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Old 03.05.2015, 16:06
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Helsana

Hi,


We are currently in dispute with Helsana and I want to know if anyone else has had this issue and how we go about resolving it.


I contacted Assura online in mid January 2015 and we had a rep contact me and come to my home and provide information about a number of health insurance companies and we put an application in with Helsana through the agent/rep in mid January. I followed up with the agent 5 weeks later (end Feb) and again first week March as we had not received any information nor contract from Helsana and emails from the agent to the effect that Helsana was behind in its administration and it should be resolved and we will have our contracts by end March. Our contracts arrived end March acknowledging our application and providing our insurance policy numbers.


However, we have been requested to backpay over CHF3500 commencing from January 1.


I understand health insurance companies require the 1st of the month insurance coverage, however, our application was not even processed by Helsana until the last week of March. How can they request backpayment?


Our B permits were issued commencing January 1, 2015 and I understand we have 'within three months to have basic compulsory health insurance from the date of residency'. In addition to this, Helsana's Ts & Cs state that 'the contract cannot be accepted until Helsana advise the applicant of the application' of which they didn't do until end March with starting date April 1, 2015. However, Helsana is stating they have requested backpayment as we became B permit residents from January 1, 2015.


Can anyone advise on what we need to do here?
Thanks in advance.
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Old 03.05.2015, 16:12
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Re: Helsana

In a nutshell? Pay the bill. You are allowed a few months to sort your insurance, but it is backdated to your date of arrival. If you have seen any doctors or filled prescriptions, they are covered (subject to franchise rules).

See also:

Health insurance after 3 months

Edit after re-reading OP - Check your contract language carefully. If it has a start date of January 1 then the above is true. If the start date is April 1 then you should not need to pay backdated premiums all the way to January. But I'd think that's the exception, not the norm.

Last edited by 3Wishes; 04.05.2015 at 23:30. Reason: one link was sufficient ;)
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Old 03.05.2015, 16:14
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Re: Helsana

There is a retroactive effect on LaMal insurance starting on date of entry.

Are you sure the 3500CHF covers the 3 months for all family members?

What is now (after signing the contract) the monthly fee you pay to the insurance?
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Old 03.05.2015, 16:31
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Re: Helsana

Totally normal -- As other said insurance starts on the date of the permit.

I'm with Helsana too, we were same.. I got an email to confirm we were insured, doctors etc were happy with that. I didn't get a plastic card for about 2 months.. And didn't get a bill for I think 5 or 6 months. So for a family of 4, that was a big bill when it arrived!

On the plus side, 2.5 years with them now, no issues, bills refunded in a couple of weeks, never any disputes.
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Old 06.05.2015, 17:15
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Re: Helsana

According to the Swiss health regulations do you have to have basic health insurance (KVG) sorted within the first three months. The start date is then the date of entry into Switzerland (register date). If you would have signed the contract after the first three months, that would be the start date of your contract, although they can 'fine' you with the premium of the date of entry, without you being able to claim any benefits for that period.

The insurance card can only be printed once you have your permit and their system has received your AHV number (National Insurance number).

So it appears they haven't done anything wrong, just a bit slow
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