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Old 19.11.2020, 11:47
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First time pregnancy at 40 in Vaud - just arrived too!

Hi,

I've read all the posts I can find related to this but still need a bit of advice please.

My boyfriend started a job in Lausanne in Sept and has his Permit B. We are both British and are living in Morges. I arrived recently, was looking for work, was told I could be a tourist for 3 months so thought I would apply for the Permit and get insurance when I got work (or after 3 months).

Very surprisingly, I've just found out I'm pregnant and we were shocked but happy. I thought about returning to the UK for scans/tests etc as I know there's more risk because of my age but I want to stay in Switzerland with my boyfriend. Last week I applied for my Permit but don't yet have insurance. I found a local Gynocologist who speaks English (I'm learning French) and have just had one appointment. I was quite surprised but he did a scan then as I'm 12 weeks and he said it looks OK but he recommended extra blood tests (because of my age) and just said see you in a month. I was a bit overwhelmed by the whole situation as I've not been pregnant before, and didn't know what to expect.

I paid the bill at the doctor's and have the receipt and now I need to get insurance. From what I've read it looks like any basic insurance should be fine and will cover me from the date of entry on my Permit application. I don't quite understand which model would be best GP/phone/medical centre as ideally I'd like to see medical people who speak English and I can't work out what choice you get with the different models. I know insurance covers medical costs for pregnancy but have seen that any extra medical needs after the birth won't be covered so am not sure which excess to get. The baby is due on June 1st. Generally I'm healthy and don't go to the doctor often in the UK and am not on any other medication.

Also, as I've not had a child before or been to the doctor in Switzerland before I have no idea how the system works or what I should be doing or what to expect. I know the Swiss medical system is brilliant but am not sure if I should be contacting midwives or the doctor will send me a letter about what happens next. Any help or support would be appreciated.

Thanks
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Old 19.11.2020, 11:58
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Re: First time pregnancy at 40 in Vaud - just arrived too!

I can't give any advice, but congratulations!
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Old 19.11.2020, 12:15
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Re: First time pregnancy at 40 in Vaud - just arrived too!

I too found out I was pregnant just a couple of months after arriving here, also with a 'geriatric' pregnancy (dreadful term). Also have a lovely English speaking doctor in Morges (so many similarities). He was very thorough and he did order a number of extra blood tests. This was all covered by basic insurance and they submitted directly to the insurance company themselves. The only test I paid for was the prenatal cell-free DNA screening which my doctor felt I didn't require, but I needed to do for my own peace of mind. You will have 1 appointment a month here, and towards the end it will be every 2 weeks, then weekly. They will give you information regarding antenatal classes, midwives, hospital visits etc.
All the best with the rest of your pregnancy!!
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Old 19.11.2020, 12:18
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Hi,

I've read all the posts I can find related to this but still need a bit of advice please.

My boyfriend started a job in Lausanne in Sept and has his Permit B. We are both British and are living in Morges. I arrived recently, was looking for work, was told I could be a tourist for 3 months so thought I would apply for the Permit and get insurance when I got work (or after 3 months).

Very surprisingly, I've just found out I'm pregnant and we were shocked but happy. I thought about returning to the UK for scans/tests etc as I know there's more risk because of my age but I want to stay in Switzerland with my boyfriend. Last week I applied for my Permit but don't yet have insurance. I found a local Gynocologist who speaks English (I'm learning French) and have just had one appointment. I was quite surprised but he did a scan then as I'm 12 weeks and he said it looks OK but he recommended extra blood tests (because of my age) and just said see you in a month. I was a bit overwhelmed by the whole situation as I've not been pregnant before, and didn't know what to expect.

I paid the bill at the doctor's and have the receipt and now I need to get insurance. From what I've read it looks like any basic insurance should be fine and will cover me from the date of entry on my Permit application. I don't quite understand which model would be best GP/phone/medical centre as ideally I'd like to see medical people who speak English and I can't work out what choice you get with the different models. I know insurance covers medical costs for pregnancy but have seen that any extra medical needs after the birth won't be covered so am not sure which excess to get. The baby is due on June 1st. Generally I'm healthy and don't go to the doctor often in the UK and am not on any other medication.

Also, as I've not had a child before or been to the doctor in Switzerland before I have no idea how the system works or what I should be doing or what to expect. I know the Swiss medical system is brilliant but am not sure if I should be contacting midwives or the doctor will send me a letter about what happens next. Any help or support would be appreciated.

Thanks
Hi there, many congratulations, we've had three children here and the service is first class.

There are numerous english speaking gyno's around you can take your pick, but I want to highlight something you should get clarified, it might be nothing but its important and its around your permit.

When you have a permit here, you get your health insurance and pregnancy is fully covered without any excess (deductible its called here) for regular pregancy stuff. Anything special or out of ordinairy is covered but you have an excess to pay - there's millions of conversations about that on here you can search "health insurance" you'll get the picture in no time.

But be careful about the permit piece. If you arrive as a tourist, you're covered by your travel insurance, for all illness of which pregnancy's I expect are included.

When you have your permit you backdate your health insurance to when you arrived and thats all smooth.

However if you have a permit application underway, its not quite so clear to me. If you are 100% certain to get approved theoretically you should be fine because its just paperwork, im just slightly concerned that if they say until you get a job your a tourist you might still be classed as that until then and this would put your pregnancy classification under your travel insurance.

I might be talking complete gibberish and someone more knowledgable on the forum can correct me, but I'd get it cleared up for peace of mind.

good luck!
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Old 19.11.2020, 13:12
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Hi there, many congratulations, we've had three children here and the service is first class.

There are numerous english speaking gyno's around you can take your pick, but I want to highlight something you should get clarified, it might be nothing but its important and its around your permit.

When you have a permit here, you get your health insurance and pregnancy is fully covered without any excess (deductible its called here) for regular pregancy stuff. Anything special or out of ordinairy is covered but you have an excess to pay - there's millions of conversations about that on here you can search "health insurance" you'll get the picture in no time.

But be careful about the permit piece. If you arrive as a tourist, you're covered by your travel insurance, for all illness of which pregnancy's I expect are included.

When you have your permit you backdate your health insurance to when you arrived and thats all smooth.

However if you have a permit application underway, its not quite so clear to me. If you are 100% certain to get approved theoretically you should be fine because its just paperwork, im just slightly concerned that if they say until you get a job your a tourist you might still be classed as that until then and this would put your pregnancy classification under your travel insurance.

I might be talking complete gibberish and someone more knowledgable on the forum can correct me, but I'd get it cleared up for peace of mind.

good luck!
Thank you. Yes, I'm a bit confused too. A few people said just bill the NHS. I've got an EHIC card but have never had to use it before and am not sure if this is covered. I should have taken it to the doctor. My first thought was panic and go to the doctor and deal with the money side later. I think I will get a Permit B or maybe L as I have applied for my Permit as co-habiting with my boyfriend (who has Permit B) and we provided all his salary slips etc to say he could "afford to keep me" here. I should probably check though as I know this can take time.
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Old 19.11.2020, 13:16
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Re: First time pregnancy at 40 in Vaud - just arrived too!

For health insurance, a gynecologist does not fall under the same category as GP, nor other specialties if you take a model that means you need to a referral before seeing any doctor.
Have you seen a gynecologist or a GP? As others mentioned, you'll be followed monthly, and around 20 weeks you'll be referred for the in-depth scan where they check all organs etc are ok.
This is the route most people follow here - unlike the UK where there are many different options.
If you only have basic insurance, the delivery will be managed by the midwives on call, with the OB on-call coming at the end or earlier if necessary. However, after the birth you are entitled to have a midwife visit at home (6 visits I think), and this you can arrange yourself.



Also, agree about checking your residence status, as without a residence permit, it is unclear who is responsible for paying your bills and if you're allowed to stay here without one.



Contact jenny at inswift.ch for advice on insurance and insurance for the baby as well. She deals with expats and is very helpful.
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Old 19.11.2020, 13:21
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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I too found out I was pregnant just a couple of months after arriving here, also with a 'geriatric' pregnancy (dreadful term). Also have a lovely English speaking doctor in Morges (so many similarities). He was very thorough and he did order a number of extra blood tests. This was all covered by basic insurance and they submitted directly to the insurance company themselves. The only test I paid for was the prenatal cell-free DNA screening which my doctor felt I didn't require, but I needed to do for my own peace of mind. You will have 1 appointment a month here, and towards the end it will be every 2 weeks, then weekly. They will give you information regarding antenatal classes, midwives, hospital visits etc.
All the best with the rest of your pregnancy!!
Oh that's great to hear. Yes, I'm very happy with the quality of service and happy to follow the doctors advice, I just don't understand how the "system" works and where to get the right info. In the UK I'd just phone my GP and look at NHS advice. Does the info about antenatal classes etc come from the insurance or the Gynocologist I saw? As I don't have insurance yet, can I just choose my insurance based on this? Or are they all similar?
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Old 19.11.2020, 13:26
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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For health insurance, a gynecologist does not fall under the same category as GP, nor other specialties if you take a model that means you need to a referral before seeing any doctor.
Have you seen a gynecologist or a GP? As others mentioned, you'll be followed monthly, and around 20 weeks you'll be referred for the in-depth scan where they check all organs etc are ok.
This is the route most people follow here - unlike the UK where there are many different options.
If you only have basic insurance, the delivery will be managed by the midwives on call, with the OB on-call coming at the end or earlier if necessary. However, after the birth you are entitled to have a midwife visit at home (6 visits I think), and this you can arrange yourself.



Also, agree about checking your residence status, as without a residence permit, it is unclear who is responsible for paying your bills and if you're allowed to stay here without one.



Contact jenny at inswift.ch for advice on insurance and insurance for the baby as well. She deals with expats and is very helpful.
Midwives do very much exist in Switzerland and also work in hospitals. Even at 40, aside from an *optional* genetic scan and first trimester screaming, there's nothing all that high risk unless you get covid or have another illness that would make you high risk. If you do go with a midwife, the gynecologist would still do the scans at 12, 20 and 36-40 weeks. The midwives in hospitals can also do the blood draws to check for iron deficiency and gestational diabetes.
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Old 19.11.2020, 13:32
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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For health insurance, a gynecologist does not fall under the same category as GP, nor other specialties if you take a model that means you need to a referral before seeing any doctor.
Have you seen a gynecologist or a GP? As others mentioned, you'll be followed monthly, and around 20 weeks you'll be referred for the in-depth scan where they check all organs etc are ok.
This is the route most people follow here - unlike the UK where there are many different options.
If you only have basic insurance, the delivery will be managed by the midwives on call, with the OB on-call coming at the end or earlier if necessary. However, after the birth you are entitled to have a midwife visit at home (6 visits I think), and this you can arrange yourself.



Also, agree about checking your residence status, as without a residence permit, it is unclear who is responsible for paying your bills and if you're allowed to stay here without one.



Contact jenny at inswift.ch for advice on insurance and insurance for the baby as well. She deals with expats and is very helpful.
Thank you for the information. I went straight to the Gynocologist and have never seen another doctor here. Does that mean I need a specific model of insurance or any? I'll check on my Permit and residence status too. Thanks.
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Old 19.11.2020, 13:32
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Re: First time pregnancy at 40 in Vaud - just arrived too!

How you handle the insurance is completely dependent on your permit situation.


The regulation for a 'concubine' permit varies across the cantons, so we don't know exactly what will happen for that.


If your residency permit is agreed, your health insurance will be backdated to the date of arrival or registration. Then you can give your receipts in and the insurance will reimburse. However, there's always some sort of 'gap' so you need to consider carefully which 'franchise' you choose - in this case, as you know you will have a lot of bills, the low ffranchise is probably best - but you'll still pay the first 250chf or more out of pocket, plus around 10% on the next few thousands of bills.



Your partner will be responsible for paying all these bills if he signs the concubine agreement.



For the prenatal testing, it's very normal to do the 12 weeks scan - they check 'nuchal translucency' which is a factor in down syndrome and also of course heart and general body structures, and they are also checking for signs of any 'neural tube defect' which could cause spina bifida. It sounds like everything is normal.


For the further testing, you will test higher risk based purely on age for down syndrome. With any test, you can ask the doctor the purpose, risk and consequence of testing.



The blood testing now is much more sophisticated than 20 years ago when I had my first child.



General blood tests will include checking your immunity for some key diseases, HIV, Hepatitis, and your general health.



There are also blood tests that can check for markers for chromosomal abnormalities.



Whether you do more invasive testing (CVS) where they take a sample from the amiotic fluid, is a balance between risk of miscarriage and benefit of having results.


Underlying this is the question of whether testing would change your outcome. Keep asking lots of questions. Even write them down beforehand so you don't forget to ask during your appointments.
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Old 19.11.2020, 13:35
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Oh that's great to hear. Yes, I'm very happy with the quality of service and happy to follow the doctors advice, I just don't understand how the "system" works and where to get the right info. In the UK I'd just phone my GP and look at NHS advice. Does the info about antenatal classes etc come from the insurance or the Gynocologist I saw? As I don't have insurance yet, can I just choose my insurance based on this? Or are they all similar?

What is covered by basic insurance is the same in all companies - only differences are the price and this depends on service and the model that you go for, and excess of course!

Gynecologist gives all the information as you need it. However, do look out for english speaking pre-natal classes where you'll also get lots of info. There are independent midwives that may organize them, or may be organized at CHUV in Lausanne. Not sure if Morges hospital has English ones.
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Old 19.11.2020, 13:37
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Re: First time pregnancy at 40 in Vaud - just arrived too!

As you’ve gone straight to a Gyne, you should probably get the standard model insurance, as this allows you to go to any Dr without being referred by a GP or Telemed Dr first. When you get your insurance it will be backdated and valid from the date you applied for your permit (or the date you wrote down on the application as your “arrival date”).

Not sure you can use EHIC and bill the NHS. It’s normally for emergency treatment for tourists. Thinking a regular scan probably isn’t covered by that.
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Old 19.11.2020, 13:46
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Midwives do very much exist in Switzerland and also work in hospitals. Even at 40, aside from an *optional* genetic scan and first trimester screaming, there's nothing all that high risk unless you get covid or have another illness that would make you high risk. If you do go with a midwife, the gynecologist would still do the scans at 12, 20 and 36-40 weeks. The midwives in hospitals can also do the blood draws to check for iron deficiency and gestational diabetes.
Thank you. Yes, I panicked when he said after 12 weeks there was a 1/10 chance of Down's Syndrome but this doesn't seem to be the case. Maybe I should have had another check earlier? Maybe something was lost in translation too.
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Old 19.11.2020, 14:21
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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As you’ve gone straight to a Gyne, you should probably get the standard model insurance, as this allows you to go to any Dr without being referred by a GP or Telemed Dr first. When you get your insurance it will be backdated and valid from the date you applied for your permit (or the date you wrote down on the application as your “arrival date”).

Not sure you can use EHIC and bill the NHS. It’s normally for emergency treatment for tourists. Thinking a regular scan probably isn’t covered by that.
It doesn’t matter what insurance model she takes as the gynae is exempt from the need for a referral along with ophthalmologists and paediatricians.

If the OP doesn’t get a permit and health insurance coverage then the visit may well be covered by the EHIC as a tourist. As far as I know that will all be dealt with by the KVG place in Solothurn if necessary.
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Old 19.11.2020, 16:54
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Re: First time pregnancy at 40 in Vaud - just arrived too!

Sod the expense, kids are worth every penny !
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Old 19.11.2020, 17:07
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Re: First time pregnancy at 40 in Vaud - just arrived too!

Congrats on bringing the 7,826,501,814 person into this world

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Sod the expense, kids are worth every penny !
view all people on 1 page >

Yes, worth every penny, just not worth the headache
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Old 19.11.2020, 17:33
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Thank you. Yes, I panicked when he said after 12 weeks there was a 1/10 chance of Down's Syndrome but this doesn't seem to be the case. Maybe I should have had another check earlier? Maybe something was lost in translation too.
After 40, there is a higher risk of Down's, but the first trimester test will give you a better idea of your risk. They plug in measurements and results of blood work into an equation that determines if you're high enough risk for the insurance to pay for non-invasive blood test genetic screening. It's literally a linear regression analysis to determine risk. If it's important to you, you can still do the non-invasive testing, it's a blood test and runs around 950-1000chf.

I don't think a 10% risk is correct for a 40 year old unless there's another factor i'm not aware of. It's something like 1% at age 40 and increases to around 3.5% at age 45. If you make it to 12 weeks, I think the risk is even lower since trisomy 21 increases the risk of miscarriage in the first trimester.
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Old 19.11.2020, 17:42
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Thank you for the information. I went straight to the Gynocologist and have never seen another doctor here. Does that mean I need a specific model of insurance or any? I'll check on my Permit and residence status too. Thanks.
Unless you chose telehealth, you can see a gynecologist. BUT, keep this in mind. With the family medicine model, every time you want to see a specialist, if you have a recurring problem, but it's been too long since the last appointment, you have to see your family doctor first. I find my GP refers me to someone else for everything and when I want to go back every year, I don't need to see her with the free option. As an example, the pulmonologist for my asthma medication maintenance once a year; or the dermatologist for an allergy to a tree I have in my garden that every spring gives me a rash when I cut it back because the cream i need is prescription and my GP doesn't know it well enough to prescribe. It depends what is important to you. Keep in mind that some insurances will give children a discount on supplemental coverage.
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Old 19.11.2020, 17:54
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Re: First time pregnancy at 40 in Vaud - just arrived too!

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Sod the expense, kids are worth every penny !
I haven't had much luck selling mine so I'm not sure if I've made a profit or not

Congrats to the OP; we didn't have our kids here, and my wife is very jealous of those who did, with proper supported stays in hospital and top-notch aftercare.
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Old 19.11.2020, 19:50
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Re: First time pregnancy at 40 in Vaud - just arrived too!

No advice re insurance, but congratulations enjoy <3
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