LEVEL 4: Getting a MEDICAL INSURANCE for Switzerland: IT IS COMPULSORY TO HAVE MEDICAL INSURANCE IN SWITZERLAND, if you want to live for short or long term.
It depends on your stay:
1. Short term= stay duration less than 3 months
2. Long term stay = more than 3 months
SHORT TERM STAY
For people visiting and staying
for 3 months or less in Switzerland:
When you apply for Visa, you will be asked to get a TRAVEL INSURANCE from the insurance companies of origin country. They also provide you the list of recognised companies in your country. The prices varies according to the facilities. This must include also the accidental and medical coverage.
For Eg: I applied for visitorīs visa in 2003 in New Delhi. I had to take the travel insurance from TATA AIG. I applied online and got it on 3rd day. It costed me that time around 2500 INR for 1 month.
LONG TERM STAY
For people visiting and staying for
more than 3 months in Switzerland:
Trust me: It is one of the most important thing to do in Switzerland and people waste a lot of money because they don`t know it or pay it without knowing it or they don`t want to know it because of its complexities.
Few FACTS about BASIC INSURANCE :
* There are more than 80 health insurance companies in Switzerland. All offers the same benefits/services in the Basic health insurance policies, as laid down in Health Insurance Acts/ KrankenVersicherungsGesetz (KVG).
*Health insurance Cos must admit anyone who applies for basic health coverage.
* Every individual in free to choose his insurance company and his policy.
*Services covered by BASIC HEALTH INSURANCE POLICY:
-Outpatient treatment: Treated by officially registered doctors
-Inpatient treatment: Treatment including your stay in the general ward (=shared roooms) of a hospital in your residing Canton. This hospital must be on an official list (hospital list).
-Emergency: Emergency treatment & contributions to transport & rescue expenses.
- Medicines Medicines & Lab. tests prescribed by the treating doctors & which are on the list (specialiseed medicines list & analysis list).
-Pregnancy & childbirth: Antenatal classes & check-ups, childbirth expenses, breastfeeding advice, abortions.
-Healthcare * Gynaecological check-ups
*Vaccinations
*check-ups for children by paediatrician before starting their school.
-Rehabilitation: IPD patients` rehab after an operation / serious illness, physiotherapy and Ergotherapy if prescribed by doctor.
Illness Abroad: Emergency treatment during short trips abroad (eg. while on holiday)
Alternative therapies: Anthroposophic therapies, homeopathy, neural therapy,phytotherapy & traditional Chinese medicine.
One can get more detailed info about each of these services from the insuring companies.
IS HEALTHCARE FREE OF CHARGE IN SWITZERLAND?
BIG NO..! You pay following things:
1. INSURANCE PREMIUMS:
You
pay monthly premium for your health insurance coverage, even if you are healthy.
* The premiums are lower for children under 18.
*Most of the companies charges less from young adults (between 19-25 years).
* Above 25 are considered as adults & are charged same.
Insurance companies charges different premiums (= different range of prices) although the basic health coverage services are same (by all companies).
2. PATIENT'S CONTRIBUTION:
This is paid only when sick or hospitalised. They are:
2 a. ANNUAL EXCESS:
*This is the fixed amount, policyholder pays for medical expenses (doctor's fees, hospitals & medicines) for themselves.
*Minimum is CHF 300/year for adults (& max limit is 2500/year), if you get sick/hospitalised.
* There is no ANNUAL EXCESS for children.
* One can choose from an Annual Excess of CHF 300, 500, 1000, 1500,2000 and 2500.
*Insurance companies pays only after patient has crossed his EXCESS limit for any one particular year.
Important tips:
*If one has healthy life = s/he should choose his/her EXCESS of higher/highest amount (while taking the health insurance) = then his/ her monthly premium cost will reduce.
*If you have chronic illness, in which you need frequent medical help/ hospitalisation = s/he should choose his/her EXCESS of lower/lowest amount (while takingthe health insurance) = then his/ her monthly premium cost will be more.
2 b. DEDUCTIBLES:
This is the amount paid by policyholder for his for his medical expenses additional to his EXCESS.
This is 10% of medical bills but is limited to maximum of CHF 700 per year for adults and CHF 350 per year for children.
2 c. HOSPITAL COST:
In case of hospital stay, one has to pay a contribution towards hospital costs of CHF 15 per day.
Insurance policy's cost depends on:
* Company which one chooses: some companies have always higher costs for each policies by them
* Age of the person: younger have lower cost than adults
* Place of residence: policy costs varies from canton-canton.
* Annual Excess amount, which s/he chooses: higher the EXCESS amount, lower is the premium cost & vice-versa
* Accidental Insurance: Normally employed person(>8hrs/week) is covered by his employers for this.
* Model of Insurance service for first contact (to seek medical help/advice): see below for details
How to save money on monthly health insurance policy? * Choosing the cheapest swiss insurance model: that is Telmed/telemedicine model in Switzerland. Other cheaper models are: Hausarzt/GP Model and HMO/Health centre Model.
*Increase your annual EXCESS, this lowers the monthly premium costs (see below). INSURANCE MODEL:
Since the benefits covered under basic insurance are set out in the Health Insurance Act (KVG). This is why all benefits under any insurance model are identical with all health insurance companies.
This depends on, with whom (different types of medical help/advices) you contact with if you are sick. They are:
1. Standard Model:
The standard model is the statutory standard version of mandatory basic insurance. It is offered by all health insurance companies.
Pros:
*Free choice of doctors at all times
*You can go to a specialist directly
Cons:
*As this model grants free choice of doctors, it is the most expensive option compared to the other models.
2. Family doctor model – GP as first point of contact
Policyholders commit themselves to always consulting their fixed GP/family doctor in the event of illness.
The health insurance companies determine which doctors can be chosen by policyholders. These doctors are either affiliated to family doctor networks or independently practising physicians.
If medically necessary (decided by his GP/Hausarzt), he/she will refer the patient to a specialist in a hospital.
Pros:
Fixed point of contact for any health-related issues. (except emergencies)
Premium cost reduction of about 15 to 20 percent compared to the standard model
Cons:
*No free choice of doctors or specialists.
*Annual gynaecological check-up and regular eye examinations are exempt from this obligation.
*Emergencies are exempted from it but emergencies services can also be availed unce Accidental coverage/Unfallsversicherung.
3.HMO model (Health Maintenance Organisation)– A network of physicians
Policyholders commit themselves to always first consulting a doctor based at the HMO practice in the event of illness.
An HMO practice is a group practice including not only GPs but usually also specialists and therapists from various areas of medical specialisation.
Pros:
*Several medical specialists under one roof
*Fixed point of contact for any health-related issues. (except emergencies)
*Premium reduction of up to 25 percent compared to the standard model
Cons:
*No free choice of doctors or specialists.
*Annual gynaecological check-up and regular eye examinations are exempt from this obligation.
*Emergencies are exempted from it but emergencies services can also be availed unce Accidental coverage/Unfallsversicherung.
4. Telmed model – Preliminary consultation on the phone
For every newly appearing health problem, policyholders have to call a consultation hotline before consulting a doctor for the first time. There, medical experts give advice, make recommendations on how to behave or refer patients to a doctor, a hospital or a therapist.
Pros:
Medical advice around the clock
*Cheapest model
*Few restrictions as you are usually free to choose your doctor after the telephone consultation
*Premium reduction of about 20 to 25 percent compared to the standard model
Comparing Insurance policies:
* for english speakers:
www.comparis.ch
* for german/french speakers (official website):
www.praemiem.admin.ch Every year premium amount fluctuates/changes, one can check and decide for next/ coming year. Changing insurance company:
*Every company releases the premium plans (for each model) by October of every year. If your company has increased your premium then your registered letter to cancel your premium
must reach them by 31st May or by 30th november at the latest. THE BEST & SIMPLEST WAY TO GET CHEAPEST INSURANCE, which I had done is:
Step 1: Compare the different insurance policies/models of different companies (see above).
Step 2: Order it online every year,if you wish to change.