Hello folks,

I am new to the Swiss healthcare system and must thank all contributors on this forum for sharing their thoughts/opinions/expertise. It helped a lot in narrowing down options for me.

I am looking at SWICA and am confused with a bunch a top-ups they have offered on top of the basic and semi-private. Can anyone share their views on whether these are useful/recommended? I realize these are personal choices, but I am looking for any general advice.

In terms of our personal situation, I will likely just get basic with a 1500 CHF franchise, while for my wife (who is pregnant), we will get basic (with 300 CHF franchise) as well semi-private.

But what do we do with:
Completa Top
Completa Praeventa
Optima
Infortuna

These top-ups are best described in this flyer (page 2):
http://www.swica.ch/p/021_e_Leistung...cht_online.pdf

Any feedback is much appreciated!

Hello!

I did some research on SWICA a while ago and ended up going with them, so maybe I can help a bit. I don't know much about Optima, but it looks like it's more comprehensive travel and "unorthodox" medical treatment than Completa Top + Completa Preventa. A few things:
- Infortuna is accident insurance - if you are working (more than 8 hours a week for the same employer), than you will have accident insurance through your employer. If your wife is not working, however, she will need accident insurance. It costs ~10 CHF/month.
- If your wife is currently pregnant, than the semi-private supplemental insurance will not work for her, as there is a waiting period of 12 months with SWICA for use of this coverage. There is a waiting period of 9-12 months for pregnancy for this kind of coverage with all insurance providers.
- However, with pregnancy, all costs are covered by basic insurance, with no franchise/deductible. Some costs associated with complications may not be covered. For more information on what is covered, check out this FAQ from comparis (8th question down) - http://en.comparis.ch/krankenkassen/...q/default.aspx
- The Completa Top coverage provides some random benefits with regards with dental cleaning, optician exam, physician prescribed homeopathic medicines, etc. However, the main benefit is that has global travel insurance (Full cover in for inpatient and outpatient treatment in emergencies) and lowers the cost of ambulances in Switzerland (from 50% up to 500 CHF paid under basic insurance to 90% paid up to 20000 CHF)
- The Completa Preventa can only be added on if you also have the Completa Top - it provides more cover for homeopathic treatment and for preventative medicine. The main benefit seems to be that it covers part of a gym membership or other fitness activity (50% up to 500 CHF, or up to 300 CHF per activity - so it would cover 300 CHF of a yearly gym membership, as a I read it)

For your reference, my husband and I went with Basic insurance with SWICA with high franchises as we're pretty healthy. I added on Completa Top for the travel insurance and ambulance insurance (my husband has travel insurance through work) and the Infortuna, since I do not work.

Hopefully that helps Good luck!

I do not know too many details about your specific question, but I am happy with Swica because they do documentation in English. Others not.
I switched to them this year.

I am not an expert on this stuff.. but, when I moved here my company sort of said Swica was the way to go. Met with them, set up the plan, and now I pay. After a few months of being here I started to learn that while there are good and bad insurance company's, I could have found much better rates than Swica. I, for one, cannot wait for November to give them my notice and save myself a couple of hundred CHF a month.

sorry - i was just ranting versus helping :|

I don't know if your wife having a lower franchise makes huge sense unless she is likey lo be ill.
Pregnancy is covered without any franchise, regardless of what your franchise is, I guess her premiums will be 800 a year more for the benefit of a 300 franchise, seems very expensive unless your going to spend more!

Most people at work who are Swiss go with Swica.
The good thing is, they pay for everything in advance and collect from you afterwards.
Other insurers don't pay anything in advance - you have to pay all the bills and then haggle with them about what they pay, sometimes waiting for months to get the money back)
I must admit that so far, I have yet to achieve my 1500 CHF franchise with bills...so I don't know how it is to deal with them once there is a dispute.

not where I work. I can tell you a very small percentage have Swica (at least in the group I am in) as I have surveyed

I would have to disagree with this as well, sorry. My partner broke her foot a few months ago. All of the bills we had to pay up front but one (emergency room), and send the receipt to Swica. In fact, when we called them, this is exactly what they instructed us to do.

Here is what I think, and I have discussed this with my finance colleague (since I am terrible at these things).

Suppose you take the 2500 franchise instead of the 1500. This will save you roughly 100 a month per person on Swica. This is, 1200 CHF annually of course. The difference between the two is 1000, so you come out 200 ahead of the game. It is double for me since I pay for two people. I currently pay 720 a month, and just this one change will take me down to about 520-530 a month depending on who I go with.

We have swica and are very happy with them- a bit expensive but every year Ive done the analysis on price and found out, because we take advantage of the gym and dental reimbursements, we work out ahead with the supplements vs. other insurances.

If you are first insuring yourself in CH you can sign up for whatever your wife likes even though pregnant as I believe. Its the switching once here that requires the notice. Check the allgemein plus upgrade option, You can pay cash to upgrade to semiprivate room and private clinic, and it can be less than paying for the insurance all alone if your wife doesn't need semi-private when not pregnant

I second the comments on the high franchise option unless there are other preconditions/illnesses ect. And have never had to pay upfront.

Hi OntheRoad,

I don't know if this is much help but I am also with SWICA and am now 7 months pregnant. I took out the lower franchise at the start of the year (300 CHF) and am extremely glad I did.

All normal pregnancy costs are covered 100% by SWICA, but if any sort of complication were to arise (eg diabetes) then this is not treated as "normal" and will come out of your franchise. For example during one of my early pregnancy check-ups my gynecologist discovered I have a heart murmur. He sent me for some tests to make sure it wasn't going to be dangerous for me or baby as the pregnancy progressed. The bill came to almost 500CHF. So that used up my franchise for the year.

Also I saw a few people comment on the fact that SWICA don't settle all the costs directly (ie you have to pay the doctor and then get reimbursement from SWICA). While this is true in about a third of all our medical bills, did you know that you don't actually have to pay the bill before you send it to SWICA for reimbursement?
An example - my husband received a medical bill for 948 CHF. He did not pay the bill but immediately sent a copy to SWICA. Within a month he had been reimbursed around 850 CHF from SWICA. Only then did he pay the original bill of 948CHF. It's a perfectly acceptable way to operate and we have never received late payment notices etc.

Hope that helps :-)

I am also with Swica, since more than 10 years, and extremely happy.

Yes, they might be more expansive than average, but I never had any problems with them, even on extreme cases like emergency abroad for more than fr.10K: one phone call and everything was solved.

Depending on you contract/extras, they cover up to 90% your gym costs, 90% check-ups, good coverage for glasses, and for my daughter's braces, 75% is covered.

For the bills, I do like naynay's husband. When we receive a bill, I quickly send it to Swica, and get reimbursed before 30 days, normally within 3 weeks. So you can pay the bill without advancing your own money.

Don't know much about other companies, but for me this is good enough to stay with them.

cheers,

My family is also with SWICA and I have been with other health companies. SWICA has been more expensive but is the most efficient and best customer service I have encountered so far. Offered excellent support during my wifes pregnancy.

Hi, I have also been with SWICA for 5+ years and 2 pregnancies. It really is an easy (if expensive) relationship with them, and to be honest ,good health coverage is more important to me than a few good evenings out pa. I want to have top coverage, to cover for the awful circumstance when something goes wrong, which happens, more often than one can imagine.

I save on other things and spend on health! But I do know others have a very different outlook. It's all about priorities.

IMO, Swica provides amazing value for money. To a couple of points raised in this thread:

1. Anowheels, they pay me 500 a year for my Fitnesspark membership. That alone covers the additional cost of the Top program.
2. Someone else mentioned paying in advance. That depends on where you get services, as Swica has to have a system in place with them. For example, the permance at the HB never requests payment from me, and the Apotheka was able to bill my prescriptions directly to them as well - though they made me pay cash for optional extras that the doctor suggested but didn't prescribe, as Swica wouldn't cover them anyway.

Sending the invoices is dead simple, they provide stickers that you affix to the itemized receipt and mail it in. Money is in my account in days.

They've yet to make a mistake that I've discovered, their customer service is fantastic, and thoughs who want it can get their docs in English. Highly recommend them.

Can I just add that once you have medical problems, very few (if any) insurers will insure you under their additional insurance scheme - so like manythings in life, once you realise you need it/would be good to have it, it is too late.

Our son was born with a lifelong disability. Before his birth we organised basic and supplemental insurance with Swica. We are so glad we did as we cannot subsequently obtain any supplemental insurance from any other company due to his condition - but for as long as we keep paying Swica, they will not withdraw this supplemental cover. So it looks like Swica for life for him then!

Incidentally they are expensive. After 7 years with Swica we have moved our basic insurance to another company with which we are happy (and saving a lot of money) but son number 2 has stayed for the supplemental part with Swica.

The costs of the childrens' supplemental insurance are paid for by the reminbursement we get from swica for their swim classes. Brilliant.

Dear all,

This is truly amazing how one can learn so much from people on these forums. I am a newbie - so don't see a 'thank-you button' . So I would like to say many thanks to anowheels, HAT, sashimiso, Kepete17, naynay, gfadel, AnAustralian, dottie, Corbets, and ecb.

• I did not realize that the franchise doesn't count costs related to pregnancy (which I know now thanks to you guys).
  So we may go for the 2000 CHF franchise (that's the highest offered to us by SWICA)
• I will now also look into the upgrade option at the hospital (vs. paying for semi-private/private)
• I had also not realized:
  • Premium is paid for the full month regardless of when coverage starts. We are arriving on July 30th - so will have to pay for the full month of July
  • Apparently SWICA allows you to 'increase' coverage any # of times during the year but 'decrease' only once a year and needs to be notified by September 30th
• Regarding the top-ups, we are now planning to take Completa for both and the accident insurance for my wife (mine is through the employer)

Many thanks again everyone for your help in taking these decisions! As and when I find additional information on this topic, I will be sure to post it here. Now we are on to finding an OB-GYN! Not an easy task I am told..

Swica is definitely a good insurance ... the customer's satisfaction is high. Yet it is an expensive one. Therefore not too popular among locals.
(exceptions made when they strike enterprise deals ... like any other insurance .. then people in this enterprise will tend to take the very interesting offer)

Others, like Helsana, Group Mutuel are of excellent service as well but come with a much cheaper prices, finally allowing for a same amount to get higher coverage/protection.

For a lady, i would always recommend 300 franchise. (unless an exception) My wife is at 300 franchise and i never regretted it. For people with excellent health, i recommend 2500 franchise. In between is generally to the advantage of the insurance.

The average price difference on the Swica basis compared to other, cheaper insurances varies between 10 frs to 30/40 frs per month depending where you live. (check on comparis.ch !) Of course Assura doesn't count since their service is way lower than most other insurances.

The Swica top ups completa top and completa praeventia are grossly ok. On glasses, ambulances and cross biting, they are not too performant (in coverage), yet in the other areas like fitness, non-medical psychotherapy or complementary medicines they are as competitive as the other good ones.
(so if you wear glasses ... it is not optimal, yet if you don't wear glasses but practice fitness ... they would fit you very well.)

I can always provide some help if interested ... only for the sake of comparing services and prices !! and ... yes i am insurer ... but if you go through me, it won't cost you 1 more centime than the normal price !!

Be careful with Swica. What it does that no other insurers do not do is to apply a deductible to everything. Read the fine print.

You would think that you chose the Fr.1500 franchise for the basic healthcare only. Most other insurers do not apply the deductible for things like alternative medicine (if you need a massage/ acupuncture for a bad back), regular gyny visits, glasses, but Swica will apply the deductible.

According to their website:

"Transparent and calculable cost sharing
You determine how high your maximum share of costs is per year. SWICA is the only health insurer to add the costs shared in both the basic and the top-up insurance, as a result of which the excess costs are much lower than they are with other insurers. For example, if you agree on a cost sharing of 2,000 francs, you can be certain that this annual maximum sum applies across all insurance plans with SWICA and will not be exceeded."

Sounds good, except that most other insurers do not apply any deductible for a lot of stuff in top up insurance, but Swica does.

Eg: Completa Top covers alternative medicine but with a Fr.600 deductible. If I get acupuncture treatment for my bad back once a month, it will cost me Fr.1200 per year, but Swica will only pay once I hit Fr.600.

Had I gone with Visana or Intras (the ones I was with before), they would have paid from the first Fr., without applying any deductible. I may have saved Fr.300 by choosing Swica over Visana, but I just lost Fr.600 with Swica.

Axman is fully right in that. What

Others have a franchise of 150 on the complementary and others (my prefered is Helsana) have no franchise at all on the complementary. Meaning that even if you have 2500 franchise on the basis, with the completa of Helsana, you can already benefit for acupunture ... glasses, whatever; it doesn't bite into the 2500 franchise at all.
Therefore Axman, with a Helsana insurance would have saved 600frs straight. less the difference in the price of the complementary ... which goes in favour of Swica (normal ... but adjust with the franchise and ... Helsana is way cheaper) then, to that, add the difference in the price of the basis and you end up with a serious difference in favour of Helsana !!

appreciable.

A franchise is an indirect premium to the insurance meaning that you should take the franchise, divide it by 12, add it back to the price of the insurance and compare it to the others.

Inversly, having help for glasses or fitness should be diminished to the premium to assess the real cost for your personally (you know that you will be getting a refund !). Like this you see what complementary best fits your specific needs.

I would like to share a couple of experiences with SWICA that might be useful in about 18 years time or so to you ontheroad!

About 3 years ago I switched from an expat to a local contract and therefore had to look at paying for our own Health Insurance. We looked at 4 of the major insurers and went with SWICA both on price/value and after listening to some friends and colleagues experiences. One of the major selling points was that the premiums might start out higher but they do not increase as much as the other insurance companies premiums. Then my renewal came last year and it had gone up by almost 50%! What had happened was that my eldest son had turned 18 and was no longer charged as a child/juvenile. This also meant that he no longer had a zero franchise and SWICA automatically set it at 300chf. Additionally my third son's premiums also rose dramatically. Why? Because normally the third child's premium is negligible and now that my eldest son had become an adult according to SWICA I only have 2 children! Luckily I changed jobs and my new employer pays for my health insurance and by raising the franchise for my son to 1500chf I am actually back to where I was last year!

I would also like to echo the earlier comments that SWICAs customer service (we deal with the Zug office) is excellent and they have so far been very good in processing claims.

Good luck!