Should we use our U.S. health insurance or purchase Swiss health insurance*?

We have been here in Zurich for one month (of a one-year stay) and we suspect our 18-year old daughter may have an ulcer. The pain is getting worse, so we have to take her to the doctor asap.

She has health insurance from the U.S. which she can use here -- she goes to Swiss doctor, pays cash, gets reimbursement from U.S. health insurance company.

Given my daughter's condition, however, we are wondering whether it would be wiser to just go ahead and buy one-year's worth of Swiss health insurance just for her.

Does anyone have any words of wisdom in that regard?

In addition to the obvious cost issues, we are wondering whether doctors here may be more willing to see her and/or give her better care if she has Swiss health insurance vs U.S. health insurance.

I became concerned when I called Zurich University Hospital today and they won't see her because she is an American.

*We originally planned to apply for an exemption from the compulsory Swiss insurance that is (sometimes?) granted to academics and their families.

TIA.

Sorry to hear this. At this stage, just get her to a doctor and ask to refer to a specialist if doctor feels it is necessary. If she is ill and in pain, waiting to discuss may not be a safe option. Ask your colleagues or neighbours to recommend somebody.

Surprised about this exemption. My understanding is that all residents, even if temporary, have by law to have Swiss Health Insurance, payable from day 1, but with 2 months to organise. Would be interested to know if that exemption for academic staff does indeed exist.

Good luck, play safe.

Have you registered with the local authorities as living here? You will then have to get Swiss health insurance, and maybe claim exemption later.

The cost of swiss insurance for a child is maybe 70-80chf per month. Then you pay 10% of the doctor's bills, some prescriptions and hospital bills.

I think you have basically answered your own question in saying that zurich university hospital were not keen to see you if you are US insured. In a difficult situation, they may also demand a hefty up-front fee for agreeing to do any sort of surgery. That is because they don't trust that you have adequate coverage, and they don't want the hassle of the extra paperwork or unpaid bills if you leave the country.

That said, I assume you'd go to the kinderspital if it was urgent with a small child (kids hospital, Zurich) - and if not strictly urgent (when you say 'ulcer' do you mean a mouth ulcer or a skin ulcer or a stomach ulcer?) - then find a good local Paediatrician.

If it's urgent, there is a 24 hour number where they can give you the details of doctors who are on call, or suggest the hospital, depending on the case...

Also, this is a new service in Zurich - for kids - an 'after hours' paediatric clinic - http://www.kinderpermanence.ch/web/i...erztlichesteam

You can see the doctor without having the insurance organised. Technically, you are insured from the day of arrival, have three months to organise the basic insurance, and it's back-dated. It'll cost you about 150-200chf to see the doctor, including very basic blood test or swabs or medicine, so you'll very quickly get your money back on the insurance.

The cost for an 18 year old will be 200-300CHF. (My son is 20 and is in that range).

Sorry, I read '18 month' not '18 years'.

Does anyone have any information about this possible exemption for academic staff? Must say I've never heard of it.


I'd always advise anyone arriving here (or anywhere actually) to quickly find a good general practitioner/physician, through neighbour/colleague recommendations and make a visit. Yes, it will cost you a little- but will be go towards your 'franchise'. That way you can discuss any re-existing conditions you have, medication, concerns, family history of certain illnesses. That was, if you do have to visit in an emergency, the doctor will know who you are, and vice-versa, and it will make things much easier for all. Money well spent, really (of course if you come from the UK where this would be free... it's unpalatable to have to pay - but...).

I was here for 6 years before I saw a dr & 8 years before I had compulsory medical insurance. The law changed after about 6 years & spent 2 years stalling as I had BUPA international at the time! How times have changed.

If I'm understanding correctly, it looks like we are going to pay cash up front regardless. So, for now, it doesn't matter which route we take ... at least for the initial visit.

Furthermore, we have time to decide which insurance to use (Swiss vs U.S.) because the Swiss insurance is retroactive anyway.

Did I get that right?

After doing some research on EF, I am thinking of starting with the doctors at Permanence Hauptbahnhof.

My second choice is to take her directly to a gastroenterologist, Dr. Martin Kaufmann.

My third choice is to take her to the Arztzentrum Sihlcity.

If anyone has any opinion either way, I'd love to hear it.


Re: Type of ulcer
Stomach (peptic). I think. But, I'm not a doctor. It's not so bad that it's an emergency, but we do need to take care of it within the next couple of weeks. We've already been to the pharmacist and he recommended an antacid and acid blocker. That is buying us a little time too.

Re: Exemption from mandatory Swiss health insurance
My husband is still an employee of and being paid by his U.S. university. He is merely on sabbatical at the univ here, not an employee. As such, we are still paying for our U.S. health insurance. (We must. Otherwise, we won't have health insurance when we go back to the U.S. We would have to wait until the next open enrollment period.) So, apparently, *IF* we can prove we have adequate coverage, we may be exempted from buying Swiss health insurance. Still remains to be seen whether it will actually be approved.

EF has been an invaluable resource for me and my family. It is truly a gem, especially for people that are newly arrived like me. Thanks!

I believe it is one of those things that varies a bit, or is more/less transparent, by Canton. Not sure of this particular case, but for certain teachers/researchers and the like there is an exemption for Vaud.

For Vaud, these are the exemptions:

Dérogation à l'obligation d'assurance

• les agents de la Confédération, en exercice ou retraités, qui sont soumis à l'assurance militaire ;

• les personnes qui séjournent en Suisse dans le seul but de suivre un traitement médical ou une cure ;

• les fonctionnaires internationaux ou membres d'une mission diplomatique ou consulaire, ainsi que les membres de leur famille.

De plus, d'autres personnes sont exemptées sur requête si elles bénéficient d'une couverture d'assurance équivalente et font parties des catégories suivantes;

• les personnes qui sont obligatoirement assurées contre la maladie en vertu d'un droit étranger ;

• les personnes qui séjournent en Suisse dans le cadre d'une formation ou d'un perfectionnement, telles les étudiants, écoliers et stagiaires ;

• Les enseignants et les chercheurs qui séjournent en Suisse dans le cadre d'un enseignement ou d'une recherche ;

• les travailleurs détachés en Suisse ainsi que les membres de leur famille qui sont exemptés de l'obligation de payer des cotisations de l'AVS/AI en vertu d'une convention internationale de sécurité sociale ;

• les anciens fonctionnaires internationaux et les membres de leur famille s'ils bénéficient auprès du système d'assurance-maladie de leur ancienne organisation d'une couverture d'assurance analogue pour les traitements en Suisse:

• les personnes dont l'adhésion à l'assurance suisse engendrerait une nette dégradation de la protection d'assurance ou de la couverture des frais et qui, en raison de leur âge et/ou de leur état de santé, ne pourraient pas conclure une assurance complémentaire ayant la même étendue ou ne pourraient le faire qu'à des conditions difficilement acceptables.

Si l'assuré possède un des statuts mentionnés ci-dessus et qu'il bénéficie d'une assurance offrant des prestations équivalentes à la LAMal, une dispense lui sera délivrée pour la durée de son séjour en Suisse.

http://www.vd.ch/themes/sante-social...ie/derogation/

If my child was unwell I would seek medical attention first and figure out how to pay for it second.

Cheers,
Nick

Sounds exactly the right thing to do.

Re: non-Swiss insurance

You might want to get your employer involved in determining if your non-Swiss insurance is acceptable to the canton, or not.

For what it's worth, we were not required to have Swiss insurance the first 5 years we were here, because we were classed as temporary residents on a limited time expat contract. Expat as in paid out of the US office, contributing to US social insurances, etc. As I understand it, this was a deal between the company and the canton - and the insurance we carried (BUPA International) was provided by the company.

I have also known folks on academic sabaticals who were given similar exemptions.

As I understand it, the exception to Swiss insurance is limited to narrowly-defined temporary residents, and the alternative coverage must be approved by the canton.

If in doubt, get your employer involved in negotiation with the canton.

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As to being refused treatment by the hospital because you are an American - yep, American 'medical tourists' aren't welcome (with the exception of emergency care) due to the long reach of American tort lawyers. Americans resident in Switzerland would not face this, though. (Presumably, you couldn't sue in US courts. )

http://www.swissinfo.ch/eng/Home/Arc...html?cid=45738

American residents here also face problems, a colleague of mine has been turned refused treatment by a couple of surgeons solely on the grounds of him being American. Seemingly their insurance will cover them due to the high risk of being sued if something goes wrong.

I would get her to a doctor/hospital first and sort out the insurance later. You think it is an ulcer, but it could be something else like appendicitis.