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Old 04.10.2015, 19:57
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When do you send medical bills to Assura?

On their website, it is recommended that one sends the medical bills (reimbursement justification) only when the franchise is reached.

Now my annual franchise is reached. What is a bit complex is that, sometimes the doctors send the bills to Assura directly, and then Assura took from my bank account, in this case I do not have the reimbursement justification; sometimes they send the bill to me, I paid and kept the justification. If I count all these, my franchise is already reached, but Assura does not know that because they are not aware of all the bills that I paid myself. So I guess now it is the moment to send them all the bills that I paid?

Or should I wait until the end of year? (I anticipate some other bills in November/december)
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Old 04.10.2015, 20:11
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Re: When do you send medical bills to Assura?

Hmm AFAIK you should send any bill to Assura to inform them about incurred medical costs. They calculate then the overall costs and add it to your franchise. Once you top the franchise, they will issue reimbursement in your favour minus 10% up to another 700chf yearly. After you reach self-participation in cost limit, they will issue 100% reimbursement of any subsequent qualified costs to your bank account. Anyone correct me if I'm wrong.
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Old 04.10.2015, 21:09
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Re: When do you send medical bills to Assura?

You can send them any time you want - they'll keep a tank of them and send you back a statement of what was reimbursable, part of the franchise, or not covered (for example we choose to use a surgeon/clinic in a different canton and bear the small cost difference ourselves, but we send them everything and they deal with it as required).
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Old 04.10.2015, 21:19
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Re: When do you send medical bills to Assura?

http://de.assura.ch/krankenkasse/rue...andlungskosten

Tiers garant:
You can send every bill you receive to Assura at any time after paying the doctor/pharmacy for treatment or meds and wait for the refund minus your deductible/retention fee.

OR

Tiers payant:
You can have your doctor send bills to Assura rather than to you so that Assura pay the doc directly and then bill you if you need to pay part of your retention fee or deductible.
If you don't want to pay for your meds at the pharmacy and send the bill to Assura, you can ask your pharmacist to deal with Assura directly (even though Assura says they deal with meds by tiers garant, they have to accept tiers payant for meds/pharmacists (since that's stipulated in health insurance law).

With tiers payant, once you've paid your e.g. CHF 1200/year (e.g. 500 deductible, 700 (yearly upper limit) retention fee) you won't have to pay any more bills aside from your premiums.

Last edited by glowjupiter; 05.10.2015 at 03:09.
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Old 04.10.2015, 22:35
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Re: When do you send medical bills to Assura?

I send mine when I want a refund

Seriously, the only reason why they want you to wait and only send them if you go over the franchise is to save them the paperwork, which seems absolutely fine, and if you send it in one batch then it's probably more efficient for them.

I'm not with Assura, but I send my bills in throughout the year, as I need the money to pay my doctor back
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Old 05.10.2015, 20:27
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Re: When do you send medical bills to Assura?

And please retain a copy of everything for your records.
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Old 05.10.2015, 21:01
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Re: When do you send medical bills to Assura?

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I send mine when I want a refund

Seriously, the only reason why they want you to wait and only send them if you go over the franchise is to save them the paperwork, which seems absolutely fine, and if you send it in one batch then it's probably more efficient for them.

I'm not with Assura, but I send my bills in throughout the year, as I need the money to pay my doctor back
Ya they wish! They would like to have maximum gain with minimum effort :> We will provide them with enough work
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Old 05.10.2015, 22:12
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Re: When do you send medical bills to Assura?

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Ya they wish! They would like to have maximum gain with minimum effort :> We will provide them with enough work

It's only additional administration cost that you'll pay with next years' increased premiums along with the rest of us

You think the insurance company cares or loses money ?
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Old 05.10.2015, 22:15
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Re: When do you send medical bills to Assura?

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It's only additional administration cost that you'll pay with next years' increased premiums along with the rest of us

You think the insurance company cares or loses money ?
We will elevate prices until no one can afford niahaha
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Old 05.10.2015, 23:27
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Re: When do you send medical bills to Assura?

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I send mine when I want a refund
send the bill right away if you know you will go over and they must pay

if you know you will not go over then just hold on to it because you might not want to inform your health insurance of health problems if they dont need to know... they can use it against you any time they want...
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Old 06.10.2015, 00:03
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Re: When do you send medical bills to Assura?

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send the bill right away if you know you will go over and they must pay

if you know you will not go over then just hold on to it because you might not want to inform your health insurance of health problems if they dont need to know... they can use it against you any time they want...
It's so sick this system... Instead of helping people in need, it only seeks ways to maximise profit at the expense of public health and general well-being...
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Old 06.10.2015, 00:56
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Re: When do you send medical bills to Assura?

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send the bill right away if you know you will go over and they must pay

if you know you will not go over then just hold on to it because you might not want to inform your health insurance of health problems if they dont need to know... they can use it against you any time they want...

If this is for basic, compulsory insurance, they can't use info about your health problems against you. Supplimental is a different story, of course.
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Old 06.10.2015, 22:22
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Re: When do you send medical bills to Assura?

Assura lets you save money compared to others because of this system where you pay your own bills and send them once a year when you reach the franchise, less paperwork for everyone. People that want the insurance to take care of everything or are just lazy are free to pay more and choose another insurer. The profit margins for insurance companies have probably plateaued from years now, additional costs are all paid by us.

Anyway on the website http://it.assura.ch/cassa-malati/rag...-delle-fatture it says that once you reach your franchise you can send them everything immediately (makes sense since you might need the money for what they know). The major money-saving comes from not processing paperwork of people under the franchise.
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Old 06.10.2015, 22:38
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Re: When do you send medical bills to Assura?

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If this is for basic, compulsory insurance, they can't use info about your health problems against you. Supplimental is a different story, of course.
Yes and ... no. Your medical history can be used for access to life insurance and a mortgage, etc, including testing for HIV and history of mental illness, attempted suicide, etc, etc. When someone applies for life insurance or some mortgages, they have to sign a consent form for medical report and history to be requested from your GP. Not so easy in Switzerland where many people do shop around and visit several doctors without stuff being written in patient's notes however. Would also be the case if a person wants to later apply for supplemental insurance here too.
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Old 20.10.2016, 14:57
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Re: When do you send medical bills to Assura?

I recently reached my Franchise limit & then got another big medical bill >1K CHF (despite having told the Doctor to send it direct to Assura). I duly sent off the bill to Assura unpaid (no orange form torn off, etc.). However instead of paying it & then charging me 10%, they just refunded me 90% but the original bill is still unpaid. Doh!

In future, I think I will save up the little bills & indicate clearly which ones were paid & which not.

I have a big Hospital bill coming soon, so I hope Assura pay most of this one for me...

Cheers, Greg.
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Old 20.10.2016, 15:07
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Re: When do you send medical bills to Assura?

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I recently reached my Franchise limit & then got another big medical bill >1K CHF (despite having told the Doctor to send it direct to Assura). I duly sent off the bill to Assura unpaid (no orange form torn off, etc.). However instead of paying it & then charging me 10%, they just refunded me 90% but the original bill is still unpaid. Doh!

In future, I think I will save up the little bills & indicate clearly which ones were paid & which not.

I have a big Hospital bill coming soon, so I hope Assura pay most of this one for me...

Cheers, Greg.
They don't care which are paid, and they don't pay them, that's up to you to do.

Hospital bills are paid directly, but not doctor, lab, etc.

Tom
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Old 20.10.2016, 15:17
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Re: When do you send medical bills to Assura?

What Tom says is correct.

If the bill has come to me, I have to pay. And then reclaim from Insurance company to the extent it can be. If they got the bill directly, they will pay and recharge me to the extent they have to (e.g. medicines, physio, hospitals etc).

To ensure things are not lost, its best to send them all the bills if you think you are anywhere near the franchise. They will do the accumulative calculations.

And actually, they only need the official looking treatment paper which details what was done. They don't need all the cover letters, orange slips or proof of payment etc.
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Old 20.10.2016, 15:25
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Re: When do you send medical bills to Assura?

However, with some other insurers (Visana, for example) they pay first, and then send you the bill for your part.

It depends on the insurer.

Tom
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Old 20.10.2016, 15:28
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Re: When do you send medical bills to Assura?

Just to add that if you have a big bill, which has come to you, you do have 30 days to pay it. What I used to do (once I had gone over my franchise), was take a photocopy of the bill, and keep the paying in slip, and then send the original bill to Assura as soon as possible. Generally, I would be reimbursed the 90% before the bill was due... Then I would pay the bill.

If Assura were late reimbursing me, I found my doctors were very understanding... If I received a reminder I would phone up and explain there was a delay with Assura and that would be fine.
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Old 21.10.2016, 09:51
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Re: When do you send medical bills to Assura?

Just to be clear - if you receive a bill, it's up to you to pay it, not Assura (or any other insurance company). The insurance company will reimburse the part of the cost due (that's what tiers-garant means, third-party guarantee).
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