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Old 01.02.2016, 18:32
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My health insurance subsidy is larger than the Visana policy!

This may affect a few EF members, and in view of the recent news on the criminal foreigner deportation initiative Feb. 28th vote on enforced implementation of the deportation initiative I became a little concerned. In the initiative, (and it may even be the law now, I am a bit confused), if a foreigner cheats the Swiss social security system he can be deported automatically with no appeal.

I have a Visana health insurance policy (since 1990!), and for a few years now I have the HMO option, and up to this year I have always paid some money to Visana for my insurance, - fair enough and no complaints. I get great service at a low cost.

However this year my subsidy exceeds my basic compulsory health insurance policy cost, by a cool Fr 59.80 each month. (KVG HMO policy is Fr 329.20 and the canton Fribourg subsidy is Fr 389,-- )

Today I went to the town hall and reported my good fortune. The clerk was a little bemused, until she realised this will become Fr 717,60 for the year 2016. I asked her to officially stamp & photocopy my original documents, and send the copies to the canton department for investigation. (By doing this I have proof that I reported my unexpected profit, and I will hopefully be dealt with correctly).

However I wonder how was it possible that somebody in government approved this high level of health insurance subsidy? I believe the subsidy is calculated by central government, and the canton only administers the subsidy. I don't think this problem is purely a canton Fribourg phenomena.

When I get more news I will post it here.
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Old 02.02.2016, 08:57
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Re: My health insurance subsidy is larger than the Visana policy!

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However I wonder how was it possible that somebody in government approved this high level of health insurance subsidy?
The effect of averages.

http://www.caisseavsfr.ch/fr/particu...rance-maladie/

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La réduction ne peut toutefois pas dépasser 100% de la prime nette due par l'assuré pour l'assurance obligatoire des soins.
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Old 02.02.2016, 09:27
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Re: My health insurance subsidy is larger than the Visana policy!

Thanks Daffy, but I still fail to see how a 20% error results after averaging something.
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Old 02.02.2016, 09:35
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My health insurance subsidy is larger than the Visana policy!

They (the canton) probably compute the subsidy over a large group of people (for example, everyone in a postcode or group of post codes) and apply the same rule to everyone in the group, because they don't know how much each individual pays.

You might be on the low end of the cost distribution. Some people on the other end probably pay 20% or more.
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Old 02.02.2016, 09:39
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Re: My health insurance subsidy is larger than the Visana policy!

The percentage of reduction and the value of a health policy are defined every year by the Conseil d'Etat of Fribourg for each district. The definition is done by a some statistical calculation.
What it means is that you're bellow average (in canton fribourg it's 367-392 CHF depending on districts. You are an outlier in the statistical data as you picked the optimal/cheapest insurance policy.
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Old 02.02.2016, 10:03
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Re: My health insurance subsidy is larger than the Visana policy!

Sorry if you've explained this in your post - I didn't understand if you did - but is this for retirees?

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Old 02.02.2016, 10:04
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Re: My health insurance subsidy is larger than the Visana policy!

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Thanks Daffy, but I still fail to see how a 20% error results after averaging something.
It depends on
* your individual selection of health insurance provider for KVG and rebate system
* the distribution of cost of basic health insurance in your canton

Example: If, on average, health insurance is quite expensive in your canton / region, and you are with a cheap provider _and_ use the HMO concept to get a rebate on top of that, then, well, chances are that you are below average in your individual cost.

After all, to have something like an average, there is those above average and those below average :>
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Old 02.02.2016, 10:56
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Re: My health insurance subsidy is larger than the Visana policy!

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Sorry if you've explained this in your post - I didn't understand if you did - but is this for retirees?

It's for anyone who is on a low income. You get subsidies if your total income is below a certain level.
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Old 02.02.2016, 10:58
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Re: My health insurance subsidy is larger than the Visana policy!

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Sorry if you've explained this in your post - I didn't understand if you did - but is this for retirees?
Not especially a problem for retired people. But it could be a problem for anyone with a low income: anyone can claim a subsidy to their health insurance, this is well known, and is based on the previous finalised tax calculation, for the tax year 2014.

However if the subsidy paid is greater than the health policy insurance premium, you would be "taking an unexpected advantage" or even cheating the system, and you might even be prosecuted for defrauding the social security system, for me it would be a theft of Fr 717,60 per year. In the eyes of the SVP politicians, this is a case for immediate foreigner deportation!

I find it quite worrying that this situation can arise: especially as Visana is usually one of the most expensive insurance companies.
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Old 02.02.2016, 11:06
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Re: My health insurance subsidy is larger than the Visana policy!

Just checked a few links for the subsidy, and they say 'up to the lowest insurance premium' available in the K/C' - so Sbrinz is right to have declared as it could indeed have bitten him back at some point.
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Old 02.02.2016, 20:44
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Re: My health insurance subsidy is larger than the Visana policy!

I'm envious. I'm feeding a 6 head family, paying a few tens of thousands of taxes every year and have no bloody subsidies whatsoever... And this is called a capitalistic country :-)
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Old 02.02.2016, 20:57
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Re: My health insurance subsidy is larger than the Visana policy!

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I'm envious. I'm feeding a 6 head family, paying a few tens of thousands of taxes every year and have no bloody subsidies whatsoever... And this is called a capitalistic country :-)
Shouldn't you be proud of yourself that you are generating a high income, above the limit qualifying for subsidies?

Keep in mind that health insurance subsidies are "Sozialhilfe" and that being a recipient of subsidies might influence future permit renewals. I doubt anyone is applying for these subsidies just for fun!
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Old 02.02.2016, 21:10
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Re: My health insurance subsidy is larger than the Visana policy!

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I'm envious. I'm feeding a 6 head family, paying a few tens of thousands of taxes every year and have no bloody subsidies whatsoever... And this is called a capitalistic country :-)
Indeed, very very lucky you.
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Old 02.02.2016, 21:40
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Re: My health insurance subsidy is larger than the Visana policy!

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I'm envious. I'm feeding a 6 head family, paying a few tens of thousands of taxes every year and have no bloody subsidies whatsoever... And this is called a capitalistic country :-)
Trust me, you wouldn't want to be trying to feed a 6 head family on the sort of income that qualifies you to request health insurance subsidies so you should really be considering yourself lucky.
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Old 02.02.2016, 22:29
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Re: My health insurance subsidy is larger than the Visana policy!

I'm amazed that you have this issue.

After several years on the subsidy (Assura, CHF 300 franchise), last year my legal guardian's office changed my health insurance to Galenos with a CHF 2000 franchise (without asking me). As I didn't have the finances to pay a CHF 2000 franchise upfront, and as Galenos proved to be less-than-good on the whole 'speaking French' thing (yes, I meant to type French, not English), this meant I had a lot of hassle in 2015 because I ended up having to send my medical bills to my legal guardian, who then paid them and claimed back from Galenos... would have been a minor issue had he paid the bills on time.

So at the end of last year I told my legal guardian I wanted to change my health insurance back to Assura. I assumed I'd be able to go back to the CHF 300 franchise and manage things myself.

However Assura's premium hike meant I had to get a franchise of CHF 1500 in order to find a health insurance with premiums covered by the subsidy... and they were the cheapest!

I'm sure you did the right thing by informing the necessary authorities.
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Old 02.02.2016, 23:10
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Re: My health insurance subsidy is larger than the Visana policy!

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Trust me, you wouldn't want to be trying to feed a 6 head family on the sort of income that qualifies you to request health insurance subsidies so you should really be considering yourself lucky.

Actually I did, but didn't get the subsidy because I learned about it too late to apply for it, and then moved from Deutschschweiz to Romandie for a better paying job and a tough ride for getting us to learn the new lingo.
Fortunately we had a Denner across the road so I sent my kids to buy the bread 50% off before the shop closing hours. Not complaining, I could afford the butter as well :-)
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Old 02.02.2016, 23:39
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Re: My health insurance subsidy is larger than the Visana policy!

Hardly Sbrinz's fault though is it? So what was the point of your post?
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Old 03.02.2016, 02:17
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Re: My health insurance subsidy is larger than the Visana policy!

The subsidy is not calculated on people having HMO I think, HMO doesn't work very well in some areas too, btw why don't you naturalize so you don't have to worry about UDC. Personally I don't think it's cheating, it's just being smart in face of people too lazy to change insurer/model, but you're right to worry.

@yacek
I don't get your point about having 4 kids, for kids health insurance is less expensive and you also get family allowance i would guess?
Sometimes i hear people complaining about families getting subsidies even though they earn like 10k a month, this in ticino where subsidies are very high (about 1/3 of population gets at least a partial one, 1/10 a full one).
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Old 03.02.2016, 02:40
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Re: My health insurance subsidy is larger than the Visana policy!

I would naturalise, but being a low earner I don't think my application would be successful. Anyway, if the Swiss want me as a citizen, they can ask me. I have a UK passport which is much more valuable.

I did earn 100'000 plus a VW Passat in 1998, but those days have gone forever.
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Old 03.02.2016, 09:59
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My health insurance subsidy is larger than the Visana policy!

In my opinion mid middle-class families with kids are penalized for any extra income too steeply compared to the solo guys. 0.5% per child of a tax break is a joke. Instead of working a... of I could bum around, collect all the subsidies, and the financial nett effect would be similar.
Edit: the non-pro rata health insurance is also a real killer for the working poor/barely a middle class.
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