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Old 02.09.2015, 22:05
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Zero franchise for children- what is charged

I have health insurance with S**ca. My children have zero franchise.
I have Favourite Sante policy with Medical centre as first port of call for all medical issues. I emailed my insurance broker about getting my children a paediatrician and he vaguely said that was ok. I don't speak German and he wasn't fluent in English!
I signed up and attended a paedatrician today with my 3 month old.

I'm now worried I will get a big bill!
The website says with favorite Sante that children up to 12 can attend an outside Paedrician.

Does zero franchise mean I don't have to pay? When does the 10% come into play?
Are some Paedricians not covered by some insurance policies?
Will the insurance inform me if I have attended an "expensive" larger practice?
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Old 02.09.2015, 22:09
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Re: Zero franchise for children- what is charged

Zero franchise means you don't have an excess to pay before the insurance company start to pay out. Not sure if kids have to pay the 10% or not?? But this means you are liable for 10% of any bill, up to a total of 700chf, after that the insurance pays everything.

However, the franchise has nothing to do with your insurance model. If you have telmed, or hausartz or similar model.... and then just go to any doctor of your choice, the insurance may not pay as you didn't follow the rules of your insurance model.

Last edited by Island Monkey; 02.09.2015 at 22:39.
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Old 02.09.2015, 22:24
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Re: Zero franchise for children- what is charged

Everybody has to pay 10% of the cost up to the maximum of 700chf per year even children. There will be nothing else to pay as you have a 0 franchise.
Usually even with the GP or health centre model you can choose a paediatrician, gynaecologist and ophthalmologist yourself without having to go to the GP or medical centre first:
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