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  #21  
Old 14.11.2012, 17:12
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Re: Gynecologist

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I think you'll find matters relating to pregnancy are fully covered under insurance without recours to your fanchise
Not all costs, and not all fully. Only a certain number of visits and ultrasounds are covered unless the doc tells the insurance company more are medically necessary. There might be a copay for those visits even if you have reached franchise, but I am not 100% sure. Heard it from a spouse of OH's co-worker so not really firsthand. Anyone that can clarify based on experience?
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  #22  
Old 14.11.2012, 17:47
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Re: Gynecologist

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Not all costs, and not all fully. Only a certain number of visits and ultrasounds are covered unless the doc tells the insurance company more are medically necessary. There might be a copay for those visits even if you have reached franchise, but I am not 100% sure. Heard it from a spouse of OH's co-worker so not really firsthand. Anyone that can clarify based on experience?
Yes ! My wife visited every 5-6 weeks for ultrasounds etc and it was ALL picked up by the insurance company directly, didn't even see the bills, and it was a normal pregnancy.

The franchise is NOT used, pregnancy is treated apart
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  #23  
Old 14.11.2012, 19:17
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Re: Gynecologist

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I think you'll find matters relating to pregnancy are fully covered under insurance without recours to your fanchise
In my pregnancy (ongoing at the moment), my prescription drugs are all under franchise not under pregnancy. I haven't sent the bills for the gyne visits yet, but I suppose that once I've reached the 6 visits allowed by Lamal pre-birth, the franchise will come into play again. Yes, my cheap insurance is stingy! Looks like I'll be paying my 2500 franchise this year!
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  #24  
Old 14.11.2012, 21:06
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Re: Gynecologist

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In my pregnancy (ongoing at the moment), my prescription drugs are all under franchise not under pregnancy. I haven't sent the bills for the gyne visits yet, but I suppose that once I've reached the 6 visits allowed by Lamal pre-birth, the franchise will come into play again. Yes, my cheap insurance is stingy! Looks like I'll be paying my 2500 franchise this year!
If the perscription drugs are directly realted to pregnancy then i think you'll find they're covered.

As for having more than 6 visits in 9 months.....maybe get a job at the Doc's ?

The Uk is 1 possibly 2 pre-natel visits to my understanding
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  #25  
Old 14.11.2012, 23:00
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Re: Gynecologist

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If the perscription drugs are directly realted to pregnancy then i think you'll find they're covered.

As for having more than 6 visits in 9 months.....maybe get a job at the Doc's ?

The Uk is 1 possibly 2 pre-natel visits to my understanding
Well my insurance company is very clear that it's under franchise. I wrote them a letter quoting the law (which is grey in some areas) to protest but frankly I have little hope that it will change their way of handling these prescriptions (I only just sent the letter a couple days ago).

As for >6 visits, I'm not the one who schedules the visits, the gynecologist decides that. So far we've had 5 and should have another 2 before due date, but since we're moving canton before birth, I'll probably have a couple extra visits.
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  #26  
Old 15.11.2012, 05:02
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Re: Gynecologist

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But 20 minutes down the road in canton ZH one is spoiled for choice of doctors. So if your insurance allows you to go out of canton, perhaps this might be a better route..
I got a note in my bill a couple of months ago saying that I could see a doctor in any canton without prior approval and I only have basic insurance. The note mentioned something about a change to the insurance laws. I don't have it handy, can anyone confirm this?
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  #27  
Old 15.11.2012, 09:04
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I got a note in my bill a couple of months ago saying that I could see a doctor in any canton without prior approval and I only have basic insurance. The note mentioned something about a change to the insurance laws. I don't have it handy, can anyone confirm this?
This is pretty much true. The law changed in January, 2012. There might be some differences within kantons...and if the treatment in the outside kanton is is way more expensive than your home kanton, the cost difference might be passed on to you. So, you may wish to verify.

But as far as i can tell, it's not been an issue for me. We moved to kt zurich from bern, and i kept the same gyn, oncologist, and if i have to go to hospital for something non emergent or outpatient, my preference is the lindenhof in bern (for example, this year i've had mammography and an MRI) I do have a GP near my house in Winti, and she's very good, but even she said to keep my specialists in Bern, in part because they document everything so well. And of course, i like them.

Last edited by edot; 15.11.2012 at 09:33.
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  #28  
Old 15.11.2012, 12:39
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Re: Gynecologist

hey all,
My gyn in france asked me to visit a gyn as soon as i arrive to switzerland, and now i have an appointment with Dr Shahira Stadelli. Does anyone know anything about her? is she a good doctor?
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  #29  
Old 15.11.2012, 12:41
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Re: Gynecologist

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hey all,
My gyn in france asked me to visit a gyn as soon as i arrive to switzerland, and now i have an appointment with Dr Shahira Stadelli. Does anyone know anything about her? is she a good doctor?
Dr Städeli, gynaecologist - any recommendations?
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  #30  
Old 15.11.2012, 12:48
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Re: Gynecologist

thank you helped alot!
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  #31  
Old 15.11.2012, 15:34
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Re: Gynecologist

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I got a note in my bill a couple of months ago saying that I could see a doctor in any canton without prior approval and I only have basic insurance. The note mentioned something about a change to the insurance laws. I don't have it handy, can anyone confirm this?
I thought the new law only affected hospitalization?

For instance, from Comparis:
http://www.comparis.ch/krankenkassen...ng.aspx#punkt1

Grundsätzlich besteht eine freie Arzt- und Chiropraktikerwahl für ambulante Behandlungen, ausgenommen für Versicherte mit einem Telmed-, Hausarzt- oder HMO-Modell. Die Kostenübernahme durch die Krankenkasse richtet sich jedoch nach den geltenden Tarifen am Wohn- oder Arbeitsort. Wer sich nicht in der näheren Umgebung von Wohn- oder Arbeitsort behandeln lässt, muss mit ungedeckten Kosten rechnen.

Roughly: you are covered up to the tariff in your own canton, or where you work. If you are treated outside of your canton or the area where you work you pay the extra costs, if any.

Any insurance pros care to comment? (Jenny?) I'd love to find that I've been over-paying...



And, the free hospital choice - at least in SZ - is limited to hospitals and departments on the SZ Spitallist.

http://www.sz.ch/xml_1/internet/de/a...237/p27200.cfm

(A big controversy in Ausserschwyz is that Klinik im Park amd Klinik Adelheid have been dropped from the SZ Spitallist. Both hospitals are challenging the decision, so until the courts decide they remain on the list. But if SZ wins, treatment for Schwyzers will no longer be covered at these hospitals under the basic insurance. )
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  #32  
Old 15.11.2012, 15:42
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I honestly don't know, but i keep going to my gynecologist in Bern, and they keep paying!
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  #33  
Old 15.11.2012, 15:59
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Re: Gynecologist

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If the perscription drugs are directly realted to pregnancy then i think you'll find they're covered.

As for having more than 6 visits in 9 months.....maybe get a job at the Doc's ?

The Uk is 1 possibly 2 pre-natel visits to my understanding

I just found 2 of my 3 pregnancy "passports" my gyne in the US used. I had over 13 visits for each one (the last "visit" was the check up in the hospital after the birth). We had appointments every month and then every week at the end. Mostly just to check weight and that all is in order, so they were always quick, but appointments nonetheless....
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  #34  
Old 04.12.2012, 15:04
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Re: Gynecologist

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Well my insurance company is very clear that it's under franchise. I wrote them a letter quoting the law (which is grey in some areas) to protest but frankly I have little hope that it will change their way of handling these prescriptions (I only just sent the letter a couple days ago).
Just to follow up...

The insurance uses this case (K 101/06 dated 3rd nov 2006) taken to the Federal Court of Justice as an example that prescription drugs prescribed during pregnancy for prophylaxis (= preventive medicine) are under franchise, hence not covered under maternity.

So if, when pregnant, you're prescribed whatever drugs to prevent potential problems (could be magnesium, vitamins, anticoagulants, anti-nausea meds, or like in this court case, rhesus-antibodies injections), and the medicine/medical service is not on the list of specific products/services included in maternity coverage (listed in art. 13-16 OPAS), then it goes under franchise.
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