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  #21  
Old 30.08.2010, 19:24
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Re: Health cost questions

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So let me get this right....

I go to the doctors, pharmacie etc... I pay. I then get reimbursed by my insurance straight away.

At the end of the year I pay the franchise?

Or I pay all my bills then send all of the receipts at the end of the year?

I have got myself really confused I think!
Nope, not quite. The franchise is like an excess on your car insurance - the amount you agree to pay in the event of a claim, before the insurer has to put their hand in their pocket. Like all insurances, it's a question of risk versus lower premiums. The higher your franchise, the lower your premiums, because the insurer is much less likely to have to pay out that year.

When you run the numbers on franchises against monthly premiums, you'll find that it's a one way bet - the difference in premiums between a 0 chf franchise and a 2,500 franchise (maximum allowable) is about 2,500 chfs a year. Unless you have a medical problem that means you will absolutely be hitting the franchise, it almost always makes sense to take the biggest franchise possible and cross your fingers you don't get ill - no brainer.

Otherwise, the process is visit the doctor, get a prescription, go to the chemist and get your drugs (either you pay and claim back, or the chemist invoices the insurer directly, depends on your policy), doctor will send you a bill some weeks later which you pay and then claim back (or again, sometimes it goes straight to the insurer).

What we're discussing above is for people like me, who have a franchise of 2,500 chfs, which means that even if the doctor or chemist invoices the insurance company, the insurer pays it and then sends ME a bill because I've agreed to pay the first 2,500 of medical costs that calendar year.
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  #22  
Old 30.08.2010, 19:26
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Re: Health cost questions

You pay out-of-pocket until you have hit your deductible. After that point, the insurance either pays directly or reimburses you for paying.

You will receive with each bill: the payment slip, a copy of the itemised bill for your records, and a copy for the insurance ("jusitificatif de remboursement" in FR).

Send each justificatif de remboursement to your insurer. For instance, say you have a deductible of CHF500:

You get a first bill for 200CHF - pay the bill yourself and send the justificatif de remboursement to the insurer. They start totting up your payments against your deductible.

You get a second bill for 350CHF - pay the bill yourself and send the justificatif de remboursement to the insurer.

The insurer now owes you CHF50 minus a 10% contribution from you (CHF5), so you will receive CHF45 in your bank account.

It's all pretty clear once you see the forms, but basically you are responsible to pay the full amount up to the deductible, provide documentation of all your payments (the justificatifs) to the insurer, and for anything above your deductible you will be reimbursed 90%.
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  #23  
Old 30.08.2010, 19:32
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Re: Health cost questions

(Sorry for double post, can't do an edit on this iPad)

And alongside all this you're paying your premiums (mine, for example, are about 210 chfs a month). So you pay your premiums regularly, then you or your insurer pay any bills as they arise during the year.

In practice, it works out that you're not out of pocket by much if anything - if the doctor sends you a bill, you usually have a month to pay it, so can post it to the insurer and get the credit in your bank before paying the bill.

I, and Carlos, are saying that we don't bother posting our bills to the insurance company, because of the high franchises we have - the insurer will simply say 'oh, that's nice, off you go and pay this bill then' and make a little note on their system to deduct 17 chfs off our annual running total of 2,500 chfs. Of course, if I was suddenly sick and hospitalised in December, then I would send in all my backlog stuff, as my total spend would then be well over 2,500 chfs.
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  #24  
Old 30.08.2010, 19:32
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Re: Health cost questions

Got it!

All makes sense now.

Thanks everyone!

Just got to find the right insurance company now. I have been contacted by Nationale Suisse (as I joined coop bank and they are linked) anybody have any opinions about them?

Thanks again

Alex

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  #25  
Old 30.08.2010, 19:38
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Re: Health cost questions

I (and many others) use a broker called Jenny who is active on this forum - can't work out how to link to her details at present, but do a search for her name and insurance, that should work.

She's independent, so will get you the best deal across the whole market - she is then paid by commission from the insurer, so there's no cost for you. She's very helpful, and a really nice person to boot!
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  #26  
Old 30.08.2010, 19:39
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Re: Health cost questions

Great! Welcome to the wonderful world of Swiss insurance!

Shop around a little for your policy with comparis, especially if you have family members to insure.

http://en.comparis.ch/krankenkassen/default.aspx

Happy hunting! SB

PS: Oh yes, and definitely ask Jenny's advice as Kodokan suggests. She's the best.
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  #27  
Old 30.08.2010, 20:04
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Re: Health cost questions

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Got it!

All makes sense now.

Thanks everyone!

Just got to find the right insurance company now. I have been contacted by Nationale Suisse (as I joined coop bank and they are linked) anybody have any opinions about them?

Thanks again

Alex

I would recommend talking to EF user Jenny who does a lot of health insurance for people on the forum and has done for yearss. send me a PM if you want and I will send her details.
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  #28  
Old 30.08.2010, 20:16
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Re: Health cost questions

Here is a bit of interesting info I got with a bill from my Dr. this morning....

From (about) October 2010 the bill will be directly sorted with the health insurance company.
This means you won't get the bill anymore from the Dr., just the bill from the insurance with the reductions calculated....
The same system has been running in Germany for as long as I know.

Hopefully it won't have the same effect on Dr.s practices as it had in Germany... the insurance companies put all sorts of limits on the Dr.s practices as to how much cost and what sort of treatrment they were allowed to give patients..... that led to Dr.s only being allowed to give basic treatment and cheaper medicines and the quality of treatment went down..... and the health insurance premiums went up...
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  #29  
Old 30.08.2010, 20:27
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Re: Health cost questions

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Great! Welcome to the wonderful world of Swiss insurance!

Shop around a little for your policy with comparis, especially if you have family members to insure.

http://en.comparis.ch/krankenkassen/default.aspx

Happy hunting! SB

PS: Oh yes, and definitely ask Jenny's advice as Kodokan suggests. She's the best.
Don't forget to "shop around" at the end of each calender year as you may well find your current insurer's premiums compare less favourably the coming year.
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Old 30.08.2010, 20:54
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Re: Health cost questions

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Don't forget to "shop around" at the end of each calender year as you may well find your current insurer's premiums compare less favourably the coming year.
Actually shopping around defeats the whole idea of having a low premium - as the more clients one insurer has, the more the obligatory reserves (and hence premiums) eventually rise.

Welcome to the wonderful world of insurance.
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  #31  
Old 30.08.2010, 21:34
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Re: Health cost questions

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Actually shopping around defeats the whole idea of having a low premium - as the more clients one insurer has, the more the obligatory reserves (and hence premiums) eventually rise.

Welcome to the wonderful world of insurance.
Absolutely - that's why you have to do it every year.

I was telling my Swiss neighbour once about my wonderful insurance broker following one of Jenny's visits; she was a bit puzzled as to what the broker actually did for me, so I explained and was then staggered to be told that she had not only never changed insurance since reaching adulthood some decades ago, but had even then just used the same insurance company as her parents always had...

Changing insurers from thingie-beginning-with-a-V to Assura saved me (and hubby) nearly 2k in this one year alone. I don't even want to try and do the sums to see how much she's frittered away over a couple of decades.
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Old 31.08.2010, 23:25
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Re: Health cost questions

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I, and Carlos, are saying that we don't bother posting our bills to the insurance company, because of the high franchises we have - the insurer will simply say 'oh, that's nice, off you go and pay this bill then' and make a little note on their system to deduct 17 chfs off our annual running total of 2,500 chfs.
... and send you a nice letter asking you not to send individual claims but keep them until you reach your limit as they can only provide a cheaper service if we, the paying punters, leave them alone...



Swiss customer service, where the customer is a royal pain in the arse...



...is that a medical condition, and can I claim for it?
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  #33  
Old 31.08.2010, 23:35
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Re: Health cost questions

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... and send you a nice letter asking you not to send individual claims but keep them until you reach your limit as they can only provide a cheaper service if we, the paying punters, leave them alone...
Do Assura do that? Mind you, I can see their point - V-Thingie insurance company last year had a system of:

- I go to chemist and get inhaler
- bill of 19.95 chfs is sent to insurer
- insurer pays chemist
- insurer sends me facture for 19.95 chfs, along with a letter noting that I now have 2'480.05 chfs until my franchise is finished and the insurer will actually pay

No wonder Assura are cheaper - their business model must be to suck up all the people like me who have to have insurance by law but are almost always just going to send the monthly premiums and see nothing back. Because if I thought I'd actually USE the insurance, sure, I'd want one with exemplary customer service (which, to be fair, V-Thingie did have on the very few occasions I had any contact with them).

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  #34  
Old 01.09.2010, 17:30
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Re: Health cost questions

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Absolutely - that's why you have to do it every year.
Absolutely not actually. Maybe you're not aware of this, but not only Assura (not only Assura actually) Romandie clients got shafted with premiums building excess reserves - but said reserves are now possibly going to be redistributed to the other cantons where reserves haven't been building up fast enough to match the client base size.

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Old 12.07.2011, 18:54
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Re: Health cost questions

Hi

I think this thread has completey got me confused. I hope someone reads this and helps me.

I am moving to Switzerland, Ticino region (italy side) in a few weeks.

1. I will be moving over with my wife and 3 children as an IT contractor. Can anyone recommend health insurance for the family and what the approximate costs will be. I think accident cover is gonna be paid by my company.

2. Also if anyone knows of a good accountant to maximise my earnings rather than using the agency account department it will really help. Any tips out there?

3. Finally as the job is near the italy border the English private school is half the price in Italy compared to switzerland, so I will be living for a year in Como, Italy rather than Ticino, switzerland. not sure if taxes are lower as I will be living in italy not swiss, anyone out there who knows more about this?

Thanks
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