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Old 13.07.2015, 15:34
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Having surgery in Switzerland as a visiting student

Good day,

So I have kind of a two fold question. To begin with, I am a student here at ETHZ, and I have lived in Zürich for a year now. My masters ends in a year, so I'll be here for at least another year. I'm originally not Swiss however; I am Dutch, and I have kept my Dutch health insurance. I don't go home often however, especially not for extended periods of time. Now, I have a health problem, and maybe without going into specifics lets say that it requires the attention of a urologist. I met with one two years ago in the Netherlands, and he told me surgery was required to fix my problem. It was however not very bad at that time. He told me that it would not go away without surgery, and that it would slowly get worse over time. I would have to decide for myself when it was too much to deal with, and at that point I should come back to have the procedure done.

Now, I'm getting to the point where I would probably like to get this out of the way. However, while it is in no way a big and complicated procedure, it does take place in a hospital and there is recovery time (at home) involved, which means you have to come back for checkups at times. This means that having it done back home in the Netherlands is simply not that doable, at least for the next year. I'd therefore like to see if it is possible in Switzerland. My first question is therefore, is this even possible? Can I have surgery here (with a residence permit and such), and will this generally be super expensive, or covered by my insurance from back home (I'd need to check with them of course)? I'd like some general opinions on this, as perhaps someone has experience with this.

Then the next question is, if it is not a terrible idea to have it done here, how should I approach it? The way it works in my country is you go to a general practicioner first, and he/she tells you that it is beyond his/her capabilities and redirects you to a urologist at a hospital, who then decides what to do. Does that work like this here too? I'm located in Zürich, so I guess all parties involved will be located there in any scenario.

Kind regards!
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Old 13.07.2015, 15:42
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Re: Having surgery in Switzerland as a visiting student

This is the problem with living here without Swiss health insurance.

You have 3 options

1 - ask if your insurance will let you be treated in Switzerland.

2 - go home for treatment.

3 - take out Swiss health insurance and get treated here via that insurance.

I'd go to a GP, because they'll be able to make you an appointment with a suitable Urologist.
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Old 13.07.2015, 16:59
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Re: Having surgery in Switzerland as a visiting student

How could you keep your Dutch health insurance? Always thought that when applying for a permit, also a student one, you need local insurance.

Anyway, your Dutch insurance will quite likely NOT pay for an operation done in Switzerland as the cost probably will be much higher than in the Netherlands. So they will probably ask you to have it done there or you would have to pay the difference yourself.
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Old 13.07.2015, 17:22
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Re: Having surgery in Switzerland as a visiting student

If you apply for Swiss insurance, they will probably ask for the date of arrival here, as per your registration at your Gemeinde/Commune (you have done that, haven't you???) and back charge you from 1st day of the arrival month. Surely you must be aware it is illegal for you to have kept your Dutch Insurance and that you are required, by law, to take up Swiss insurance (as said dated from 1st of month of arrival in CH).
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Old 13.07.2015, 17:40
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Re: Having surgery in Switzerland as a visiting student

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How could you keep your Dutch health insurance? Always thought that when applying for a permit, also a student one, you need local insurance.

Anyway, your Dutch insurance will quite likely NOT pay for an operation done in Switzerland as the cost probably will be much higher than in the Netherlands. So they will probably ask you to have it done there or you would have to pay the difference yourself.
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If you apply for Swiss insurance, they will probably ask for the date of arrival here, as per your registration at your Gemeinde/Commune (you have done that, haven't you???) and back charge you from 1st day of the arrival month. Surely you must be aware it is illegal for you to have kept your Dutch Insurance and that you are required, by law, to take up Swiss insurance (as said dated from 1st of month of arrival in CH).
No, it's not always.

"I am a EU citizen and insured by the state. Do I still need health insurance in Switzerland?

No. If you own a European Health Insurance Card, you can apply for an exemption from the Swiss health insurance obligation. Please do not forget this application for the exemption! The procedure is described on the reverse side of this sheet."


https://www.ethz.ch/content/dam/ethz/main/education/internationales/pdf-en/exemption-guidelines.pdf

If the OP is covered by a State insurance then he has the exemption. If not, then he'll have to decide to go home and have the procedure done or get Swiss health insurance which, being backdated, is going to cost - a LOT!
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Old 13.07.2015, 17:45
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Re: Having surgery in Switzerland as a visiting student

Reginar, I think Island Monkey laid down the three most obvious option. Personally, if it's a rather simple and affordable surgery, I'd get it done here. Do you have any friends that can take care of you during rehabilitation? You could also take advantage of the summer vacation and go back home.

I agree with what Medea said. When I was a student in Switzerland I was allowed to be insured through my EU insurance model. Later I changed to a Swiss insurance without being back charged.
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Old 13.07.2015, 17:47
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Re: Having surgery in Switzerland as a visiting student

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I agree with what Medea said. When I was a student in Switzerland I was allowed to be insured through my EU insurance model. Later I changed to a Swiss insurance without being back charged.
Yes, if you were allowed to have your Dutch insurance by the Swiss authorities, then you should just be able to switch to Swiss insurance without and penalties. This might be the easiest option if you want the surgery here.
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Old 13.07.2015, 17:48
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Re: Having surgery in Switzerland as a visiting student

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No, it's not always.

If the OP is covered by a State insurance then he has the exemption. If not, then he'll have to decide to go home and have the procedure done or get Swiss health insurance which, being backdated, is going to cost - a LOT!
There is no longer a state insurance in the Netherlands. The NHS (ziekenfonds) insurance was stopped in 2006 and everyone had to choose an insurer (basic insurance).

And isn´t the EHIC only for "necessary" medical care whilst abroad for a shorter term? To interpret this as accidents etc, and not something that was known before the OP moved to Switzerland. But I´d be happy to be corrected on this
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Old 13.07.2015, 17:51
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Re: Having surgery in Switzerland as a visiting student

I'm pretty sure the OP would have had to prove he had acceptable health insurance to get his permit, so we can assume the authorities accepted his Dutch insurance.... unless the authorities messed up.
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Old 13.07.2015, 18:07
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Re: Having surgery in Switzerland as a visiting student

I think for students it's different roegner looking at the document I linked to. It wouldn't apply for the likes of you and me though, we're stuck with the emergency treatment only with the EHIC. Still, that worked fine for the OH when he was taken ill suddenly in the UK, even if it did take the NHS 10 days to get around to giving him the relevant paperwork to fill in.
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Old 13.07.2015, 19:15
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Re: Having surgery in Switzerland as a visiting student

If, as a student registered here, you have permission to keep your Dutch insurance from the SVB (Dutch social security office - in brief: you cannot be gainfully employed here) and have an exemption from Kanton Zurich for the Swiss insurance you can use your EHIC even without permission from the Dutch insurer (you shouldn't deal with them yourself actually, the KVG (see link below) will deal with the billing of your treatment at home). You will be treated to basic insurance standards and will have to participate in the costs in a similar way as if you had Swiss basic insurance - 92CHF for each 30 day treatment period - for this you will either get a bill from the KVG if your doctor or hospital sent the bill directly there, or you have to ask the KVG for reimbursement of the bills you paid yourself and they will hold this amount from your reimbursement.

[The above is also valid if for whatever other reason you are resident in Switzerland but exempt from Swiss insurance and are allowed to use your EHIC here]

As any person with Swiss basic insurance you are free to visit a GP first or go directly to a specialist or hospital. If you are not sure where to go, the GP will be a good option as they will direct you to the right place.

[edit: Im not sure, as you stay here for a 2 year Master's programme you might have to pay the usual Swiss franchise of 300CHF + 10% above that (up to 700CHF) for the calendar year and not the monthly amount, which we had to pay when my husband was exempt from Swiss insurance the first three months after moving here while he was still receiving German unemployment benefits - I cannot find the monthly franchise amount on the website at present, you should probably ask them what is valid in your situation]

Last edited by mgosia; 13.07.2015 at 19:53. Reason: not sure about franchise
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Old 13.07.2015, 19:25
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Re: Having surgery in Switzerland as a visiting student

Do you have a link for that?

OP should check that out as getting the operation and then possibly finding out that this is a different issue might be very expensive

Addition:

Zorgverzekering en aanvullende verzekeringen

Als je in het buitenland studeert, dan ben je over het algemeen verplicht je Nederlandse zorgverzekering aan te houden. De Sociale Verzekeringsbank kan je vertellen of dit in jouw geval zo is.
Met een Nederlandse zorgpolis heb je in EU/EER-landen en Zwitserland met een European Health Insurancy Card (EHIC), die je bij je zorgverzekeraar kunt aanvragen, recht op de noodzakelijke medische zorg.

http://www.wereldwijdestudenten.nl/n...rgverzekering/

Apologies for the link in Dutch. It says that you are entitled to necessary medical care. I would check, OP, if that also covers your operation. It also states that you should check what exactly is covered by your insurance.

Last edited by roegner; 13.07.2015 at 19:39. Reason: Addition
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Old 13.07.2015, 20:03
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Re: Having surgery in Switzerland as a visiting student

'Noodzakelijk' doesn't mean 'emergency'
[U] heeft [met de EHIC] recht op noodzakelijke medische zorg in het land waar u studeert. De vergoeding is volgens de regels en tarieven die in dat land gelden.

The ETH confirms this procedure on slide 52 of this information event for International Master's students.
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Old 13.07.2015, 20:05
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Re: Having surgery in Switzerland as a visiting student

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'Noodzakelijk; doesn't mean 'emergency'
[U] heeft [met de EHIC] recht op noodzakelijke medische zorg in het land waar u studeert. De vergoeding is volgens de regels en tarieven die in dat land gelden.
Yes, I can read Dutch and no, I didn´t say emergency in my last post. But still it could be that some things could be excluded.
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Old 13.07.2015, 20:16
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Re: Having surgery in Switzerland as a visiting student

No you didn't, but what this says is that coverage by EHIC is accordig to the law and tariffs of the country where you are studying. This means that a Swiss doctor decides if treatment is necessary, not the Dutch insurance provider. ETH claims the same by mentioning students with exemption should deal with KVG, not their home insurers.
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Old 13.07.2015, 20:43
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Re: Having surgery in Switzerland as a visiting student

Two more links on European rules concerning EHIC treatment:

Unforseen medical treatment in Switzerland

The crux here is the definition of 'unforseen'. Treatment is unforseen if it is not the sole purpose of a temporary stay in another country. If that was the case, you are right, for planned treatment some things that are covered here but not in the home country might not be covered by EHIC.

Now please reconsider if I really deserve that groan for providing all those useful links
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Old 13.07.2015, 20:49
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Re: Having surgery in Switzerland as a visiting student

Thanks a lot for the very useful replies!

As some of you have pointed out, I've indeed followed some procedure for being allowed to get an exemption, and keep my dutch health insurance. I have one of those EHIC passes, as mentioned.

From what you guys write, it seems like I might have a chance. 'Noodzakelijk', or neccesary, seems to be the case. I'm sure I can get a doctor to agree with that, as the previous basically said it has to be done, but when is up to me to decide, based on how much discomfort it causes.

As for unforseen versus planned.. I'm not sure what it is in this case. It's not like I still have a form I can hand in whenever I want and get the procedure done in NL, at this stage I'd have to go through a GP again. I could also go with not stating that it has been looked at before (this is a bit iffy, in my opinion) but the problem is they start with some topical steroid treatment that only works in like, 10% of the cases, which didn't. So that would be at the very least a nuisance.

All in all though, from the super helpful links provided, it seems like it is possible. Best would probably be to a GP? They can then tell me the hows and whats of how to go about getting in touch with a specialist here, and where, I guess.

As for having it done back in NL, I'm only there for two weeks this summer, which is too short for recovery sadly.
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Old 13.07.2015, 20:58
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Re: Having surgery in Switzerland as a visiting student

Yes, go to a GP and he/she will send you to the appropriate doctor/surgeon.

And in case you do not have a GP, Airport Medical Center Zurich (at the airport....) is also open for non flying persons. And they speak English :-)
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Old 13.07.2015, 21:16
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Re: Having surgery in Switzerland as a visiting student

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Two more links on European rules concerning EHIC treatment:

Unforseen medical treatment in Switzerland

The crux here is the definition of 'unforseen'. Treatment is unforseen if it is not the sole purpose of a temporary stay in another country. If that was the case, you are right, for planned treatment some things that are covered here but not in the home country might not be covered by EHIC.

Now please reconsider if I really deserve that groan for providing all those useful links
Well ... considering the only one you have dates back to 2011 it's a bit late to be complaining about it now isn't it?
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