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Old 19.07.2019, 20:29
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Can't understand the cost of health insurance

Hi,

We are new to Switzerland and I am trying to figure out the right insurance for myself and my wife. We are both healthy. I haven't gone to the doctor for several years and my wife goes to ob/gyn once a year and sometimes needs a dermatologist due to some repeating minor skin issue.

I compared costs on Comparis and read A LOT about the basic insurance, and there is two things I can't understand:

1. From my calculations, based on premiums from a specific company, it is better for my wife to have 2500 deductible if we expect her to have up to CHF 1900 expenses / year. From what I understand this is quite a nice amount that can include several doctors visits, tests, and medications. Does this sound reasonable?

2. From the same Excel worksheet I made I noticed a strange fact: The annual cost of insurance is between CHF 4200 and 5600. If you add the deductible + min(10%, CHF 700), you get to understand that the break even point is if you have annual expenses of CHF 6000-7000. This is A LOT! Under what circumstances one reaches more than CHF 6000 a year? I can't see why this is so expensive.

So I thought maybe I am all wrong and I didn't get some of the basics. If this doesn't make sense to you, I'd be happy to discuss it and understand why...

Thanks,
Yotam
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Old 19.07.2019, 20:33
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Re: Can't understand the cost of health insurance

Link to my spreadsheet:
https://docs.google.com/spreadsheets...it?usp=sharing
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Old 19.07.2019, 20:53
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Re: Can't understand the cost of health insurance

6.000,- May sound like a lot, but the moment you have something longlasting/serious/need expensive meds/need therapy etc.. it is very easily reached. Also pay insurance for 25 years while claiming nothing and have a year of cancer with treatments, hospitalisation etc.. and you still in total saved money due to the insurance. The 6.000,- is not only based on your healthy yrs but also on your unhealthy years.

And skip the break even point, it is a forced insurance, so you are only interested in the price difference between the premiums and the deductible they have.

Pay 1.400,- more for a deductible that is 2.200,- lower, meaning that if your annual costs are to be expected to come above 1.400,- you do wel by choosing the more expensive premium.
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Old 19.07.2019, 20:56
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Re: Can't understand the cost of health insurance

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6.000,- May sound like a lot, but the moment you have something longlasting/serious/need expensive meds/need therapy etc.. it is very easily reached.
I understand... Still sounds high for break even point but at least I may got the system correctly... Thanks!
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Old 19.07.2019, 21:01
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Re: Can't understand the cost of health insurance

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I understand... Still sounds high for break even point but at least I may got the system correctly... Thanks!
I added some more to my post
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Old 20.07.2019, 07:42
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Re: Can't understand the cost of health insurance

As mentioned, healthcare costs here can be very expensive and if you end up with a chronic condition or a rare condition 6k will get swallowed up very quickly. I personally have gone for a very low deductible (300), which works for me. I also was rarely sick, but have found that I have made good use of the system here for mild ailments, sore back etc.

Our daughters birth cost well over 20k and that was fully covered.

You also need to change your view on this insurance. Think of it like car insurance. You don’t expect to ‘break even’ on car insurance, do you?
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Old 20.07.2019, 08:21
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Re: Can't understand the cost of health insurance

Can confirm what Edwin and Nick have said. It only takes a serious/long term illness and that money is used up very quickly. My husband has an ongoing incurable disease and a 3 month supply of his medication for this costs CHF4,000 alone. For a year that's 16,000 francs. Add in his diabetes treatment and you're talking regular blood control tests, follow ups with his GP plus at least one MRI a year and follow ups with his neurosurgeon and diabetes specialist and he soon passes his franchise and part-quote and so pays nothing for the rest of the year on those bills. We have a low franchise of 500, but even with a 2,500 one it would be done very quickly.

I'm not sure you understand how the system works. If your wife goes for the 2,500 franchise then she will be paying that 1,900 out of her own pocket because the insurance doesn't kick in until that 2,500 is spent. So you should be aiming for a lower franchise if you don't want to foot all the bill yourself.
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Old 20.07.2019, 09:16
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Re: Can't understand the cost of health insurance

Hip replacement (BHP)...Chf 40k (4 day hospital)
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Old 20.07.2019, 11:39
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Re: Can't understand the cost of health insurance

Try not to overthink it.

For the first year, if she's relatively healthy, take the higher franchise if you have that 3,200 co-pay in your savings and are willing to "risk" it. After that year, compare what your expenses are and decide whether or not to change. We did that for several years and saved a bundle in premiums.
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Old 20.07.2019, 13:29
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Re: Can't understand the cost of health insurance

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2. From the same Excel worksheet I made I noticed a strange fact: The annual cost of insurance is between CHF 4200 and 5600. If you add the deductible + min(10%, CHF 700), you get to understand that the break even point is if you have annual expenses of CHF 6000-7000.
It's insurance. You're not supposed to "break even".

Would you analyse car insurance in the same way, calculating how many accidents a year you need to have in order to break even? Of course you'll do the sums to decide what level of cover and excess you want, but you will recognise that it's a legal requirement and hope that you never have to make a claim. Why would you expect health insurance to be any different?
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Old 22.07.2019, 10:48
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Re: Can't understand the cost of health insurance

As others have said, think about it like you're paying for your old years. You wouldn't want it to be free now, then once you retire, have to pay 50K a year.

And if you want the most cost efficient option, look at a good insurance with 300,- franchise and sum up the costs (12 * monthly premium + 300), then look at the cheapest option, with 2500,- franchise (12 * monthly premium). Look at the difference between the two, and decide if you think your medical expenses will be greater than the difference.

Example for canton Vaud:
- 300,- franchise: 5500,- yearly
- 2500,- franchise: 3600,- yearly

I don't expect my medical expenses to be higher than 1900,- so the cheaper option is "better value".
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Old 22.07.2019, 12:53
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Re: Can't understand the cost of health insurance

As others have said here it's expensive to the un-initiated but let me give you a personal example as to why the insurance here is worth it's weight in gold and I just have the bulk standard insurance with the option for CHF9 a month to go semi-private on my supplementary insurance.

I went to the dermatologist earlier this year for my annual proactive check-up. She found something she didn't like and a few days later I was back for a biopsy. 48 hours later on a Friday she told me it's a type of skin cancer and referred me to a specialist who I saw on the Monday morning - so 72 hours later.

On Friday morning the same week (would have been Weds but I had tickets to Bon Jovi) I was admitted to a private clinic on the edge of Lake Zurich and underwent 3 hours of surgery to remove the bad stuff. The surgeon had a motorbike courier standing by whilst I was in surgery who biked the bad stuff to a lab where they did an hour of tests whilst I was knocked out to ensure the surgeon had got everything out and he could finally stitch me up.

When I woke up I was told straight away that I was now in the clear. The level of service and quality of care was simply insane. At no point did my insurance try and ask for a second opinion or send me to another hospital or pull any stunt. They just paid a bill of CHF20k - no questions asked and everything was approved with a 2 min phone call.

So yes the headline price is expensive - but it's insurance and when you need it the system IMHO is simply awesome. As an aside I didn't touch my insurance for the first 6 years I was here making me question my premiums but you only need one instance like the above to understand why it's expensive but worth every penny.
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