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Old 08.07.2020, 16:23
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Moving with Pre-Existing health condition

Hi,

I was wondering how in practice would moving to Switzerland work with a Pre-Existing condition, more specifically the transition and handover. My wife suffers from CML and is under daily medication. It is very important that her medication continues. In theory when she leaves UK her NHS cover seizes.

I am wondering if any one has experience of how the transition to the swiss system would work as in do we just get insurance and just turn up at the GP ?

I also gather that some types of insurances allow you direct access to a specialist (which is what we plan to get), but was wondering what it means in practice as in I suppose one cannot just turn up to an oncologist directly can they ?
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Old 08.07.2020, 16:33
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Re: Moving with Pre-Existing health condition

Sorry to hear that. It will be covered by the basic health insurance, which is all you would get with a pre-existing condition anyway, but covers all you need (better than NHS). Gets standard policy then you have free choice of Dr within your canton. Best thing is to choose your GP, then they know all the specialists and can refer you to the best place.
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Old 08.07.2020, 16:53
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Re: Moving with Pre-Existing health condition

You can bring three months worth of her medication here with you when you move which should be enough to see her through until she gets doctors and insurance sorted out.
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Old 08.07.2020, 17:00
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Re: Moving with Pre-Existing health condition

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Hi,

I was wondering how in practice would moving to Switzerland work with a Pre-Existing condition, more specifically the transition and handover. My wife suffers from CML and is under daily medication. It is very important that her medication continues. In theory when she leaves UK her NHS cover seizes.

I am wondering if any one has experience of how the transition to the swiss system would work as in do we just get insurance and just turn up at the GP ?

I also gather that some types of insurances allow you direct access to a specialist (which is what we plan to get), but was wondering what it means in practice as in I suppose one cannot just turn up to an oncologist directly can they ?
Hi you will be able to get coverage under Basic insurance - which is mandatory for everyone in switzerland. This is like almost everything you need, it's really complete coverage, and its the same for everyone here.

After that if you want to go top dog you can buy Supplementary Insurance which is like your Bupa stuff back home but as with Bupa thats where pre-existing assessment will actually be needed so might exclude you.

the good news is basic is all your going to need to get your medicine, see a doctor and see a specialist. Nice thing out here is you can normally see your specialist within a matter of days, not months so you'll be fine.

if your wife's medicine costs then you will be offered what "deductible" (think excess) for your policy and you should go for the lowest (300CHF) which will be a higher monthly cost but only 300 excess until the medical insurance pays for the whole lot (well, almost, you pay 10% of the next 7000, i.e. 700 CHF, then its 100% covered). Of course if your wife's medicine is not expensive you can go for a higher excess (up to 2500) and lower monthly costs but im guessing the former will be more suitable.

Don't be concerned, this one aspect of switzerland is done brilliantly and your wife will be fine. the only downside of it is if you do have a high excess, the 2500, then you sometimes dont go to the doctor because of the cost and personally im against that, but its a whole other social discussion.
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Old 08.07.2020, 17:18
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Re: Moving with Pre-Existing health condition

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I have Dr.s in Geneva, although I live in Vaud and no issues from Mutual Assurance. This may not be the case everywhere.
By law the basic health insurance has to cover the cost of treatment in your canton (or outside your canton if treatment is not available in your canton). If you go to a canton where the treatment costs less, no problem. Costs more, then you may be asked to pay the difference. Also have a feeling this is only for in patient treatment, out patient treatment no issue, but don't quote me on that.
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Old 08.07.2020, 17:28
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Re: Moving with Pre-Existing health condition

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There may be an exception for GE/VD ... The number of VD residents that work in GE is staggering.
"You can choose a hospital from the Hospital List of your canton of residence, or of the canton where you wish to be treated (listed hospital). The Hospital List can be obtained from your health insurer or from the cantonal health department. If you wish to be treated at a listed hospital not included in the Hospital List of your canton of residence, the costs of accommodation and treatment on the general ward will be covered only up to the amount that would be charged at a hospital on the Hospital List of your canton of residence. However, if the treatment has to be carried out at a hospital not included in the Hospital List of your canton of residence for medical reasons (emergency, specialised treatment), the costs of accommodation and treatment on the general ward of that hospital will be fully covered under compulsory health insurance."

From this downloadable info from BAG
https://www.google.com/url?sa=t&rct=...IOtCS_mx5tQe60
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Old 08.07.2020, 17:29
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Re: Moving with Pre-Existing health condition

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There may be an exception for GE/VD ... The number of VD residents that work in GE is staggering.
Also seems to work for Schwyz and Zurich. I live in Schwyz and have lower premiums than I did in Zurich, but will normally see a doctor in Zurich near where I work. The Telmed even ask where I would like the doctor to be located.
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Old 08.07.2020, 17:56
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Re: Moving with Pre-Existing health condition

As I said... it’s for in patient hospital treatment only! So if you have just seen a Dr as an out patient it won’t have affected you.
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Old 08.07.2020, 19:15
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Re: Moving with Pre-Existing health condition

If you can find a medical insurance company that will let you buy cover not just for your canton, but also for the two add-ons "whole of Switzerland", and "free choice of doctors" (i.e. not bound to go through your G.P. first), that combination can have distinct advantages. The premiums will be a bit higher, but can be a relief to be able to choose, and move so see a different doctor or go to a different hospital, as one needs/wants to.
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Old 08.07.2020, 19:16
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Re: Moving with Pre-Existing health condition

Thanks all, very reassuring.
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Old 08.07.2020, 21:18
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Re: Moving with Pre-Existing health condition

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Hi,

I was wondering how in practice would moving to Switzerland work with a Pre-Existing condition, more specifically the transition and handover. My wife suffers from CML and is under daily medication. It is very important that her medication continues. In theory when she leaves UK her NHS cover seizes.

I am wondering if any one has experience of how the transition to the swiss system would work as in do we just get insurance and just turn up at the GP ?

I also gather that some types of insurances allow you direct access to a specialist (which is what we plan to get), but was wondering what it means in practice as in I suppose one cannot just turn up to an oncologist directly can they ?
Just to add my 2 rappen, we moved here when Mr HH had active, known cancer. Accepted for "basic" insurance without any hassle and every bill was paid without question (...and there were many many bills!) So "pre-existings covered" works in reality as well as in principle.

Generally, no you don't just rock up at the oncologist. But some will take direct appointments without a GP (or other) referral. Ideally, bring a recent discharge letter or summary from the UK oncologist. Show it to the GP and get them to tell you who they recommend. Once you are on the onco's books, you in future can go direct.

If you have a recommendation already for an onco, you can try contacting the clinic to see if they will take a new patient without formal (Swiss) referral.

NHS cover: when we left, NHS cover continued for a period (couple of years, maybe longer) if one had not left permanently. Of course, I would not recommend cheating the system and intentionally continuing to use the NHS... but in worst case scenario of a problem in the immediate months after moving in Switzerland, it is a backup option.
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Old 08.07.2020, 22:15
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Re: Moving with Pre-Existing health condition

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if your wife's medicine costs then you will be offered what "deductible" (think excess) for your policy and you should go for the lowest (300CHF) which will be a higher monthly cost but only 300 excess until the medical insurance pays for the whole lot (well, almost, you pay 10% of the next 7000, i.e. 700 CHF, then its 100% covered). Of course if your wife's medicine is not expensive you can go for a higher excess (up to 2500) and lower monthly costs but im guessing the former will be more suitable.
In BL at least, we get a tax deductible based on self-paid contributions to health. That needs to be taken into account when figuring out the best excess.
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Old 08.07.2020, 23:07
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Re: Moving with Pre-Existing health condition

**Do not** go with the GP model or the telehealth model if she has chronic health problems. It's just one headache after another in case you ever need a second opinion. You want to be able to easily get a second opinion when needed.

The annoying thing you might have to deal with is specific drug or treatment coverage. With things like arthritis, they may want proof the cheaper drugs failed before paying for biologics as an example. With cancer, I would guess any testing that rules out any cheaper therapy has already been done and you would need to bring all the records with you.

Your coverage is retroactive to the day you move here. Just make it a priority to register for health insurance and residence upon moving..
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Old 09.07.2020, 00:03
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Re: Moving with Pre-Existing health condition

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The annoying thing you might have to deal with is specific drug or treatment coverage. With things like arthritis, they may want proof the cheaper drugs failed before paying for biologics as an example. With cancer, I would guess any testing that rules out any cheaper therapy has already been done and you would need to bring all the records with you.
I didn't think of that .. she is on a specific drug this is not a first line treatment here in the UK .. she's been specifically put on that drug because the first line treatment (which is cheaper and equally effective) can have long term side effects like increased cholestrol levels ... what may be difficult would be to reason out why her new medication should be continued when she's not had clinically high levels of cholestrol.
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Old 09.07.2020, 00:25
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Re: Moving with Pre-Existing health condition

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I didn't think of that .. she is on a specific drug this is not a first line treatment here in the UK .. she's been specifically put on that drug because the first line treatment (which is cheaper and equally effective) can have long term side effects like increased cholestrol levels ... what may be difficult would be to reason out why her new medication should be continued when she's not had clinically high levels of cholestrol.
Hi Marog

I would recommend that you look up in advance the area where you may be moving and find a suitable oncologist that you may want to use. You can just call his/her office and try to explain the situation and discuss the case with them (if you can find an english speaking one, or you can work the local language). The doctor may not want to give specific advice without seeing the patient and the full history, but he/she should be able to tell you if/how treatment can be covered by the basic insurance, particularly regarding reimbursement of specific drugs under the Swiss system (it's called Tarmed)

Doctors can consult freely outside of the insurance system if you come from abroad, and in that case they bill you the costs.

Considering the chronic condition it's worth building connections in advance - this can be valuable, as the local doctor will also be following your wife's case over time. You can have a GP, but specialists tend to do their own follow-ups as well.

Also the recommendation is to go for the full "standard" model for the basic insurance with the lowest "franchise" for your wife - cost-wise this will be the most efficient, you may be paying more for the insurance but this will be worth it as you will pay less for consultations and treatments. Make some calculations in advance.
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Old 09.07.2020, 00:59
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Re: Moving with Pre-Existing health condition

Hi, Marog--

The health system here is (thankfully!) great, and there doesn't seem to be much hassle with billing. I just recently moved, so wanted to offer my experiences, in case they would be helpful:

- Get the insurance with the lowest franchise (deductible) for your wife (and maybe yourself!). It'll def be worth it!
- Look up doctors in the area where you are planning on living and see if anyone looks good. The standards here are high, so don't feel pressured to find "the best" -- an oncologist that cares about their patients and whom you can easily communicate with will be great. You can also switch doctors later, if needed/desired. Set some time aside to call around and chat to folks -- I talked to a couple of practices before I chose the GP that I liked.
- Get your wife's medical records (all of 'em!) from your practice and all of the oncology records from the NHS. I'd recommend a hard copy you can mail and a soft copy you can e-mail (if you feel comfortable doing that). I had a soft copy that my GP here read before my appointment and seemed to know my "case" well before I ever walked in the door, which was super helpful for me and put me at ease. (I don't even think I got charged for that time, but I would've hit my franchise anyway with that appointment.) This should help the doctor prescribe the same medication to maintain (and not change) treatment. Get your medical records, too -- it's helpful for doctors to have a record of patients' medical histories.
- Get your current doctors to prescribe 1-3 months of meds in advance. Doctors should be fairly reasonable about this, but you might have to do some insisting.

Basic insurance covers all the same things, so once you know your postcode, you can shop around (comparis.ch is a good resource - from their list, I visited individual providers' websites to see what they had in English and what other things they offered as supplemental; if you don't have time for any of it, you can get the cheapest basic option on comparis and then figure out supplemental later).

If you do have the time, a couple of things I comparison-shopped for that I found super helpful was: insurance company with documentation/website/terms in English (our German is definitely not good enough for legal documents) and the practice billing the insurance company directly (the practice I chose does this, so I don't have to worry about bills at the doctor's office -- they come through the mail or the online account when the insurance company needs me to settle some balances).

Good luck with the move, and all the best to you and your wife!
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Old 11.07.2020, 09:48
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Re: Moving with Pre-Existing health condition

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I didn't think of that .. she is on a specific drug this is not a first line treatment here in the UK .. she's been specifically put on that drug because the first line treatment (which is cheaper and equally effective) can have long term side effects like increased cholestrol levels ... what may be difficult would be to reason out why her new medication should be continued when she's not had clinically high levels of cholestrol.
It might be a first line here, or her age may be a factor. In general, cholesterol isn't seen with the same negative lens in Switzerland as in the UK. Increased total Cholesterol actually improves cancer outcomes. That being said, I don't think they would change her treatment as long as the treating doctor can write a letter.
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Old 11.07.2020, 12:44
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Re: Moving with Pre-Existing health condition

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Hi Marog

I would recommend that you look up in advance the area where you may be moving and find a suitable oncologist that you may want to use. You can just call his/her office and try to explain the situation and discuss the case with them (if you can find an english speaking one, or you can work the local language). The doctor may not want to give specific advice without seeing the patient and the full history, but he/she should be able to tell you if/how treatment can be covered by the basic insurance, particularly regarding reimbursement of specific drugs under the Swiss system (it's called Tarmed)

Doctors can consult freely outside of the insurance system if you come from abroad, and in that case they bill you the costs.

Considering the chronic condition it's worth building connections in advance - this can be valuable, as the local doctor will also be following your wife's case over time. You can have a GP, but specialists tend to do their own follow-ups as well.

Also the recommendation is to go for the full "standard" model for the basic insurance with the lowest "franchise" for your wife - cost-wise this will be the most efficient, you may be paying more for the insurance but this will be worth it as you will pay less for consultations and treatments. Make some calculations in advance.
I'll add to this that if you can find one to consult with, check that the medication your wife is on is actually available here. Not all medicines will be.
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Old 11.07.2020, 13:11
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Re: Moving with Pre-Existing health condition

Here is the Swiss Cancer League, which might be able to give you some information.

I don't know whether you speak a Swiss language, but even if you don't, you might try to write to them, or phone them, in English. In such a case, it could be that they won't be able to help you immediately, but may be kind enough to look for someone who can do so in English, and therefore may suggest a different time for you to phone back.
https://www.krebsliga.ch/?gclid=EAIa...SAAEgIgofD_BwE

In case you do speak a Swiss language, here are their fora:
https://www.krebsforum.ch/forum3_de/index.php (German)
https://www.forumcancer.ch/forum3_fr...hp?f=61&t=1854 (French)
https://www.forumcancro.ch/ (Italian)
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