Hi there,

Im just about to choose my health insurance provider.

I broke my wrist about a year ago, I think I need to go back for some phisio therapy.

Would my new insurance cover that physio (obviously after the deductable).. but the question is if its a problem that its an old injury.

Thanks,
Alan

you might have to pay for physiotherapy. If you broke your wrist whilst under insurance, you'd have a lifetime guarantee - I have had my leg upgraded and downgraded and it's still under warranty

I'm really confused by all the replies on here about pre existing conditions not being covered. In my experience, all treatments are covered under the mandatory health scheme, they don't ask you to disclose your medical history when you sign up and they will refund you no matter what.

Then you must be quite lucky.

One should bear in mind that not all medical treatment is covered under basic health insurance.

Generally, all applicants are required to disclose their prior medical history when signing up to a new health insurer. Your "prior medical history" should include everything from asthma to breast cancer.

In most instances, a new health insurer will accept most "minor" pre-existing conditions. But for more serious (and expensive) conditions which would not be covered under your basic health insurance, an insurer should be informed of such so they can properly assess their risk, see what coverage is best for you and, if necessary, adjust any premium they wish to charge you.

To take an extreme example, if you had heart surgery 2 years ago and then switch to a different health insurer without disclosing this fact, it is unlikely that your new health insurer will fund future surgery/treatment if related complications occur.

It is possible that you may have inadvertently failed to disclose your prior medical history at the time of signing up with your current health insurer. But if you do have a serious medical condition, I would recommend that you alert your health insurer to this fact before any need for treatment arises. Otherwise, come the time for treatment, you may find that your health insurer will refuse to cover your treatment, and you don't want to be dealing with financial woes at a time when you should be focusing on your health.

I'm not sure that's correct. The Geneva International Center clearly state:

"Mandatory basic health insurance (also known as basic insurance): guarantees access to high-quality healthcare and a broad range of services, identical for all insurance holders (without reservations concerning pre-existing conditions and with an identical premium range for insurance holders covered by the same health insurer)."

http://www.cagi.ch/en/Assurancemaladie.htm

Of course not all treatment are covered under the mandatory scheme, but I think the ones that are covered are covered regardless of whether they are new or pre existing.

My feeling is that a lot insurance companies will try to blur the line between mandatory and complementary insurance. That's just part of there sales pitch.

This is not correct as far as the basic insurance is concerned. You are not asked and do not have to declare any pre-existing conditions.

The terms of the policy are fixed by the Federal Government and cannot be changed by the insurer.

For the question raised by the OP, physio would be covered if prescribed by a doctor but it will be dealt with as an illness (maladie) rather than an accident.

We can agree to disagree. My experience is the opposite to what you have described.

Perhaps one is best advised to read the terms and conditions of their basic health insurance. The law (Bundesgesetz über die Krankenversicherung) sets out the provisions dealing with mandatory health insurance. But it is your insurance policy which will deal with matters of indemnification.

My previous post was merely to inform people that it is better to be upfront and to disclose your prior medical history than to be later inconvenienced when you discover that your health insurer will not provide coverage.

As to the question raised by alanmack, his health insurer is likely to view the broken wrist as a result of an accident, and accidents are not covered by your basic health insurance unless you are not employed at the time of taking out the basic health insurance. If you are employed, your employer will have organised accident insurance for you, which covers accidents both at work and outside of work. If the broken wrist did not occur when an accident policy was in place, then it is unlikely that a current accident insurer will provide coverage for physio in relation to an accident that they are not liable for.

If you visit a physician and tell him/her of your injury, and the physician prescribes physical therapy then I don't see how it would not be approved - subject to the limits of your particular basic insurance - and therein lies the rub, I guess - you probably want to investigate what the physical therapy benefit is for potential insurers.

Also, Jenny, who is a member here is incredibly helpful with insurance issues - you might PM her for advice.

I can agree with your comments about disclosure of previous medical history if it relates to private insurance but not to the basic Swiss health cover.

For the basic insurance an insurer cannot ask about your medical history and, even if you did decide to disclose it, they cannot refuse you or charge a premium higher than their published rate. If they attempted to do so they should be reported to the insurance Ombudsman. See this on the Comparis website (if it comes up in German you can switch it to English).

As you say, the insurers do issue their own policy but they all have to apply the law in an identical manner. See the Federal Government website which says:
So, there is no scope for an insurer to issue a policy which does not provide the full benefits. See Comparis.

In your first post you state: What serious conditions are not covered by the basis insurance ? There are certain procedures which may not be covered but these tend to be when a more expensive one is available over and above the normal one. For example: Dealing with varicose veins by the traditional surgical method is covered but, treatment by laser is not. (This information was correct in 2006 but may have changed since).

If a doctor proposes any procedure that is not covered by the basic insurance they are required to inform you of this fact.

The example you give of someone having a heart operation and then needing further treatment is not correct. The new insurer has to pay the bill for any further treatment that may be necessary. For example, if towards the end of the year you have a condition needing treatment such as physiotherapy and on the 1st January you change insurers then the new insurer has to pay the bills from that point on.

With regard to the original question raised by alanmack, if he had been covered by a Swiss employer at the time of the accident then, as you say, anything relating to it would be their responsibility. However, as he was not, apparently, here when the accident happened it can be dealt with as a medical condition under the basic insurance.

Some more links: Explanation of Swiss health system. Here and here.