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Old 13.11.2008, 15:25
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when to claim your medical expenses?

Guys,

I'm coming to the end of my second year in Switzerland, and have a query about when to submit my medical bills to my insurer (which is 'Swica').

During the course of last year, on the advice of the girlfriend who has lived here for years, I saved all of my medical related invoices then submitted them all together towards the end of the year. A number of weeks later I received an itemised statement showing that my medical bills did not exceed my franchise, and therefore I wouldn't recieve anything. That was fine, no problem there.

This year I know that my bills will exceed my franchise, and I'm planning to send them in soon. The only problem could be that, on Swica's website, I've just discovered that you're expected to submit your bills as you receive them, throughout the year. This is news to me, and I'm now a bit worried that they now won't honour them because of their late submission.

Has anyone else had an experiences with submitting claims late, either good or bad, and especially with Swica?
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Old 13.11.2008, 15:30
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Re: when to claim your medical expenses?

Don't know about Swica, but with assura I could send invoices corresponding to earlier years and they accepted them and paid them.

When you see your expenses are higher than the franchise, you can then send them no problem with that.
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Old 13.11.2008, 15:36
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Re: when to claim your medical expenses?

We're also insured with Swica and there have never been any problems at all. Just go ahead and submit your bills now, don't wait till the end of the year.
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Old 13.11.2008, 15:45
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Re: when to claim your medical expenses?

I was under the impression with Swica that they automatically received the bills from doctors, apotekes etc. At least if I visit either I pay nothing but receive the bill directly from Swica. I would assume that once (no chance) my priority is exceeded then Swica would pay....

They have been very good and extremely quick in refunding my my gym expense when i've sent them in though. (less than ten days and they refund 500chf of the annual membership).
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Old 13.11.2008, 16:49
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Re: when to claim your medical expenses?

Thanks for this thread, I have been here for almost a year. I received the first bill for CHF150 which arrived a week ago and I hope to claim it back as well. From what I understand one needs to pay it first and then send the copies to the medical aid (in my case Avanex). I just wonder if there are special forms that one has to download from the internet or I just send the copy with accompanying letter?
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Old 13.11.2008, 17:11
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Re: when to claim your medical expenses?

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Thanks for this thread, I have been here for almost a year. I received the first bill for CHF150 which arrived a week ago and I hope to claim it back as well. From what I understand one needs to pay it first and then send the copies to the medical aid (in my case Avanex). I just wonder if there are special forms that one has to download from the internet or I just send the copy with accompanying letter?

My insurer sent me stickers to put on any bills i get. It helps them deal with the claim faster. I think it just states my name and insurance number. I'd make sure you write it on whatever you send them. I have never heard of special forms.
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Old 13.11.2008, 17:14
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Re: when to claim your medical expenses?

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Thanks for this thread, I have been here for almost a year. I received the first bill for CHF150 which arrived a week ago and I hope to claim it back as well. From what I understand one needs to pay it first and then send the copies to the medical aid (in my case Avanex). I just wonder if there are special forms that one has to download from the internet or I just send the copy with accompanying letter?
Hi Jacek

I don't think you are going to be able claim back only one bill for chf 150....
You would have to have no or an incredibly low deductible for that to happen. Most people have around 1000chf deductibles..
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Old 13.11.2008, 18:23
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Re: when to claim your medical expenses?

To my understanding the lowest deductible is Chf 300.00 but most people choose higher as the "saving" is substantial if you are in good health.
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Old 14.11.2008, 11:20
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Re: when to claim your medical expenses?

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My insurer sent me stickers to put on any bills i get. It helps them deal with the claim faster. I think it just states my name and insurance number. I'd make sure you write it on whatever you send them. I have never heard of special forms.
Yup, I received stickers too which are pasted on the bills and sent to Avanex.
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Old 14.11.2008, 11:52
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Re: when to claim your medical expenses?

If you receive a bill, pay it and send it the receipts directly to SWICA as soon as you can. They will process them on a rolling basis. You have 12 months to submit your receipts.

If you are not eligible for a refund, there is no harm in sending it in. They will let you know if it counts or not. It all depends on the arrangement you have with them (e.g. supplemental insurance might pay 50% of your gym).

As others have mentioned, it helps to process quicker if you include the stickers they send you (on their statements). Alternatively, I attach a photocopy of my SWICA medicard with all the details for them to do a quick lookup.
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Old 14.11.2008, 12:09
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Re: when to claim your medical expenses?

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Guys,

I'm coming to the end of my second year in Switzerland, and have a query about when to submit my medical bills to my insurer (which is 'Swica').

During the course of last year, on the advice of the girlfriend who has lived here for years, I saved all of my medical related invoices then submitted them all together towards the end of the year. A number of weeks later I received an itemised statement showing that my medical bills did not exceed my franchise, and therefore I wouldn't recieve anything. That was fine, no problem there.

This year I know that my bills will exceed my franchise, and I'm planning to send them in soon. The only problem could be that, on Swica's website, I've just discovered that you're expected to submit your bills as you receive them, throughout the year. This is news to me, and I'm now a bit worried that they now won't honour them because of their late submission.

Has anyone else had an experiences with submitting claims late, either good or bad, and especially with Swica?
With my medical insurance, I never experienced any problem with submitting claims late and I don't think you will face any problem if you submit late bills but it should be done within a period of 12 months. All insurance companies want the bills to be submitted as you receive them. The fact obviously remains that if you submit your bill asap, it makes everyone's (your and insurance people) work easy and leaves less space for missing out on a bill.

For the future, you can do one thing which can help you not to think about late submission of your bills: you can ask your doctor sect. to send the bills directly to the insurance. Thus the insurance will pay it first and then they will send your share of bill to you and you can pay it will your other monthly bills. This works well for me and doesn't worry me thinking about late submission.
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Old 18.11.2008, 19:20
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Re: when to claim your medical expenses?

Always send all medical bills to the insurer, even if the threshold "franchise" is not exceeded. Reason: the insurer scrutinizes and may spot inaccuracies, over-charging etc. Also helps the insurers to identify doctors who are over-invoicing.

Depending on your income, non-reimbursed medical expenses may be tax deductible. For that you must have proof that you were not reimbursed.
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Old 02.12.2016, 00:03
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Re: when to claim your medical expenses?

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With my medical insurance, I never experienced any problem with submitting claims late and I don't think you will face any problem if you submit late bills but it should be done within a period of 12 months. All insurance companies want the bills to be submitted as you receive them. The fact obviously remains that if you submit your bill asap, it makes everyone's (your and insurance people) work easy and leaves less space for missing out on a bill.

For the future, you can do one thing which can help you not to think about late submission of your bills: you can ask your doctor sect. to send the bills directly to the insurance. Thus the insurance will pay it first and then they will send your share of bill to you and you can pay it will your other monthly bills. This works well for me and doesn't worry me thinking about late submission.
Except for Assura...The doctors can never send the bills directly to Assura, you have to pay it first and then send it to the insurance. Thats probably why this insurance is cheaper than other insurances. I asked them what happens if I need to stay in a hospital and they said then they would pay the bill directly. As for maternity , they have some rule about starting to pay from a certain day of your pregnancy...I guess there is never a risk of having to pay 50 000 on your own first but its a little inconvinient having to keep track of all these bills. In the pharmacy is the same, they never send the bills for me...
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Old 02.12.2016, 09:31
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Re: when to claim your medical expenses?

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Except for Assura...The doctors can never send the bills directly to Assura, you have to pay it first and then send it to the insurance. Thats probably why this insurance is cheaper than other insurances. I asked them what happens if I need to stay in a hospital and they said then they would pay the bill directly. As for maternity , they have some rule about starting to pay from a certain day of your pregnancy...I guess there is never a risk of having to pay 50 000 on your own first but its a little inconvinient having to keep track of all these bills. In the pharmacy is the same, they never send the bills for me...
Utter rubbish my dear !

Doctors and hospitals can and do send bills directly to Assura, who, if you haven't reached your franchise then re-invoice you, copy conform.
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Old 02.12.2016, 10:41
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Re: when to claim your medical expenses?

Hello,

I guess with doctors i couldve insisted that they, as you said, send the original to the insurance and a copy to me. But what about assura?
Assura told me that i have to pay the invoice first.
I know that with other insurances they want to check the corectness of the invoice first.
i dont want to change the topic of the thread...
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Old 02.12.2016, 10:43
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Re: when to claim your medical expenses?

I have Assura and I pay everything upfront. At the end of the year I gather up my receipts and figure out if it is worth sending them in. I will usually wait until February/March to submit them, as some of the bills arrive months after the service.
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Old 02.12.2016, 10:46
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Re: when to claim your medical expenses?

I want to submit them all because i thought i was under thr deductible but realised I am way over. The problem is i lost s couple of them, for some I have copies and they want the original. I am not sure if i can ask the doctor for a copy and assura will actualy accept it. Lets see.
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Old 02.12.2016, 11:00
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Re: when to claim your medical expenses?

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I want to submit them all because i thought i was under thr deductible but realised I am way over. The problem is i lost s couple of them, for some I have copies and they want the original. I am not sure if i can ask the doctor for a copy and assura will actualy accept it. Lets see.
You need to submit the original invoice, so just ask your doctor to send another original, not a copy. If the insurance has processed it already after all (even if you think they haven't), they will know anyway.
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Old 02.12.2016, 11:26
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Re: when to claim your medical expenses?

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Except for Assura...The doctors can never send the bills directly to Assura, you have to pay it first and then send it to the insurance. Thats probably why this insurance is cheaper than other insurances. I asked them what happens if I need to stay in a hospital and they said then they would pay the bill directly. As for maternity , they have some rule about starting to pay from a certain day of your pregnancy...I guess there is never a risk of having to pay 50 000 on your own first but its a little inconvinient having to keep track of all these bills. In the pharmacy is the same, they never send the bills for me...
Doctors can send bills directly to Assura, as can pharmacies, if you ask them to create a document called (in French) a cession de créance. You will have to sign this at the start of each year, and then the doctor / pharmacy sends the bills directly to Assura, who then bill you for the franchise or 10%.

I used to do this when I lived in Switzerland as I was on a low income and couldn't afford to pay my medical bills up front.

For this to work with a pharmacy you need to always get your medication from the same pharmacy.
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Old 02.12.2016, 11:53
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Re: when to claim your medical expenses?

With Assura you need to use "Sun Stores" unless it is an emergency.

You need to use the same pharmacy for each treatment if you wish to have the pharmacy bill Assura who then bills you.
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