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  #21  
Old 20.12.2014, 22:33
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Re: Health Insurance - first 3 months...once again

Sour grapes me thinks. Expats who are more swiss than the swiss too. It all works itself out....you win some you lose some....I'm sure it will come back in some fines at some point in the future.
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  #22  
Old 20.12.2014, 22:58
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Re: Health Insurance - first 3 months...once again

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So what you're saying, basically, is that you can get away with it.

Yes, I agree. I wasn't aware of these things, and didn't take out health insurance for two years after I was first here.

But as a broker, advising clients to take advantage of a lack of sufficient controls is a very different thing.
Wich lack of sufficient control ? The cantonal Health insurance services (services de l'assurance maladie in french) control if residents get the compulsory health insurance. They get the list of new residents directly from another state service (the foreigners services. Offices de la population/contrôles des habitants in french). They perfectly agree (maybe would be better to say than they are not against) than people start their health insurance few months after the arrival. The compulsory insurance is provided by insurers (64 health insurers in Switz.). Not by brokers or agents.

There is a "tolerance" from the swiss state and health insurers for new residents who start their insurance within 6 months.

I dont say it's a good thing to be not insured for health. Medical treatments are very expensive, specially here in Switzerland. But it's not because of lack of control than new residents are often able to start their health insurance few months after their arrival. It's just because they prefer it (i.e. because they had no medical treatments up to now) and the state and the insurers accept for it.
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  #23  
Old 20.12.2014, 23:04
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Re: Health Insurance - first 3 months...once again

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Medical treatments are very expensive, specially here in Switzerland.
No, they aren't.

I definitely prefer the time when it was optional, as I have NEVER spent in a year what I pay for insurance.

Tom
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  #24  
Old 20.12.2014, 23:25
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Re: Health Insurance - first 3 months...once again

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No, they aren't.

I definitely prefer the time when it was optional, as I have NEVER spent in a year what I pay for insurance.

Tom
I have never speand also.

But medical cost are very high anyway. Health insurance companies have covered approx. CHF 3200 per affiliate in 2013 for medical treatments.
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  #25  
Old 21.12.2014, 00:01
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Re: Health Insurance - first 3 months...once again

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Keeping in mind how much questions have been already stated here about, I need to start the new topic, to get the final question.

case:
I have came in August. At the beginning obviously I ve managed all the things with registration and started to look for health insurance. Meanwhile I ve of course got a letter wich had remind me about this obligation etc.
From the very beginning, I have had valid EHIC card.
In October I chose the insurance, applied for it with a coverage starting from 1st of November (so exactly after 3 months).

Here come the question - what with 3 first months (August, September, October)? Answer seems to be obvious, as it has been thousand times stated - the insurance is backdated and I should pay for 3 months as well.

...but...

(and here comes the real questions

- where exactly it is stated (I mean some legal statements whch said, that I am supposed to pay back for the insurance which covers me (according to the agreement which I have personally signed) from 1st November)
- on the forum I have already read some stories where it is mentioned "someone suggested me not to pay those backdated part" etc. are there any success-stories on that?
- does EHIC card makes here any difference?
- (the best part) what if my insurance company has issued for me backdated-bill only for October (so 1 month back, not 3), should I stand up and say that I will pay for all 3 months?
- any ideas why they did so?
- what if I will not pay the backdated part of the bill? any user-stories on that?

Thank you very much in advance for any help with this case and any input!

In your situation you should pay all the premiums from the begining (Oktober). You cannot pay the backdated premiums if the insurance company has decided to backdate you. If you don't pay all the the premiums you will have fine.
If you have signed your insurance contrat in Oktober I guess than the insurance was not able to start in November. That's because you were aleady a swiss resident in Oktober and according to the rules the insurance must start on first day of the month you have signed the insurance contract.
For example it doesnt work if you mention as date of signature the 25th of Oktober and you ask for to start the insurance on 1st of November. In that situation the insurance would at least start on 1st of Oktober )
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Old 21.12.2014, 23:16
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Re: Health Insurance - first 3 months...once again

Helvetia1967, you seem to know what you're talking about and appear very certain of the practice you describe. (Assumed) illegality doesn't make you lie, so please accept my apologies for calling you a liar.

In effect, based on your description the insurers give immigrants up to 100% rebate on the first 6 months, without telling anybody other than the Kantone, who should control their actions and make sure they remain within the legal frame.

This practice by the insurers is clearly illegal. The Verordnung KVV by the Bundesrat (in german, sorry) defines amount and duration of the surcharge and essentially says that surchage is computed based on the registration date. Obviously the term SURcharge would make no sense if ordinary/basic charge were not or no longer owed.
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  #27  
Old 22.12.2014, 01:25
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Re: Health Insurance - first 3 months...once again

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Helvetia1967, you seem to know what you're talking about and appear very certain of the practice you describe. (Assumed) illegality doesn't make you lie, so please accept my apologies for calling you a liar.

In effect, based on your description the insurers give immigrants up to 100% rebate on the first 6 months, without telling anybody other than the Kantone, who should control their actions and make sure they remain within the legal frame.

This practice by the insurers is clearly illegal. The Verordnung KVV by the Bundesrat (in german, sorry) defines amount and duration of the surcharge and essentially says that surchage is computed based on the registration date. Obviously the term SURcharge would make no sense if ordinary/basic charge were not or no longer owed.

I would not say than you are wrong Urs Max ("it's illegal"). But it is common practice (to start the basic insurance few months after the residence registration date) accepted by all the insurers and the cantonal health insurance services.
In that situation what the insurance brokers, insurance agent, insurance product sellers can do ? My testimony : i have met a client last Friday. An Indian woman who is living with her husband in Geneva. She gave me copy of her residence permit. It's mentioned August as date of arrival. The cantonal health insurance service has probably forgotten to quickly check about her situation, if she got an insurance or not. She has only received few days ago the letter of the cantonal health insurance service saying than she must send them the proof (the insurance policy) than she is insured for health in Switzerland according to the law. Last day for to show them the proof is on 9th of January 2015. Then what can I do ? I am insurance agent. I work for an insurer. This insurer agrees to start the basic insurance up to 6 months after the date of residence registration. With my client we have decided to start the insurance on 1st of december 2014 : 4 months after the arrival. It will work, I know this.
What can I do in that sort of situation ? It almost always happens than a client meets an insurance broker or agent several months after his arrival and not before. That's because it's not possible for them to get an health insurance before to have received the famous residence permit. In Geneva for example people need to wait up to 4 months before to receive that document.
I don't agree with you when you say than insurers give a 6 months discount to the immigrants. They just "tolerate" than new residents have not to pay backdated premiums when they suscribe at last an health insurance.
The insurers (and the brokers, and the swiss state) have nothing to gain when someone starts the insurance several months after the arrival. It's lack of premiums (money). We just kindly "tolerate".
I repeat: all the insurers and cantonal services tolerate that situation. I dont need to be the only one guy to be "more royalist than the Queen" )
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  #28  
Old 22.12.2014, 01:59
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Re: Health Insurance - first 3 months...once again

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Helvetia1967, you seem to know what you're talking about and appear very certain of the practice you describe. (Assumed) illegality doesn't make you lie, so please accept my apologies for calling you a liar.

In effect, based on your description the insurers give immigrants up to 100% rebate on the first 6 months, without telling anybody other than the Kantone, who should control their actions and make sure they remain within the legal frame.

This practice by the insurers is clearly illegal. The Verordnung KVV by the Bundesrat (in german, sorry) defines amount and duration of the surcharge and essentially says that surchage is computed based on the registration date. Obviously the term SURcharge would make no sense if ordinary/basic charge were not or no longer owed.
Here is interesting link (in english). Read carefully. The practice seems be not illegal at all ) Seem be even totally legal )

http://www.bag.admin.ch/themen/krank...x.html?lang=en

06. Within which period do I have to take out insurance, and what are the consequences of delayed registration?
You have to take out health insurance within three months of the beginning of compulsory insurance (e.g. of the date you take up residence or give birth to a child in Switzerland). The insurance is then back-dated to the beginning of compulsory insurance. Since expenses are reimbursed retroactively, consequently it is mandatory to pay the premiums retroactively from the beginning of coverage on.

If you do not meet this three-month deadline, your insurance cover will only take effect from the date you register, and you will have to pay a premium supplement unless you can give good reasons for the delay.
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Old 22.12.2014, 02:16
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Re: Health Insurance - first 3 months...once again

It's a link directly to the Federal Office of Public Health (FOPH).

"(Assumed) illegality doesn't make me a liar", you said ? I hope you will be fair play now )
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  #30  
Old 22.12.2014, 12:41
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Re: Health Insurance - first 3 months...once again

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Evidence please, not blabla (to Hevetia67- show me the Law which states this).


MaybeeSkint, you should have been paying for August too, month of arrival. Insurance should have been in place for basic insurance, and other complimentaries/dental, etc, added later, as they are totally separate anyhow. It does seem unfair that people applying via big companies get preferential treatment in this way, same with pre-exisiting conditions, etc, which are accepted if insured via big company (big clients, big money) or for individuals.


Later edit.

From the official Swiss Government website:

The Law:

832.10

Loi fédérale sur l'assurance-maladie

(LAMal)

du 18 mars 1994 (Etat le 1er mars 2014)
L'Assemblée fédérale de la Confédération suisse,
vu l'art. 34bis de la constitution1,2 vu le message du Conseil fédéral du 6 novembre 19913,

The Law, part 2:

Titre 2 Assurance obligatoire des soins

Chapitre 1 Obligation de s'assurer

Section 1 Dispositions générales

Art. 3 Personnes tenues de s'assurer


1 Toute personne domiciliée en Suisse doit s'assurer pour les soins en cas de maladie, ou être assurée par son représentant légal, dans les trois mois qui suivent sa prise de domicile ou sa naissance en Suisse.


Translation- each person resident in Switzerland has to insure themselves for health care in case of illness, within 3 months of taking up residence, or birth in Switzerland.
The law that you quote says "WITHIN 3 months of taking up residence". It doesn't say "within 3 months which must then be back dated the date of arrival".


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We didn't pay for the month we arrived either. ( son and myself as OH was already living here.)
We registered on October 28th, filled out all the forms for the health insurance during our first week here but we only started paying from December 1st. We got ours directly from the insurer so no broker involved.
We didn't either.
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Old 22.12.2014, 13:16
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Re: Health Insurance - first 3 months...once again

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The law that you quote says "WITHIN 3 months of taking up residence". It doesn't say "within 3 months which must then be back dated the date of arrival".




We didn't either.
That's what I thought when I read the link.
We were asked to give proof of insurance to the commune/canton ( can't remember which) and we showed them our policies which started on December 1st and they said it was fine and everything was in order. They never said that we needed to pay for the previous two months ( October and November) as well.

The first I heard about the retroactive thing was quite a bit later when somebody posted about it on here.

Last edited by Belgianmum; 22.12.2014 at 15:25.
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Old 22.12.2014, 14:15
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Re: Health Insurance - first 3 months...once again

I as well never paid backdated insurance. I arrived in Switzerland last year at the end of August for my studies and I signed my insurance directly with an insurance company, not through a broker. I payed only from after that date, I never got any receipt for September and August, even though my permit clearly says that I have arrived at the end of August.

Maybe the retroactive thing has been relaxed in the past years and is not being enforced right now.
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Old 22.12.2014, 15:20
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Re: Health Insurance - first 3 months...once again

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No, they aren't.

I definitely prefer the time when it was optional, as I have NEVER spent in a year what I pay for insurance.

Tom
But what if one day, you needed expensive treatment??
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  #34  
Old 22.12.2014, 21:38
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Re: Health Insurance - first 3 months...once again

Here is the official link about back-dating. Same applies to a baby born at the end of a month, insurance is payable from start of month of birth. so if you are having an elective ceasarian for triples, ask for a beginning of month date

05. My child was born at the end of the month. I registered in Switzerland in the middle of the month. Is the insurer entitled/obliged to charge a premium for the whole month?Yes. Although this question is not explicitly mentioned in the law, it is important to note that premiums for compulsory health insurance are not calculated on a daily but exclusively on a monthly basis and that, in addition, these premiums are payable in advance. Premiums thus have to be paid for the whole month.

06. Within which period do I have to take out insurance, and what are the consequences of delayed registration?You have to take out health insurance within three months of the beginning of compulsory insurance (e.g. of the date you take up residence or give birth to a child in Switzerland). The insurance is then back-dated to the beginning of compulsory insurance. Since expenses are reimbursed retroactively, consequently it is mandatory to pay the premiums retroactively from the beginning of coverage on.

Sour grapes. Well yes, I see what you mean. We arrived on the 29th of March- and registered with the Commune/Gemeinde within 2 weeks as per the Law, and gave the true date of arrival. We could have said 1st of April- but we didn't. We then organised Health Insurance within the 3 months of arrival, as per the Law, and were asked to backpay to the 1st of March. We did try to argue that this was not fair, as we'd arrived right at the end of the month- but were quoted the official article above. We then asked my niece, who has worked for the insurer for 30+ years- and it was confirmed to her that this was required- even for her favourite aunt. So we paid because the law is quite clear- took it on the chin and lesson learnt. Which is why I have often on EF advised to avoid arriving at the end of a month. If you arrived late August, and registered within the legal framework of two weeks, for instance, you could get away with backpaying to 1st of September. If an individula gets away with not paying for a month or a two, I do not know, as it is clearly against the regs. But good on you, if the insurance didn't do their job properly- you can't be to blame.

However, there is a big nuance, and fact a massive difference, between an individual saying ' the insurance didn't charge for 2 or 3 months, so I didn't quibble- and a professional broker advising people that defrauding the insurance system is fine and dandy. Many of the insurances, which all have to be non profit organisations for complusory insurance, and can only make profit on supplemental/extra cover (private care, etc) are ont heir knees and premiums are going up for all, even those with low income. These insurance are not private concerns like Bupa and so on.

Last edited by Odile; 22.12.2014 at 22:11.
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  #35  
Old 22.12.2014, 22:16
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Re: Health Insurance - first 3 months...once again

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Here is the official link about back-dating. Same applies to a baby born at the end of a month, insurance is payable from start of month of birth. so if you are having an elective ceasarian for triples, ask for a beginning of month date

05. My child was born at the end of the month. I registered in Switzerland in the middle of the month. Is the insurer entitled/obliged to charge a premium for the whole month?Yes. Although this question is not explicitly mentioned in the law, it is important to note that premiums for compulsory health insurance are not calculated on a daily but exclusively on a monthly basis and that, in addition, these premiums are payable in advance. Premiums thus have to be paid for the whole month.

06. Within which period do I have to take out insurance, and what are the consequences of delayed registration?You have to take out health insurance within three months of the beginning of compulsory insurance (e.g. of the date you take up residence or give birth to a child in Switzerland). The insurance is then back-dated to the beginning of compulsory insurance. Since expenses are reimbursed retroactively, consequently it is mandatory to pay the premiums retroactively from the beginning of coverage on.

Sour grapes. Well yes, I see what you mean. We arrived on the 29th of March- and registered with the Commune/Gemeinde within 2 weeks as per the Law, and gave the true date of arrival. We could have said 1st of April- but we didn't. We then organised Health Insurance within the 3 months of arrival, as per the Law, and were asked to backpay to the 1st of March. We did try to argue that this was not fair, as we'd arrived right at the end of the month- but were quoted the official article above. We then asked my niece, who has worked for the insurer for 30+ years- and it was confirmed to her that this was required- even for her favourite aunt. So we paid because the law is quite clear. Which is why I have often on EF advised to avoid arriving at the end of a month. If you arrived late August, and registered within the legal framework of two weeks, for instance, you could get away with backpaying to 1st of September. If an individula gets away with not paying for a month or a two, I do not know, as it is clearly against the regs. But good on you, if the insurance didn't do their job properly- you can't be to blame.

However, there is a big nuance, and fact a massive difference, between an individual saying ' the insurance didn't charge for 2 or 3 months, so I didn't quibble- and a professional broker advising people that defrauding the insurance system is fine and dandy. Many of the insurances, which have to be non profit organisations, are ont heir knees and premiums are going up for all, even those with low income. These insurance are not private concerns like Bupa and so on.

Odile. You have mentioned here what say the (swiss governmental) Federal Office of public health about when should start the mandatory health insurance. Very well. But you have "forgotten" to mention the three last lines ! Here is the link : http://www.bag.admin.ch/themen/krank...x.html?lang=en

And herebelow the full comment :

[B]06. Within which period do I have to take out insurance, and what are the consequences of delayed registration?
You have to take out health insurance within three months of the beginning of compulsory insurance (e.g. of the date you take up residence or give birth to a child in Switzerland). The insurance is then back-dated to the beginning of compulsory insurance. Since expenses are reimbursed retroactively, consequently it is mandatory to pay the premiums retroactively from the beginning of coverage on.

(Here-after are the three last sentenses you have "forgotten to mention) :

If you do not meet this three-month deadline, your insurance cover will only take effect from the date you register, and you will have to pay a premium supplement unless you can give good reasons for the delay.[/B]

As you can understand Odile, it's possible to get insurance after the three-month deadline. With no back-dated premiums ! )

Then please don't say bad things about these stupid brokers who would tell stupid things ) That's because the Federal office of public health is saying absolutely the same !
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  #36  
Old 22.12.2014, 22:26
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Re: Health Insurance - first 3 months...once again

Sorry, the link is here .

http://www.bag.admin.ch/themen/krank...x.html?lang=en
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Old 22.12.2014, 22:41
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Re: Health Insurance - first 3 months...once again

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Since expenses are reimbursed retroactively, consequently it is mandatory to pay the premiums retroactively from the beginning of coverage on.

(Here-after are the three last sentenses you have "forgotten to mention) :

If you do not meet this three-month deadline, your insurance cover will only take effect from the date you register, and you will have to pay a premium supplement unless you can give good reasons for the delay.[/B]

As you can understand Odile, it's possible to get insurance after the three-month deadline. With no back-dated premiums ! )

Then please don't say bad things about these stupid brokers who would tell stupid things ) That's because the Federal office of public health is saying absolutely the same !
What part of "mandatory" is it you're struggling with?

All your missing sentences are saying is what's already been stated earlier "you'll probably get away with it". Advising clients to do so is in fragrant breach of the rules (remember, it's "mandatory").
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Old 22.12.2014, 22:41
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Re: Health Insurance - first 3 months...once again

It is possible- in exceptional circumstances we were told- otherwise it it totally contradictory and does not make any sense. Just as in the case of a baby. You are clearly advising people that they can get away without paying for months, and even, in a previous post, that should they become ill during the unpaid period, even beyond the 3 months, they can get away with still gettting cover. (If the new resident has serious (and costly) medical problems within 6 months after he becomes a resident - but he is still not insured - he can ask to the insurer he wants to start the insurance back to the first day of residence. The same even if he has started his insurance few months after he became a resident. If the new resident has serious (and costly) medical problems within 6 months after he becomes a resident - but he is still not insured - he can ask to the insurer he wants to start the insurance back to the first day of residence. The same even if he has started his insurance few months after he became a resident. In my book, that goes clearly against the regs and how the system works.

As said, I shall check this with FRC and Bon à Savoir legal departments after Christmas- as well as our legal representatives for the Canton here- as it does not make sense unless there are extremely good reasons for the delay.

Last edited by Odile; 22.12.2014 at 23:44.
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Old 22.12.2014, 23:01
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Re: Health Insurance - first 3 months...once again

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It is possible- in exceptional circumstances we were told- otherwise it it totally contradictory and does not make any sense. Just as in the case of a baby. You are clearly advising people that they can get away without paying for months, and even, in a previous post, that should they become ill during the unpaid period, even beyond the 3 months, they can get away with still gettting cover. In my book, that goes clearly against the regs and how the system works.

As said, I shall check this with FRC and Bon à Savoir legal departments after Christmas- as well as our legal representatives for the Canton here- as it does not make sense unless there are extremely good reasons for the delay.
Odile, let me answer.

>It often happens than people ask for the mandatory health insurance weeks or even months after the 3 months dedline. And it's often not their fault. For to suscribe an health insurance here new residents must provide copy of the residence permit. In few area, for example Geneva, Zurich and Basel (areas were are lot of foreigners) it takes several months (up to 4 for Geneva) for to receive the resident permit. Then people are often applying for the health insurance much after the 3 months deadline. Here are the good reasons for the delay.

> You say I am clearly advising people to avoir the law. It's wrong. I have just some knowledge about insurance field and I have answered to the forum question about "what about the 3 months back-dated premiums". Let me telling you something else. This. What I said here is what is mentioning the swiss government (by the Federal Office of Public Health (FOPH) on his official website under "FAQ about the requirement to take out insurance". Because the swiss government is telling the same on the world wide web than me here on Englishforum would you say than the swiss government is also advising people to avoid the law ? I guess no.
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Old 22.12.2014, 23:06
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Re: Health Insurance - first 3 months...once again

I have written to them for clarification. So give them time to answer- I'll go with what they say. The official website is indeed contradictory.

Last edited by Odile; 22.12.2014 at 23:41.
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