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Old 09.09.2011, 12:38
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State funded care?

Hi,
We're hoping to move over to Zurich in a few months and my son has an ongoing personal injury claim due to a car accident where he suffered a head injury. Its left him with learning disabilities similar to autism and he has problems with his balance and muscle strength.
I am hoping to get all the care he needs over there funded by the insurance company that is liable over here in UK (as he currently see's a physio, support worker, speech therapist and behavioural threrapist) but im wondering (as insurance companies have a tendancy to be awkward) if they won't pay for some things over there for any reason, if there's any state funded care over in Switzerland? I have read that there isn't but a Swiss website I found called 'The learning room' have told me that they are part private/part state funded? So this contradicts what I have read?
I am just unsure about what will be available free and what will need to come out of our own pockets if I can;t get the UK insurers to cough up for some things?
Thanks in advance!
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Old 09.09.2011, 13:51
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Re: State funded care?

Hi,

Just to start out with a disclaimer.... I am by no means an expert...

But I suggest you might want to investigate Invalidity Insurance (http://www.ahv-iv.info/iv/index.html?lang=de). This is part of the social security system, and an application can lead to financial support and / or professional reintegration.

This partly depends on the age of your son (which you don't mention), and, if applicable, his work history.

For example, I worked for 6 years in the UK, with some health problems, moved here, worked for 3 months, became ill again... I'm entitled to professional reintegration, but not to financial support.

On a more general note, pre-exisiting conditions cannot be used to deny basic health insurance cover. They can't even ask if you have any medical conditions. So your son will be entitled to basic health insurance (make sure you get a low franchise). But you may have difficulty getting complementary insurance.

Physio is covered, at least up to a certain amount.

Can't help you on the other things... my personal experience is more on the mental health side. But the only times I've had trouble with my insurance is over my dental (complementary) treatment. All the other treatment I've had has been paid for. Oh, except for an ambulance ride (I had to pay half... well, social aid did), and when I was hospitalised I had to pay 15fr a day towards food etc.

This might be helpful...
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Old 09.09.2011, 15:05
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Re: State funded care?

Vlh22 is quite right in that when you were reading about state funded care, it would be funded pursuant to your son being accepted for assistance under the AHV (diasbility benefit) scheme.

As you say in your profile that you are 29 years old, I'm taking it that your son is still quite small. The only benefit in applying at this age for AHV would be for the financial benefits it brings (as opposed to the reintegration assistance which is obviously applicable to adults).

We have a young son with learning disabilties (sounding not too dissimilar to your son) and we are in the process of applying for AHV as we have recently not been able to get full costs of his speech therapy paid for by our health insurance, plus it required for the special schooling that is lined up for him to start next year. We however already get special needs play therapy paid for by the health insurance. We are rather new at this game, but it seems to be a very unclear area as to when and why you apply for this disability benefit, but the reality is that people usually apply for it on behalf of kids when they are reaching a problem regarding getting costs met.

There are strict criteria set out for the diagnostic grounds for an application and you need a doctor (or a few in our case) to support your application with their diagnosis, including strict age cut off dates for certain conditions (eg child must be 5 or under for ASD disorders). I am not sure how this works however when the cause is an intervening accident as opposed to a birth defect (as it is in our case). The AHV site has a link to the actual statutory wording (for want of a better term) for these grounds which you might find helpful rather than relying on other peoples' hearsay.

Whilst I usually find this wonderful forum is the fount of all knowledge and wisdom, I should tell you that there is a group for ex pat parents in CH on yahoo with children with disabilties, called special kids. Many of the people on this smallish yahoo group have direct experience of applying for AHV, some having got it and some not. If you cannot get more precise help here, then you could try on that forum too.

Good luck.
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Old 09.09.2011, 15:09
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Re: State funded care?

Think about it like this. If you had been a Swiss citizen on holiday with your son in the UK when the accident happened, the UK insurance company couldn't deny liability on the grounds that you weren't resident in the UK, nor could they insist on treatment in the UK.
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Old 09.09.2011, 15:50
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Re: State funded care?

Thank you for all this advise. Sorry I should have said how old my son is, he's 8. Over here in the UK (as many of you will be aware) we have a local authority to approve a statement of special needs, which would mean, had it not been for our pending move, that he would receive a one to one TA at school. His UK application for disability benefit is still going through.
I'm just still trying to research as much as I can about what will be available to him once we move there.
Thank you all again.
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Old 09.09.2011, 16:21
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Re: State funded care?

I might add that like in the UK, the application for AHV can take many months. Also I am not so sure how you would get on with only doctors' diagnoses from the UK. It would certainly be a good idea to get in touch with your son's future doctor (s)and arrange preliminary visits so that they are onboard with his case and his needs as quickly as possible .. as also the health insurance usually require doctor recommendations before they pay out for any therapies. Again, it would be easier if the recommendations came from a CH dr recognised by your Swiss insurance company.

Finally, I am led to believe that not all health insurers are equal and different ones are more generous about paying for different things. Our company is Swica and whilst we are always being told they are on the expensive side, we have found that until recently they took a very sympathetic view to paying out for my son's various therapies. However, once it has now become clear that this is a long term problem, they are beginning to attempt to retrench and a first step is not covering the total costs of his speech therapy (due to the fact that the English speaking therapist is charging almost double the usual agreed rate .. so you can understand where they are coming from on this one ..). But this is only our experience .. and I think you will find many many threads on the subject of health insurance on this forum.
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Old 22.09.2011, 22:31
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Re: State funded care?

I've sent you a PM with more information on special educational needs in Switzerland and claiming disability benefit for children.
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