Go Back   English Forum Switzerland > Help & tips > Family matters/health  
Reply
 
Thread Tools Display Modes
  #1  
Old 23.02.2021, 10:38
Newbie 1st class
 
Join Date: Jan 2021
Location: Zurich
Posts: 24
Groaned at 0 Times in 0 Posts
Thanked 3 Times in 2 Posts
diesomnius has no particular reputation at present
GP Referral to See Specialist

Hello everybody,

last week Monday, I went to see a GP due to a looming middle ear infection and he gave me Ibuprofen to help reduce inflammation.

He also suggested I should see a specialist and made a referral. Next week, I am supposed to see an otologist at Universitätsspital Zürich and was wondering if you could help me figure out how much, if anything, is this going to cost me?

Do you pay for a specialist visit in Switzerland if you get referred by your GP? And if so, do you maybe know what the price range for that would be?

When it comes to my health insurance, my franchise is 2500,- CHF as I usually don't go see a doctor very often (twice to three times a year max) and what's going on at the moment is an isolated case.

Thank you for your insights!
Reply With Quote
  #2  
Old 23.02.2021, 10:46
Island Monkey's Avatar
Forum Legend
 
Join Date: Mar 2008
Location: Wallis
Posts: 6,192
Groaned at 106 Times in 71 Posts
Thanked 6,924 Times in 3,149 Posts
Island Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post
Do you pay for a specialist visit in Switzerland if you get referred by your GP? And if so, do you maybe know what the price range for that would be?
Yes you have to pay. Hard to say cost when you don't know what tests they may carry out. When I saw a neuro consultant about migranes last year the cost was 400chf which included an EEG test. (Then he sent me for an MRI another day, which was a further 600).
Reply With Quote
  #3  
Old 23.02.2021, 10:50
Newbie 1st class
 
Join Date: Jan 2021
Location: Zurich
Posts: 24
Groaned at 0 Times in 0 Posts
Thanked 3 Times in 2 Posts
diesomnius has no particular reputation at present
Re: GP Referral to See Specialist

Thanks for the quick answer!

In the letter I received from USZ, it says Hearing Test and Consultation, nothing else.

Hope this helps!
Reply With Quote
  #4  
Old 23.02.2021, 10:54
Island Monkey's Avatar
Forum Legend
 
Join Date: Mar 2008
Location: Wallis
Posts: 6,192
Groaned at 106 Times in 71 Posts
Thanked 6,924 Times in 3,149 Posts
Island Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond reputeIsland Monkey has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post
Thanks for the quick answer!

In the letter I received from USZ, it says Hearing Test and Consultation, nothing else.

Hope this helps!
I’d estimate 500 for that - but with the possibility the specialist may want further tests/treatment.
Reply With Quote
  #5  
Old 23.02.2021, 10:54
Forum Legend
 
Join Date: Sep 2006
Location: na
Posts: 11,248
Groaned at 37 Times in 33 Posts
Thanked 26,732 Times in 8,253 Posts
meloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond repute
Re: GP Referral to See Specialist

If you are worried about cost, call the department (the number will be on your appointment letter) and ask how much such a consultation will likely be. You need to ask the department administrator - doctors themselves generally have no idea what costs are. They may hem and haw, but if you are persistent the administrator should be able to give you a rough estimate.

You pay for a specialist just as you would pay for a GP visit - that is, you first pay your franchise, then up to CHF 700 (10% of the next 7K) 'Selbstbehalt'. From that point on, the KK picks up the cost.

So you can figure out the worst case scenario.

A specialist at the Unispital will be somewhat more expensive than a GP visit because the specialist is paid at a higher rate. The cost will depend on what is done.

If the doctor you see orders further tests, you are well within your rights to ask for a cost estimate before doing those tests.
Reply With Quote
  #6  
Old 23.02.2021, 11:05
Newbie 1st class
 
Join Date: Jan 2021
Location: Zurich
Posts: 24
Groaned at 0 Times in 0 Posts
Thanked 3 Times in 2 Posts
diesomnius has no particular reputation at present
Re: GP Referral to See Specialist

@meloncollie

Quick question regarding the Selbstbehalt you mentioned. Did I understand correctly that I have to first pay my franchise, which is 2500,- CHF, and CHF 700 on top of that?

Let's suppose that the doctor orders further tests. Is it the department administrator whom I should ask to provide a cost estimate?
Reply With Quote
  #7  
Old 23.02.2021, 11:25
Forum Legend
 
Join Date: Sep 2006
Location: na
Posts: 11,248
Groaned at 37 Times in 33 Posts
Thanked 26,732 Times in 8,253 Posts
meloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond repute
Re: GP Referral to See Specialist

Yes, you will first pay whatever portion of your franchise remains for the year.

And then once the franchise is reached for that year, in addition you pay 10% of costs on the first CHF 7000 - so a maximum of CHF 700.

Now a consultation itself should not cost your full franchise. But tests can start adding up quickly. So the best thing to do is to ask upfront.

Call the department number on your appointment letter. Tell them you would like an understanding of costs before your appointment.

If this is some kind of standard screening where tests X, Y, and Z are usually done they should be able to give you a pretty good idea. If this is a consultation where the doctor will later decide what tests will be done, before agreeing to those tests ask for a cost estimate.

But worse case scenario, your out of pocket medical costs should not be much more than your franchise plus the max Selbstbehalt, CHF 3200.

It is unlikely that an initial consultation will reach that level, though. You are probably looking at something in the hundreds, not thousands.

Never be afraid to ask about costs upfront.
Reply With Quote
  #8  
Old 23.02.2021, 11:28
Newbie 1st class
 
Join Date: Jan 2021
Location: Zurich
Posts: 24
Groaned at 0 Times in 0 Posts
Thanked 3 Times in 2 Posts
diesomnius has no particular reputation at present
Re: GP Referral to See Specialist

@melancolie

Thank you so much for the valuable insights. I have a better idea now of how it works.

I'm new here, as you can tell, and I find the level of transparency in those regards a bit appalling. German is my second mother tongue and not even googling it in German could help me find any decent search results.
Reply With Quote
The following 2 users would like to thank diesomnius for this useful post:
  #9  
Old 23.02.2021, 11:36
Forum Veteran
 
Join Date: Jan 2014
Location: Lausanne
Posts: 543
Groaned at 44 Times in 25 Posts
Thanked 586 Times in 324 Posts
dandi has an excellent reputationdandi has an excellent reputationdandi has an excellent reputationdandi has an excellent reputation
Re: GP Referral to See Specialist

Quote:
View Post
@melancolie

Thank you so much for the valuable insights. I have a better idea now of how it works.

I'm new here, as you can tell, and I find the level of transparency in those regards a bit appalling. German is my second mother tongue and not even googling it in German could help me find any decent search results.
https://ch.ch/ is your friend

In particular

https://www.ch.ch/en/basic-health-insurance-services/
Reply With Quote
This user would like to thank dandi for this useful post:
  #10  
Old 23.02.2021, 11:54
bwkranger's Avatar
Member
 
Join Date: Apr 2019
Location: Weisslingen, ZH
Posts: 106
Groaned at 0 Times in 0 Posts
Thanked 100 Times in 57 Posts
bwkranger has earned some respectbwkranger has earned some respect
Re: GP Referral to See Specialist

Quote:
View Post
@melancolie

Thank you so much for the valuable insights. I have a better idea now of how it works.

I'm new here, as you can tell, and I find the level of transparency in those regards a bit appalling. German is my second mother tongue and not even googling it in German could help me find any decent search results.
I agree the transparency over fees here is a big problem. I've also had to push hard in the past just to get a rough idea of how much appointments and treatment would cost. It would be better for everyone if the treatment and consultant prices were more easily accessible. Another thing to be aware of is the time it might take for the bill to be issued. I was sent once a bill for an appointment I'd had about ten months previously so it might take a bit of time before you know the definite final costs, obviously this depends on how efficient the doctors and health insurance companies admin is.

Last edited by bwkranger; 23.02.2021 at 11:55. Reason: Typo
Reply With Quote
This user would like to thank bwkranger for this useful post:
  #11  
Old 23.02.2021, 13:02
Axa's Avatar
Axa Axa is offline
Forum Legend
 
Join Date: Oct 2019
Location: Suhr, Aargau
Posts: 3,864
Groaned at 52 Times in 52 Posts
Thanked 5,219 Times in 2,436 Posts
Axa has a reputation beyond reputeAxa has a reputation beyond reputeAxa has a reputation beyond reputeAxa has a reputation beyond reputeAxa has a reputation beyond reputeAxa has a reputation beyond repute
Re: GP Referral to See Specialist

I was there 3 years ago, also ear infection problem.

If i remember well the specialist fees were around 250 CHF for the more experienced doctor who made the initial diagnose, and for the follow up I was sent with another guy charging 180 CHF per check. A CT-scan around 600 or 800. I ended in the surgery room, so I quickly passed 2500 CHF franchise.

I'm sure this will sound a bit strange but you're lucky that you need the attention now. No offense. The insurance adds the costs per calendar year, so if you pass the 2500 CHF, all further costs will be payed by the insurance. If a new year starts, the accumulated expenses reset to zero and you have spend another 2500 CHF.
Reply With Quote
The following 3 users would like to thank Axa for this useful post:
  #12  
Old 23.02.2021, 13:26
Belgianmum's Avatar
Roastbeef & Yorkshire mod
 
Join Date: Jan 2010
Location: Neuchâtel
Posts: 13,481
Groaned at 251 Times in 212 Posts
Thanked 22,659 Times in 9,252 Posts
Belgianmum has a reputation beyond reputeBelgianmum has a reputation beyond reputeBelgianmum has a reputation beyond reputeBelgianmum has a reputation beyond reputeBelgianmum has a reputation beyond reputeBelgianmum has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post

I'm sure this will sound a bit strange but you're lucky that you need the attention now. No offense. The insurance adds the costs per calendar year, so if you pass the 2500 CHF, all further costs will be payed by the insurance. If a new year starts, the accumulated expenses reset to zero and you have spend another 2500 CHF.
Absolutely. It’s far better from a monetary perspective to have the big health related expenses at the start of the year rather than towards the end.
My husband schedules all his regular specialist appointments for January.
Reply With Quote
The following 6 users would like to thank Belgianmum for this useful post:
  #13  
Old 23.02.2021, 14:06
Forum Legend
 
Join Date: Aug 2015
Location: Basle
Posts: 2,801
Groaned at 72 Times in 57 Posts
Thanked 1,952 Times in 1,130 Posts
Landers has a reputation beyond reputeLanders has a reputation beyond reputeLanders has a reputation beyond reputeLanders has a reputation beyond reputeLanders has a reputation beyond repute
Re: GP Referral to See Specialist

The system discourages less well off people to get medical attention but maybe you need to think about the hundreds you're saving by having the high franchise. If you think the investigations are not necessary then you can go without them but you run the risk of not identifying a probelm until it gets much worse.



Simply because it's a specialist doesn't necessarily make the costs jump considerably. I would imagine the consultation would be the usual 100 to 200 depending what they do. For a hearing test it might be possible to get one for free at at hearing aid place. If there is something fundamentally wrong though I'd imagine there would need to be scans of some kind and then the costs can add up.
Reply With Quote
  #14  
Old 23.02.2021, 14:25
fatmanfilms's Avatar
Forum Legend
 
Join Date: Apr 2010
Location: Verbier
Posts: 21,376
Groaned at 461 Times in 352 Posts
Thanked 23,091 Times in 11,824 Posts
fatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post
The system discourages less well off people to get medical attention but maybe you need to think about the hundreds you're saving by having the high franchise. If you think the investigations are not necessary then you can go without them but you run the risk of not identifying a probelm until it gets much worse.



Simply because it's a specialist doesn't necessarily make the costs jump considerably. I would imagine the consultation would be the usual 100 to 200 depending what they do. For a hearing test it might be possible to get one for free at at hearing aid place. If there is something fundamentally wrong though I'd imagine there would need to be scans of some kind and then the costs can add up.
Pop actress to France, ENT specialist will charge €50, CT scan about €120 so probably 1/5 cost of getting it done in CH.
Reply With Quote
  #15  
Old 23.02.2021, 14:56
NickGB's Avatar
Forum Veteran
 
Join Date: Apr 2011
Location: Zug
Posts: 1,118
Groaned at 10 Times in 10 Posts
Thanked 1,542 Times in 618 Posts
NickGB has a reputation beyond reputeNickGB has a reputation beyond reputeNickGB has a reputation beyond reputeNickGB has a reputation beyond reputeNickGB has a reputation beyond repute
Re: GP Referral to See Specialist

Slightly (but not much) off topic, but am I in the minority, having the top private health insurance with the lowest franchise. Many a friends and colleagues have scoffed at this and have announced that they never get sick, so why should they 'overpay' for health insurance. In every instance something has befallen them and it's been very expensive for them.

I have really appreciated my 'expensive' health insurance and have never looked back.
Reply With Quote
The following 4 users would like to thank NickGB for this useful post:
  #16  
Old 23.02.2021, 15:16
fatmanfilms's Avatar
Forum Legend
 
Join Date: Apr 2010
Location: Verbier
Posts: 21,376
Groaned at 461 Times in 352 Posts
Thanked 23,091 Times in 11,824 Posts
fatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond reputefatmanfilms has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post
Slightly (but not much) off topic, but am I in the minority, having the top private health insurance with the lowest franchise. Many a friends and colleagues have scoffed at this and have announced that they never get sick, so why should they 'overpay' for health insurance. In every instance something has befallen them and it's been very expensive for them.

I have really appreciated my 'expensive' health insurance and have never looked back.
I have had 1 claim in 41 years of being insured, the claim an accident was €20,000 with premiums about €3500 a year. Investing the premiums would have been a better deal. Of course I have paid accident insurance in addition.....
Reply With Quote
  #17  
Old 23.02.2021, 15:31
Forum Veteran
 
Join Date: Jan 2014
Location: Lausanne
Posts: 543
Groaned at 44 Times in 25 Posts
Thanked 586 Times in 324 Posts
dandi has an excellent reputationdandi has an excellent reputationdandi has an excellent reputationdandi has an excellent reputation
Re: GP Referral to See Specialist

Quote:
View Post
If there is something fundamentally wrong though I'd imagine there would need to be scans of some kind and then the costs can add up.

And my general experience there doesn't have to be something "fundamentally wrong" for the doctors to refer you to a scan on a "just to check" basis. Unless you complain that you have a high franchise and that you want to save money, when they might reconsider. Doctors have very little incentive to not overinvestigate.
Reply With Quote
  #18  
Old 23.02.2021, 15:37
Forum Veteran
 
Join Date: Jan 2014
Location: Lausanne
Posts: 543
Groaned at 44 Times in 25 Posts
Thanked 586 Times in 324 Posts
dandi has an excellent reputationdandi has an excellent reputationdandi has an excellent reputationdandi has an excellent reputation
Re: GP Referral to See Specialist

Quote:
View Post
Slightly (but not much) off topic, but am I in the minority, having the top private health insurance with the lowest franchise. Many a friends and colleagues have scoffed at this and have announced that they never get sick, so why should they 'overpay' for health insurance. In every instance something has befallen them and it's been very expensive for them.
Can you explain this a bit? Unless your friend/s have chosen by themselves to go to private wards and incur the costs not covered by the basic insurance, I can't see how things can get "very expensive" under the basic insurance as the maximum you pay for health coverage for a year is capped?
Reply With Quote
The following 2 users would like to thank dandi for this useful post:
  #19  
Old 23.02.2021, 16:31
Forum Legend
 
Join Date: Aug 2015
Location: Basle
Posts: 2,801
Groaned at 72 Times in 57 Posts
Thanked 1,952 Times in 1,130 Posts
Landers has a reputation beyond reputeLanders has a reputation beyond reputeLanders has a reputation beyond reputeLanders has a reputation beyond reputeLanders has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post
Can you explain this a bit? Unless your friend/s have chosen by themselves to go to private wards and incur the costs not covered by the basic insurance, I can't see how things can get "very expensive" under the basic insurance as the maximum you pay for health coverage for a year is capped?

Pretty sure he just means that even though these people saved money on the premiums by having a high franchise they ended up self-paying for £expensive" treatment well into their franchise so that it negated those savings and may well have cost them more than if they'd taken the lowest franchise.
It's all a gamble but with either choice of franchise it's unlikely to break the average person if you choose the 'wrong' one.

If you're on a low franchise you're perhaps more likely to not seek medical help when you need it.
Conversely if you're on a low franchise it's easy to seek out medical advice for every little thing.
Reply With Quote
  #20  
Old 23.02.2021, 16:53
Forum Legend
 
Join Date: Sep 2006
Location: na
Posts: 11,248
Groaned at 37 Times in 33 Posts
Thanked 26,732 Times in 8,253 Posts
meloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond reputemeloncollie has a reputation beyond repute
Re: GP Referral to See Specialist

Quote:
View Post
Can you explain this a bit? Unless your friend/s have chosen by themselves to go to private wards and incur the costs not covered by the basic insurance, I can't see how things can get "very expensive" under the basic insurance as the maximum you pay for health coverage for a year is capped?
I can't speak for NickGB, but here's my concern:

I have had trouble accessing expertise, having basic insurance is one reason. For that alone I wish I had private insurance. (I did not qualify for private when I moved here.)

Technically, one needs private insurance to see a Chefarzt in a hospital setting, semi-private insurance to see an Oberarzt in a hospital setting.

Now - this might not be a problem for most of us for most of our lives, less senior doctors are fully able to provide the level of care needed.

However, if you happen to be hit with an illness where only a few doctors have expertise, being able to access that expertise might significantly alter the outcome.

Now, from posts in other threads some EFers report being able to see the Chefarzt or Oberarzt even on basic insurance. Which is great. That unfortunately has not been my experience. I would assume it boils down to hospital policy and the individual specialist. Or perhaps the 'reach' of your referring doctor.'s network

As always, YMMV, perhaps significantly.

---

One fairly cost effective alternative - if you qualify - is to choose a flex plan. Under this type of plan you pay a reasonable addition monthly for the option to upgrade to a higher level of care per hospital event. There is usually then a hefty co-pay for that event, IIRC 4-5K, but that is still significantly less than paying full private out of pocket. One would only exercise this option when really necessary, I would think.

But again you have to qualify in order to get this type of add-on to your basic insurance.

---

As mentioned above, you can also pay fully out of pocket to upgrade your care. But if one is considering this option, be sure to get a detailed cost estimate upfront!
Reply With Quote
This user would like to thank meloncollie for this useful post:
Reply




Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Referral/Affiliate Links mookicooki Forum support 3 07.12.2019 04:12
Bank Referral Please Jimmy.Johnson Business & entrepreneur 10 01.03.2013 14:22
referral needed TammieE Housing in general 1 11.08.2011 01:26
Assura health insurance referral to specialist darb Insurance 4 19.02.2011 22:33
Referral Letter: What should it contain? bARRON Employment 6 01.02.2010 23:10


All times are GMT +2. The time now is 07:25.


Powered by vBulletin® Version 3.8.4
Copyright ©2000 - 2022, Jelsoft Enterprises Ltd.
LinkBacks Enabled by vBSEO 3.1.0