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Old 08.01.2018, 15:42
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Re: Mental Health Coverage

When I lived in Swizterland I had basic health insurance with a CHF300 deductible. I had the model where there were no limits on who I saw, and where I could go directly to a specialist if I wanted to.

I registered with a GP and told them that I had a pre-existing mental health condition, and that I wanted to see a psychiatrist. They gave me the contact details of the outpatient department of my local psychiatric hospital. It took me several weeks to get through on that number, as I was working and the consultant whose number I had only took external calls twice a week in two two-hour windows... I later found out that I could have just contacted a psychiatrist directly, or indeed walked into the outpatient clinic in my town (the psychiatric hospital had two satellite clinics).

When I did get through, I explained my issues and I was referred to a junior psychiatrist and psychotherapist who spoke English. I saw her in the outpatient clinic for several years. She then moved to work in the hospital, but I was able to carry on seeing her as an outpatient there. She then moved to the other outpatient clinic, and again I carried on seeing her. She then moved to a large private practice, and asked me if I wanted to see her in that setting, and I did. (As you will gather I was very happy with her). At no point did my health insurance query this. However she then moved to another canton to get some experience in geriatric psychiatry. I couldn't follow her there, so she discussed my case with her colleagues and I ended up being treated by a psychiatrist who spoke English and a psychologist who spoke French.

I don't have the same kind of issues you do, but what I would say is that perhaps you should look for a large private psychiatric clinic where there are a number of psychiatrists and psychologists working together. I found that the benefit of this is that if your allocated clinician needs advice about your case, they have on hand a wide range of experience. You are also more likely to be allocated a psychiatrist who specialises in adult ADHD in a larger setting. Also, if your psychiatrist moves on (which in my experience they do tend to do), it seems to me a larger setting is more able to find another clinician who is a good fit for your needs.

Just to present the other side of the coin, the advantage of being seen in an outpatient clinic of a psychiatric hospital is that if you are ever hospitalised in my experience the transition to and from hospital to outpatient care is smoother if you are being treated as in an outpatient clinic of the same hospital, because it is the same global organisation. But from my limited understanding of ADHD I don't think hospitalisations are that likely.

From a cost point of view, for most of the time I was insured with Assura. I had no issues with my coverage. I was even able to arrange for something called a Cession de Creance (I don't know the German, sorry), which enabled the last clinic I was treated at to bill Assura directly, as opposed to billing me and then me submitting the bill to Assura for reimbursement.

As you may know, once you have paid the deductible you are liable to pay 10% of any additional treatment costs, up to a total of CHF 700. So if you have a CHF 300 deductible the most you will pay in any one year is CHF 1,000, plus the premiums. I found that I tended to reach that limit by the late summer, however that was often with hospitalisations as well as weekly sessions with my psychiatrist / psychologist.

Looking back, on average my sessions with my psychiatrist came to around CHF 200 - 400 or more per bill, but I don't have the paperwork so I can't be sure how many sessions that was... but judging by the frequency of the bills, two or three sessions tops, maybe less.

I hope that helps.
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