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  #41  
Old 11.10.2021, 19:39
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Re: Pharmacies, Sunday surcharge

Something I've always wondered:

Does basic insurance cover the Apotheke admin fees as well as the cost of the meds, or only the cost of the meds?

And if insurance does not pick up the pharmacy fees, can one include them in the list of out-of-pocket payments towards meeting one's franchise?


Ja, I know - the answer should be on an insurance bill. However, I get most of my meds directly from the doctor, and in SZ those bills go straight to the insurer so I never see them. The meds I get from the Apotheke are all veterinary, so no insurance involved.
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  #42  
Old 11.10.2021, 20:01
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Re: Pharmacies, Sunday surcharge

I suspect if it’s an emergency then the insurance will either pay, or include the amount in your franchise. I’ve never used the Sunday service but I assume if it’s an unavoidable cost you’d be covered.

But, then again TIS!
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  #43  
Old 11.10.2021, 20:03
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Re: Pharmacies, Sunday surcharge

If you have to pay a surcharge for an emergency plumber on a Sunday, why wouldn't you need to pay this surcharge for the pharmacy?
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  #44  
Old 11.10.2021, 20:11
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Re: Pharmacies, Sunday surcharge

It seems it is covered by the basic, compulsory medical insurance. Here's an article from a pharmacy magazine (dated 25 October 2019): https://pharmama.ch/2019/10/25/zu-vi...-der-apotheke/


Der Medikamenten-Check ist eine von zwei Pauschalen, die von der Apotheke auf rezeptpflichtige Medikamente, die von der Grundversicherung übernommen werden verlangt werden. Unsere Leistung/Arbeit ist ja seit 2004 nicht mehr im Medikamentenpreis als Marge enthalten.

Das ist nicht drauf bei freiverkäuflichen Medikamenten, nicht bei Sachen, die über die Zusatzversicherung gehen. Das sind auch keine „Beratungstaxen“, wie sie gerne genannt werden. Die Beratung gehört dazu, aber noch einiges weiteres wie Dossierführung, Wechselwirkungscheck, Lagerhaltung, Abrechnung mit den Krankenkassen undsoweiter.


The medication check is one of two flat rates charged by the pharmacy for prescription drugs covered by the basic insurance. Our service/work has no longer been included in the price of medicines as a margin since 2004.

This is not the case for over-the-counter medicines, also not for things that are covered by the supplementary insurance. These are also not "consultation (or advice) fees", as they are often called. The consultation/advice-giving is part of it, but so are other things like dossier management, interaction checks, stock-keeping, billing with the health insurance companies and so on.


And here's a Beobachter article (in German, dated 18 March 2019) setting out more info, also about chronic meds, and the way a similar fee is charged by doctors.
https://www.beobachter.ch/gesundheit...apotheke-einen
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  #45  
Old 11.10.2021, 23:18
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Re: Pharmacies, Sunday surcharge

Perhaps my question wasn't clear - what I am asking is:

A drug costs CHF 10.00
The Medikiament check charged by the Apotheke is 4.30, the admin fee is 3.25.

Total cost is then 17.55.

What does the KK pay, CHF 10 or CHF 17.55?

If the former and the patient then pays the admin fees, can that 7.55 be counted against the patient's franchise?

Last edited by meloncollie; 11.10.2021 at 23:41.
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  #46  
Old 12.10.2021, 11:02
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Re: Pharmacies, Sunday surcharge

Quote:
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Perhaps my question wasn't clear - what I am asking is:

A drug costs CHF 10.00
The Medikiament check charged by the Apotheke is 4.30, the admin fee is 3.25.

Total cost is then 17.55.

What does the KK pay, CHF 10 or CHF 17.55?

If the former and the patient then pays the admin fees, can that 7.55 be counted against the patient's franchise?
As I understand it, the Krankenkasse pays the whole Fr. 17.55. Or, perhaps more accurately, both the medication and the pharmacy's charges are considered to be legitimate medical expenses to the medical insurance's account.

If a patient has not yet fulfilled the franchise (first slice), then, of course, the patient will have to pay the whole Fr. 17.55, until they have borne their entire franchise, but yes, it all counts towards the patient's having done their bit towards bearing that first slice.
If the franchise has been fulfilled, then the patient will pay the usual 10% "Selbstbehalt" (self-pay portion), and this of the total Fr. 17.55, in your example.
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