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Old 21.01.2015, 19:15
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Ongoing treatment and new health insurance

Sorry if I missed a thread on this but a search didn't throw anything up.

I'm moving to Geneva for work in the coming weeks - transferring office from London. I have some pretty gritty pre-existing conditions that I'm still getting specialist treatment for... the likelihood is that most insurers would not be happy covering me for them. I therefore doubt I can get supplementary insurance to cover me - I'm very used to insurance companies turning me away.

I can, however, get international insurance through work (which would also enable me to continue to see my specialist in the UK).

So questions:
1) In this kind of situation, where I'm very likely to be going to need external and international cover, do I still have to get mandatory insurance?
2) Even if I'm exempt, am I likely to want to take it anyway? (My international cover is unlikely to cover dental treatment or eye tests, for example.)
3) Even if I can theoretically be exempted from mandatory insurance, is the process of getting exemption likely to be worth the time and effort (and perhaps, cost)?

Thanks.
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Old 21.01.2015, 19:27
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Re: Ongoing treatment and new health insurance

Welcome to EF.

Most of your questions have already been asked and answered. The mandatory basic Swiss insurance covers pre-conditions and all maladies, which is possibly why it is so expensive. They have to take everybody without any medical checks.

You might want to bring your medical records with you, to show them here what has been tested already.
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Old 21.01.2015, 19:32
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Re: Ongoing treatment and new health insurance

Dental Insurance is usually taken out separately, you'll be asked to take a form along to a dentist for them to assess your teeth and the insurance then decides whether they'll accept you or not; possibly even accepting you in principle but excluding certain teeth or types of work.
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Old 21.01.2015, 19:40
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Re: Ongoing treatment and new health insurance

It's unlikely you'll get exemption. Swiss basic insurance won't cover dental or eye tests either. However Swiss basic insurance should cover everything you need medically.
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Old 21.01.2015, 19:41
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Re: Ongoing treatment and new health insurance

Thanks. So basically I'd have to find one of the maybe 2 or 3 surgeons in Switzerland able to deal with my conditions, wherever they may be in the country, and put up with it? (Or, fundamentally, pay both Swiss and international insurance.)

I ask because of this:

Quote:
The following are also exempted on request:
- people for whom membership of a Swiss insurance scheme would entail a marked deterioration in insurance coverage or in reimbursement of expenses and who, on account of their age and/or state of health, could not obtain comparable supplementary insurance or could only do so on terms that would be difficult to accept;
http://www.bag.admin.ch/themen/krank...x.html?lang=en
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Old 21.01.2015, 19:50
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Re: Ongoing treatment and new health insurance

The basic insurance in Switzerland is fairly comprehensive, covers many, many chronic and acute conditions. If you visit an opthalmologist for an eye exam and subsequent treatment you might also be covered. Glasses, etc, are not covered. Dental stuff is separate, too.

My guess is that the university hospitals in geneva, lausane, bern, basel, zuerich are good places to start to look for specialists.
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Old 21.01.2015, 20:08
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Re: Ongoing treatment and new health insurance

Thanks. I am not confident that my conditions will be covered or that a surgeon able to assist will be easy to find, but the message is loud and clear!
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Old 21.01.2015, 20:57
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Re: Ongoing treatment and new health insurance

The thing is that usually, once you become a resident here, most other insurances become invalid. Now that may not be the case with your work one, but the best thing to do is contact the Geneva migration office to find out if it would be an acceptable substitute. Also have a look at these links which will provide more info:

https://www.ch.ch/en/health-insurance/

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

And as already stated pre-existing conditions must be covered by the basic mandatory insurance. You cannot be refused because of these.

Definitely bring copies of your medical records and things like x-rays, CAT/MRI scans, etc, if you can.
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Old 21.01.2015, 21:06
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Re: Ongoing treatment and new health insurance

OP, try not to panic too much. As others have said the "basic" coverage here is quite comprehensive. We've had Forum members who moved here with cancer, diabetes, heart disease, complicated pregnancies, etc. and they were still able to continue treatment. The nice thing about the system here is you have a maximum out-of-pocket per year, no matter how complicated your condition may be. It sounds like you'd be better off choosing a low franchise (co-payment) with higher premium.

Will you get the most senior doctor every time? It depends. If it's something "routine" then you'll get a less senior doctor on the basic insurance. However as soon as you're an unusual case the senior doctor is often involved from the start.

Here are two websites where you can search for doctors:
www.doktor.ch (in German, French, or Italian only)
www.doctorfmh.ch (also able to search in English)

I'm also attaching a few documents that might help you learn a bit more. These are from the admin.ch website.

Good luck, and if you feel comfortable you're welcome to ask about coverage for specific conditions.
Attached Files
File Type: pdf Health Insurace Q&A.pdf (692.1 KB, 204 views)
File Type: pdf Health Insurace FAQs.pdf (67.9 KB, 172 views)
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Old 22.01.2015, 02:01
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Re: Ongoing treatment and new health insurance

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Thanks. I am not confident that my conditions will be covered or that a surgeon able to assist will be easy to find, but the message is loud and clear!

That's what we thought too....but hubby's rare cancer and equally rare blood disorder have been really well handled here under basic insurance. In the UK there were only two hospitals doing the surgery he needed. So, we know the joys of limited choice....but far more has been available and paid for by the Swiss basic insurance than was available on the NHS or the international medical insurance that I can access through work. I don't begrudge a single rappen of the premium!

PS hubby....stop having rare medical things. It's not big and it's not clever. I know enough German medical words now!
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Old 23.01.2015, 13:58
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Re: Ongoing treatment and new health insurance

Thanks folks. We'll see, I guess!

I suppose the nervousness for me comes from my care not being so ongoing and chronic, but rather as series of annoyingly complex operations which will either improve, or possibly wreck, my mobility.

I'll talk to some more Swiss surgeons (I've already discussed with a few). I suspect, in the end, my last resort will be paying out of pocket for the operations in the UK. But such is life.
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Old 23.01.2015, 14:01
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Re: Ongoing treatment and new health insurance

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I'll talk to some more Swiss surgeons (I've already discussed with a few). I suspect, in the end, my last resort will be paying out of pocket for the operations in the UK. But such is life.
Basic insurance may actually cover you for necessary treatment abroad if there is no possibility to have the treatment in Switzerland. It's worth asking them.
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Old 23.01.2015, 14:05
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Re: Ongoing treatment and new health insurance

Whichever way it works out with the insurance and the doctors, I wish you the best and of course the soonest possible recovery.
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Old 23.01.2015, 14:05
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Basic insurance may actually cover you for necessary treatment abroad if there is no possibility to have the treatment in Switzerland. It's worth asking them.
Intriguing, thanks!

(It's probably not so much that there's no possibility, more that the chance of finding a surgeon with good experience of doing the specific work I need is pretty low. That makes the downside risk of having the work increase a lot.

Oddly, the UK is good because it has a lot of a) polo players and b) soldiers, both of whom get similar injuries. If my issue was more like a ski injury I wouldn't hesitate to be seen in Switzerland...)

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Whichever way it works out with the insurance and the doctors, I wish you the best and of course the soonest possible recovery.
Thank you I'm still excited about the move. All in the hands of those approving the work permit now!

Last edited by 3Wishes; 23.01.2015 at 14:54. Reason: merging successive posts
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Old 23.01.2015, 18:10
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Re: Ongoing treatment and new health insurance

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Oddly, the UK is good because it has a lot of a) polo players and b) soldiers, both of whom get similar injuries. If my issue was more like a ski injury I wouldn't hesitate to be seen in Switzerland...)
You know the Swiss has national service - so the doctors/surgeons will be very used to seeing soldiers.
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Old 23.01.2015, 18:14
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Re: Ongoing treatment and new health insurance

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You know the Swiss has national service - so the doctors/surgeons will be very used to seeing soldiers.
Swiss soldiers don't (currently) do the kinds of things that British soldiers do in the kinds of places that British soldiers go, that lead to British soldiers getting injuries like mine. If that makes sense.
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Old 23.01.2015, 18:14
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Re: Ongoing treatment and new health insurance

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You know the Swiss has national service - so the doctors/surgeons will be very used to seeing soldiers.
Soldiers that never go to war, so don't get serious traumas
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Old 23.01.2015, 19:09
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Re: Ongoing treatment and new health insurance

OP, it sounds like you've already made up your mind about the Swiss healthcare system. Please don't do that without digging a little deeper, as it could cost you a lot of money and stress. Yes, you can apply for an exemption but you need to prove that the Swiss system will not work...right now you don't know for sure one way or the other. You're guessing only 2-3 surgeons in a country of 8 million people can help you...that sounds very unusual indeed!

It's hard to offer more specific advice without knowing a bit more about the complications you face. But I respect your desire to keep that information private. So...

You mention on-going issues similar to those soldiers returning from war experience. This gives me the idea of repetitive motion problems, gunshot wounds, burns/skin grafting, and possibly even amputations and prosthetics. Not sure how polo players would fit in except for back and shoulder injuries.

Anyway, using the doctorfmh link above, I tried a few searches.

Plastic, reconstructive, and aesthetic surgery -

- 24 doctors with this specialty in canton Geneva, and 10 of them specifically mention speaking English
- another 32 in canton Vaud, and 13 of them specifically mention English

Orthopaedic surgeons -

- 52 in canton Geneva, 15 mention English
- another 35 in canton Vaud, 23 mention English

I hope this information helps. If not and you feel comfortable sharing a bit more, please do so we can try and point you in the right direction.
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Old 24.01.2015, 00:00
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Re: Ongoing treatment and new health insurance

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Yes, you can apply for an exemption but you need to prove that the Swiss system will not work...right now you don't know for sure one way or the other. You're guessing only 2-3 surgeons in a country of 8 million people can help you...that sounds very unusual indeed!
Pretty much. The number in the UK who have enough experience to help and know well what they are doing with specific injuries like mine can be counted in single figures...

You're right that I'm making the assumption that Swiss surgeons aren't an order of magnitude better and more experienced than those in the UK - especially because there's even less chance of them seeing similar cases in Switzerland compared to the UK. (Sorry if that sounds snarky, but it IS an explicit assumption I've made.)

It's not that I've made up my mind about the Swiss system per se, more that I am sadly very well aware of just how specific the set of skills and experiences I'm going to need from a surgeon are.

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You mention on-going issues similar to those soldiers returning from war experience. This gives me the idea of repetitive motion problems, gunshot wounds, burns/skin grafting, and possibly even amputations and prosthetics. Not sure how polo players would fit in except for back and shoulder injuries.
Yes, it's some of the above. I guess you can figure out the intersection

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I hope this information helps. If not and you feel comfortable sharing a bit more, please do so we can try and point you in the right direction.
Thanks - I do appreciate the offer! I am in touch with some orthopedic surgeons in Switzerland and am going to see if they can help me figure out if there are any surgeons with the right experience in the right areas and techniques to help.

To be honest, I am heavily leaning towards trying to get the further work done by the surgeon in the UK who has done much of the work already. I'm not here to dismiss the Swiss system, not at all! For some of the other minor medical work I'm going to need, it sounds like it'd work very well. But if I'm going to be taking medical insurance internationally anyway (if that's something that turns out to be possible), it'd be nice not to double-pay.

I do appreciate all the thoughts
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Old 24.01.2015, 08:30
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Re: Ongoing treatment and new health insurance

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To be honest, I am heavily leaning towards trying to get the further work done by the surgeon in the UK who has done much of the work already. I'm not here to dismiss the Swiss system, not at all! For some of the other minor medical work I'm going to need, it sounds like it'd work very well. But if I'm going to be taking medical insurance internationally anyway (if that's something that turns out to be possible), it'd be nice not to double-pay.

I do appreciate all the thoughts
There is an additional aspect of Swiss healthcare that you probably have not considered....because it doesn't arise in the UK context. Here, it's not uncommon for the doctors to send a patient to rehabilitation post surgery / hospital stay. This can be on a day-patient or residential basis, and means easy and intensive access to physio, massages, psych if one wishes / needs it, dressing changes and minor medical needs attended to (e.g. fluids per IV, drainage of healing wounds).

When the docs recommended it for Mr. Heckenhocker post-surgery, I took a big gulp...thinking OK, maybe I can auction off an arm and a leg. Nope...the basic insurance paid for the whole thing.

And his return to fitness after three weeks re-hab post hospital was far better /quicker than the first time round of the same extent of surgery (in the UK, without rehab).

Just something else to consider before you decide which route is right for you. Oh, isn't complex medical need decision making fun!!

Last edited by 3Wishes; 24.01.2015 at 15:42. Reason: removed real name for privacy reasons
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