over to Zurich to start his job mid December last year, he was on an initial 3 month contract and was given a temporary 4 month permit, when his job turned permanent he then applied for his proper permit and health insurace, they were insisting on him back paying his health insurance from the day of his arrival, he asked his health insurance advisor about this who insisted he had to as it was law, he kept arguing against it but the guy was adamant, he eventually spoke to the insurers and they decided that he shouldn't be charged for the first 90 days, (he had been told elsewhere that if you have health insurance such as the UK E111 form, then that covers you for the first 3 months being in Switzerland)
As for not having health insurance, I have been 'officially' in the country since April but still haven't got health insurance, I have been having problems getting some answers to an issue i have with something so i have left it a bit late, i got a letter last week from the government saying that if I didn't get my insurance soon they would take out compulsory insurance out for me. I am expecting the same issue with me that they will charge me from my entry date.
So basically one way or another every full time employee in Switzerland has to sign up for health insurance, within 3 months, otherwise bills / debt collection is levied.
And it appears this is regardless of permit or passport.
It may be expensive, it may be "not fair" if you are unemployed, but it's the rules in this here country. Your, er, friend does not have to stay here if the rules of their new host country are too onerous to comply with...
Some Swiss I've worked with (normal sensible chaps, otherwise) are also concerned that foreigners come here, don't take out insurance and the canton picks up any bills, cost them taxes etc... hhmmm maybe thank your friend for perpetuating these Swiss perceptions...
For goodness sake, tell your mate to get insurance, pronto. Even minor hospital care can runs into the gazillions here, as the hospital milks the system to get as much 'value' out of every patient, regardless of the need for treatment - ie, 9 X-rays instead of 2; mega-funky triage when a plaster would do etc. To have to pay all of this out of your own pocket would feel a bigger rip-off than paying the monthly premiums
on the bright side, employer contributions cover accident - so it's not all bad. I've had P1 coverage a couple of times due to "accidents"
When I first came, they let me have PPP for a couple of years but then the health authority started writing more and more letters and I switched to a Swiss policy.
When I moved, they wanted health insurance policy numbers. Has your mate's local office not asked for this?
Could this be more Swiss mythology, or fact? In defense of health-system-robbing foreigners I should relate a little story. My brother came to visit a few weeks ago and needed an x-ray. We tried to pay, but they wouldn't make up the bill, and they also wouldn't accept credit card as a form of payment. The *only* way they were going to allow us to pay was by sending a bill. Ok - fine, they could send the bill to my brother in Australia and he could have his insurance pay it directly. But no - they weren't going to send him a bill in Australia (where the Swiss payment slip and lack of international payment details would make it impossible to pay anyway). Instead - I became liable for it. Despite my protests I was sent the bill and it became a real mess to sort out. I don't know what the Australian insurance company did in the end - I hope they took a leaf out the Americans' book and sent the hospital a cheque (in Australian dollars!)
So I think Swiss would do well to ask why their hospitals don't take a credit card imprint for someone without insurance rather than bitching about dirty foreigners not paying the bills. As for the canton ending up with the bill - almost every visitor is visiting someone here, and it is that person, not the canton that will foot the bill in the end.
Uncle max - agree with your comments about feeding the system. I've seen some really expensive stuff being done when it could have been done otherwise. I did wonder at the time whether it was a plan to enrich the hospital. Of course the patients never complain, because they are never paying!
Lob - P1, PPP - what are you talking about? Am I the only one who doesn't understand? Is PPP a company, and is P1 private cover? I've lived here 7 years, so I must be missing something?
By the way - for the unemployed accident cover can be added to your sickness cover for less than 10 francs per month. Useful to check whether you have accident cover (if not gainfully employed) because the normal sickness cover won't cover accident...
When I registered at my local council office they insisted on seeing that I had health insurance. Mark Jones - has your "friend" also failed to register himself with the local council?
I think i must just have had an easy time of it then! I have never encountered or heard of such trouble before, and can only speak of my personal experience (in Basel at the time), so I assumed that's 'the way it is'!
As for Bupa, this was only 18 months ago that my friends arranged it in Basel. The main reason they are considering changing to a swiss insurer is because of problems with Bupa paying up, rather than with any problems with the swiss authorities. Again, just my experience. Maybe it's a glitch in the matrix (or just a Basel thing).