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Old 07.01.2013, 23:43
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Health Insurance- Cancer

We are currently in the process of deciding whether or not to make a move to Zurich for my husband's job. I was diagnosed with cancer 4 years ago and I'm stable but receive a chemo shot 1 x per month. I'm trying to find out if I will be able to get insurance and what type of costs we are looking at. Are there programs that pay 100% like in the US? Currently we pay a maximum of $2,500 US each year (2 of my shots take care of that). This is obviously a huge factor in our decision making process and I can't seem to find the answer. Any help would be greatly appreciated!
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Old 08.01.2013, 04:34
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Re: Health Insurance- Cancer

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We are currently in the process of deciding whether or not to make a move to Zurich for my husband's job. I was diagnosed with cancer 4 years ago and I'm stable but receive a chemo shot 1 x per month. I'm trying to find out if I will be able to get insurance and what type of costs we are looking at. Are there programs that pay 100% like in the US? Currently we pay a maximum of $2,500 US each year (2 of my shots take care of that). This is obviously a huge factor in our decision making process and I can't seem to find the answer. Any help would be greatly appreciated!
First of all - I wish you good health and full and fast recovery.
To your questions- I might be wrong, but I think you might find it hard to find an insurance company that will agree to insure you, in your situation.

Regarding the costs: usually you pay your monthly charge, then when you use medical services you will pay your deductible (until certain limit - the lower the deductible is - the higher the monthly payment is), above that I pay 10% of the expenses.

Take a look at this site to get an idea of the costs.
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Old 08.01.2013, 05:58
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Re: Health Insurance- Cancer

Medical insurance companies are obliged to cover everybody for basic insurance as it is mandatory. The supplementary insurance is the one that will refuse her.

I'm not sure what chemotherapy care is covered under the basic insurance (there is a list of approved drugs) but if the drugs you need are covered then your best bet would be to take out insurance with a low deductible but higher premiums I guess.


You should contact Jenny on here by PM as she is the expert in this area.
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Old 08.01.2013, 06:12
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My husband had active cancer at the time we moved to Switzerland (end of 2011). He has "basic" insurance as obviously no insurer would accept him for voluntary insurance. We took the minimum deductible of CHF 300 knowing he is a heavy user of medical services.

At the time, we had been told no further surgery was possible. However a Swiss surgeon reviewed and offered surgery last year - successful, and estimated cost CHF 80-100k ! Insurer did not question any costs, even the three weeks residential physical rehab. And this is for a procedure that many US insurers class as "experimental" to avoid paying (rare cancer, procedure been done for 15 years, not enough patients to force a change in attitude).

Our out of pocket cost was CHF 1000 :-). And we found that "basic" insurance is really not that basic!

Obviously, the specific chemo you have will be a critical factor, but if it is a well established drug, I would fully expect it to be available here and covered by the insurance.

If you are having a "look-see" trip, why not build in a visit to a doctor and ask the specific question? You'd have to pay for the doctor visit, but worth it for peace of mind.

Good luck and good health
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Old 08.01.2013, 08:00
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I think the term basic insurance is a misnomer. It is, in many cases, quite complete. You will pay a monthly fee for your insurance, usually between chf 200 and 400, and you will choose a deductible, between 300 and 2500. Higher deductible, lower monthly cost. But if you know you'll have expenses, take the lower deductible

Your out of pocket is then an additional 700chf. You pay 10% of all covered charges (including prescription meds) - no copays. When you've paid 700 out of pocket, you're with out of pocket.

If your treatment is more or less standard practice in the US, it should be covered here.

What you won't be eligible for is the supplimental insurance. The biggest issue here is the lack of private room for hospital, and perhaps physician choice in hospital. You can pay out of pocket for private room. If you have your own physician at the time of admission, then that's going to be your doctor in most cases.

I was diagnosed with breast cancer after moving here, and the care i recieved with the basic insurance was excellent.What is key is finding an oncologist to work with. I had great management of symptoms, etc. many docs have done fellowships etc in the US or UK, and speak English.

If your husband is here on an expat contract, you should find out what the company will pay, if anything, toward insurance. And also, if you plan to return to the US, will you be able to obtain insurance in the US when you get back? (Probably not an issue if husband keeps same employer).

Do contact one of the members here, Jenny. She's an expert in insurance.

Wishing you all the best.

Last edited by edot; 08.01.2013 at 09:00.
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Old 08.01.2013, 08:18
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Re: Health Insurance- Cancer

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First of all - I wish you good health and full and fast recovery.
To your questions- I might be wrong, but I think you might find it hard to find an insurance company that will agree to insure you, in your situation.

Regarding the costs: usually you pay your monthly charge, then when you use medical services you will pay your deductible (until certain limit - the lower the deductible is - the higher the monthly payment is), above that I pay 10% of the expenses.

Take a look at this site to get an idea of the costs.
You are wrong.

All health insurance companies are obliged to cover all illnesses and accidents treated by doctors and hospitals in the Canton where you live.

The extra supplementary insurance is for private hospital rooms, alternative medicine, transport, routine medical treatment and surgery in other Cantons, etc etc.
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Old 08.01.2013, 08:29
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Re: Health Insurance- Cancer

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You are wrong.

All health insurance companies are obliged to cover all illnesses and accidents treated by doctors and hospitals in the Canton where you live.

The extra supplementary insurance is for private hospital rooms, alternative medicine, transport, routine medical treatment and surgery in other Cantons, etc etc.

hasnt that changed since 2013 and is now part of the basic cover?

There were a few articles about it in the news papers for a day and then nothing more.. the insurance companies have obviously been quiet as those people paying the supplement for treatment in any canton may just continue paying.
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Old 08.01.2013, 08:57
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In January 2012, the laws changed. You can recieve care in another kanton. If the care is more expensive than in your home kanton, then you might be asked to pay the difference.

The interpretation and implementation of the law is a bit fuzzy. Different people report different experiences.

And it's always been the case that if you require specialized care that's only available in another kanton, that care is covered.
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Old 08.01.2013, 09:03
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Re: Health Insurance- Cancer

Cancer treatment under "basic" insurance it not necessarily always covered. Someone we know has been in treatment for two years, and now the insurance has said it will not pay anymore because it appears the medicine is not working.

I don't know what criteria they use, but I can tell you this person looked terrible and near death prior to treatment, and after was out hiking and skiing and living like a perfectly healthy person. Now that the insurance says it won't pay anymore, he's given up on life completely.

Edit for clarity: this is in Switzerland, under the Swiss system.
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Old 08.01.2013, 09:04
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Re: Health Insurance- Cancer

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hasnt that changed since 2013 and is now part of the basic cover?

There were a few articles about it in the news papers for a day and then nothing more.. the insurance companies have obviously been quiet as those people paying the supplement for treatment in any canton may just continue paying.
It depends.
There is the so called "Spitalliste" for each Kanton which says which clinics are actually eligible for reimbursements from the health-insurances (and for which treatments).

http://www.gd.zh.ch/internet/gesundh...wnloadfolder_3

Though, in the list the only out-of-canton clinic I could spot for Zurich was the Kantonsspital Schaffhausen (close to the German border).
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Old 08.01.2013, 09:25
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Re: Health Insurance- Cancer

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Cancer treatment under "basic" insurance it not necessarily always covered. Someone we know has been in treatment for two years, and now the insurance has said it will not pay anymore because it appears the medicine is not working.

I don't know what criteria they use, but I can tell you this person looked terrible and near death prior to treatment, and after was out hiking and skiing and living like a perfectly healthy person. Now that the insurance says it won't pay anymore, he's given up on life completely.

Edit for clarity: this is in Switzerland, under the Swiss system.
Then your friend should ask the doctor for a different treatment, one which works. or contact the health Ombudsman and complain.

I can see the health insurance company argument, why should we pay for expensive treatment when it isn't effective? In other countries too, you would be sent home or to a hospice for treatment with morphine pain killers until you die. It is a tough ending, but unfortunately not unusual. (My ex-girl friend works in Oncology at the Insel Spital. She became religious to help her cope with the stress and sadness she experiences everyday at work).
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Old 08.01.2013, 09:40
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Re: Health Insurance- Cancer

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We are currently in the process of deciding whether or not to make a move to Zurich for my husband's job. I was diagnosed with cancer 4 years ago and I'm stable but receive a chemo shot 1 x per month. I'm trying to find out if I will be able to get insurance and what type of costs we are looking at. Are there programs that pay 100% like in the US? Currently we pay a maximum of $2,500 US each year (2 of my shots take care of that). This is obviously a huge factor in our decision making process and I can't seem to find the answer. Any help would be greatly appreciated!
Medical issues can be a deal breaker for expats. In many cases, the transferee does not want the employer to know about a medical condition, and therefore asking HR to source the information for you is impossible.

My advice is to find out if the employer in Switzerland has any agreements with a particular insurance company, as it may be easier to approach them. If not, then contact several insurance companies directly, and obtain the information first hand, and in writing.

You cannot be refused insurance here, but there can be coverage restrictions particularly with medications and pre-existing conditions.

I hope you find a good solution and wishing you continued good health.
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Old 19.01.2013, 18:16
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Re: Health Insurance- Cancer

My husband's company is moving there and so they know all the problems and are trying to help figure it out. Thanks for all of the information! I though insurance was difficult to deal with in the US - this seems far more challenging!
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Old 19.01.2013, 18:58
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Re: Health Insurance- Cancer

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My husband's company is moving there and so they know all the problems and are trying to help figure it out. Thanks for all of the information! I though insurance was difficult to deal with in the US - this seems far more challenging!
try to hang in there as you get information on supplementary insurance and all the other joys of an international move...I know it seems challenging....but I'm sure it will work out.

The process for getting basic insurance (which should cover all treatments, but as advised above, ask the specific questions for your ongoing treatment) is this:

- pick an insurance company. For basic insurance, they all have the same benefits. So pick on price / inputs from broker or other expats on quality / speed of bill paying
- fill in the form....name, address. For basic, no other information required
- send it off

That's it....so as long as you can remember your name (which in the middle of an international move, can sometimes be a problem ), you can get basic insurance
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Old 19.01.2013, 19:03
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My husband's company is moving there and so they know all the problems and are trying to help figure it out. Thanks for all of the information! I though insurance was difficult to deal with in the US - this seems far more challenging!
Oh no. I think it appears to be challenging because it's different. But in my experience, there has been very little interference from my insurance company. I don't pay any copays at point of service. The required cover is available to everyone. I think it's more straightforward than in the US.
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Old 19.01.2013, 23:10
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Re: Health Insurance- Cancer

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My husband's company is moving there and so they know all the problems and are trying to help figure it out. Thanks for all of the information! I though insurance was difficult to deal with in the US - this seems far more challenging!
Just give your husband's company the name of the specific medication and let them find out for you if it is covered under obligatory insurance regardless of what insurance company you take a policy with.
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Old 20.01.2013, 12:46
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Re: Health Insurance- Cancer

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It depends.
There is the so called "Spitalliste" for each Kanton which says which clinics are actually eligible for reimbursements from the health-insurances (and for which treatments).

http://www.gd.zh.ch/internet/gesundh...wnloadfolder_3

Though, in the list the only out-of-canton clinic I could spot for Zurich was the Kantonsspital Schaffhausen (close to the German border).
I've not looked at this list, but i live in KT Zurich and my oncologist and gynecologist remain in KT Bern. So I don't think it's absolutely complete. Or maybe it's because I had a prior relationship with these docs before I moved. I'm totally puzzled.
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Old 20.01.2013, 16:21
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Re: Health Insurance- Cancer

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I've not looked at this list, but i live in KT Zurich and my oncologist and gynecologist remain in KT Bern. So I don't think it's absolutely complete. Or maybe it's because I had a prior relationship with these docs before I moved. I'm totally puzzled.
The standard rate TARMED for a doctor's visit is the same everywhere in Switzerland. This does not apply to hospitals where the rate is cantonal. In case of hospitalisation you should select a hospital in your canton or you have to pay an out-of-canton rate. The insurance won't reimburse you for the difference unless you have supplementary insurance.
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Old 20.01.2013, 16:47
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The standard rate TARMED for a doctor's visit is the same everywhere in Switzerland. This does not apply to hospitals where the rate is cantonal. In case of hospitalisation you should select a hospital in your canton or you have to pay an out-of-canton rate. The insurance won't reimburse you for the difference unless you have supplementary insurance.
Or if the cantonal rate is lower than your home canton rate.

So is TARMED the same for all outpatient procedures as well, e.g, scans, imaging, outpatient treatment?
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Old 20.01.2013, 18:37
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Re: Health Insurance- Cancer

We will be under a group policy. They said my meds will be coveted as long as the Dr deems it medically necessary. So I guess the challenge next will be to find that Dr after we choose where to live. Are visiting now and it's beautiful here!! Can't wait to move!
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