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Old 30.08.2010, 14:57
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Health cost questions

Hi all,

I am moving to Montreux with my family in two weeks. This is my second post, as I have many questions, I hope some of you can help with this!

I have read many threads on health insurance and I think I have got my head around it now, I just need to know the answers to the following, if possible.

1) Do you pay each time you see the doctor or do you receive your bill at the end of the year?

2) How much should I expect to pay for a normal GP consultation?

3) How much should I expect to pay for a prescription? For some standard antibiotics for example.

4) Can my daugter see the same doctor as me and my wife?

5) What do you do at weekends if you fall ill or have an accident if your doctor is not at work?

Thanks everyone.

Alex
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Old 30.08.2010, 15:01
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Re: Health cost questions

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Hi all,

I am moving to Montreux with my family in two weeks. This is my second post, as I have many questions, I hope some of you can help with this!

I have read many threads on health insurance and I think I have got my head around it now, I just need to know the answers to the following, if possible.

1) Do you pay each time you see the doctor or do you receive your bill at the end of the year?

2) How much should I expect to pay for a normal GP consultation?

3) How much should I expect to pay for a prescription? For some standard antibiotics for example.

4) Can my daugter see the same doctor as me and my wife?

5) What do you do at weekends if you fall ill or have an accident if your doctor is not at work?

Thanks everyone.

Alex
1. Yes, each time.
2. 50-100 CFH
3. Varies hugely depending on which medicine.
4. Yes, normally.
5. Call an ambulance / go to the hospital - same as you would on the NHS.

I'm in Montreux too so you can PM me if you have any questions about living here.
Mike
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Old 30.08.2010, 15:13
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Re: Health cost questions

Thanks Mike, that is really helpful.

So I presume if you pay each time you see the GP that you get the money back from you insurance directly?

For some reason I heard that you received a yearly bill which you have to pay? Confused!

Thanks for the PM offer, I am sure that I will have a few more questions for you !!

Alex
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Old 30.08.2010, 15:20
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Re: Health cost questions

As for 5., I wouldn't go the the hospital. Check your area but in the la Cote and Lausanne areas there is a system of doctor on-call. Typcially you call, speak with nurse, then either she helps you or if necessary get referred to dr. on call. After hours and weekend appointments by a designated dr. in the area. In large cities there is also 'permanances', clinics that offer out of hours care.

As for 4., depends on her age. Normally children see pediatrician, but if your family dr. is comfortable with whatever her age, it may be possible.

As for 1 and 3, you generally pay until you reach your deductable, then the insurance kicks in. Depending on your insurer you either pay nothing and billing is direct, or you pay and are then re-imbursed by insurer.
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Old 30.08.2010, 15:21
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Re: Health cost questions

I belive you should cal an ambulance only if it is an emergency, on sundays and other holidays there is always a doctor available. It is not very smart to walk in in a hospital and use their recource when you can get a treatment at some GP.
It is well known that foreigner like to walk in the hospital to get a treatment. Be aware that costs are much higher than at some GP who provides sunday and even emergency service.
Also consider that only some hospitals provide a GP service. When you got a problem on a Sunday cal your GP you usually go to, on the answer machine you usually get the phone number from the doctor you can go to.
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Old 30.08.2010, 15:31
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Re: Health cost questions

OK, thats really useful thanks.

For the re-imbursement, is this pretty quick normally (in France about 2 weeks) ?

Alex
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Old 30.08.2010, 15:35
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Re: Health cost questions

MikeB pretty much nails it on the head, bar the last one.

You have to remember that there are two insurances here: health and accident. The two, to all intents and purposes are treated differently.

Health is for general health, i.e. planned visits to the doctor when you are ill.

Accident is when you need to go to the emergency department.

For a working person, the company will usually pay for your accident insurance. For your family (assuming they are not working), their accident insurance premiums will be rolled into their health insurance premium. AFAIK, you don't have to pay for accident insurance, however, privately insured people have to pay the first 20% or up to their franchise.

If you fall ill during the weekend, you should ring your Dr, and he will arrange a house visit or advise you to go to the hospital.

If you have an accident that requires a trip to the hospital (e.g. broken leg), that is what you should do, regardless of whether it is the weekend or not. If possible, you may wish to call the hospital first to check where you should go (assuming an ambulance isn't on its way to pick you up).

For example, our son had a bad fall that required an x-ray. We called the Children's hospital and they advised us to go to the main hospital rather than theirs as the x-ray staff were on duty 24/7.

You may be getting confused over the "franchise".

There are different levels of franchise, or excess, which you pay before you get your medical fees covered. From memory, something like 0, 300, 1000, 1500, 2000 CHF/pa.

If you are very fit and never ill, get the 2000 CHF/pa. If you are always at the Drs, get the lowest one. You pay all fees until your franchise is used up, thereafter you pay 20% of all fees.

Children are automatically set to a franchise of 0 CHF and you pay 10% (EDIT 2) of fees.

What most people do is keep all their medical receipts to the end of the year then send it off for a refund of what's owed (if anything). This may be what you are refering to when writing about the "yearly" bill.

If you are planning on having other children, speak to a broker about getting additional pregnancy cover. You should do this immediately, as the annual premiums remain the same as the year your wife joined, while the "joining" fees go up as the mother gets older. (Based on Concordia).

Fictive example:
Joining age = 25: annual fee 200 CHF pa each year from then on
Joining age = 34: annual fee 300 CHF pa each year from then on

EDIT 1: forgot to mention that if you get the highest franchise, your annual premiums will be lower and vice versa. If you can afford it, you should also pay your health insurance annually (ouch) or quarterly (less ouch) rather than monthly, as again, the overall premiums go down.
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Last edited by Carlos R; 30.08.2010 at 15:54. Reason: EDIT 1: forgot a bit; EDIT 2: changed 20% to 10% following post below
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Old 30.08.2010, 15:35
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Re: Health cost questions

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OK, thats really useful thanks.

For the re-imbursement, is this pretty quick normally (in France about 2 weeks) ?

Alex
My insurer (SWICA) is quicker than that.
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Old 30.08.2010, 15:42
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Re: Health cost questions

Thanks Carlos, it is much clearer now.

Alex
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Old 30.08.2010, 15:46
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Re: Health cost questions

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Health is for general health, i.e. planned visits to the doctor when you are ill.

Accident is when you need to go to the emergency department.
Unless it's a health issue . Like a heart attack.

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AFAIK, you don't have to pay for accident insurance, however, privately insured people have to pay the first 20% or up to their franchise.
That's a new one on me but policies do differ.

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You pay all fees until your franchise is used up, thereafter you pay 20% of all fees.
Nope. 10% up to a maximum of CHF 700 over the franchise and then nothing.


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Children are automatically set to a franchise of 0 CHF and you pay 20% of fees.
Nope. You choose the franchise for your children. The retention over the franchise is reduced to 350 CHF for children.
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Old 30.08.2010, 15:53
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Re: Health cost questions

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Unless it's a health issue . Like a heart attack.
Nope - a heart attack is accident. Treatment thereafter (i.e. after discharge from hospital) is health.

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That's a new one on me but policies do differ.
My insurance is Assura. I don't pay for accident insurance (Mondia from my company). I also did not have to contribute anything following a hospital visit after an accident.

My family, however, all have to pay the first 10%. (Also Assura).

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Nope. 10% up to a maximum of CHF 700 over the franchise and then nothing.
Oops. You are right - we are 10%. However the 700 CHF over the franchise is new to me. We've been over that for our children (set at 0 CHF) and we still had to pay the 10%.

However, that is Assura, and although cheap, they are cheap for a reason. So maybe a difference between suppliers.

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Nope. You choose the franchise for your children. The retention over the franchise is reduced to 350 CHF for children.
You may be able to choose the franchise, but for young children, I believe it is better to take 0 CHF franchise, so in practice there is no real "choice", unless you like burning money for fun.

I don't get your comment regarding the retention - can you clarify?
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Old 30.08.2010, 16:02
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Re: Health cost questions

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Nope - a heart attack is accident. Treatment thereafter (i.e. after discharge from hospital) is health.
Not in my neck of the woods. Neither is kidney failure nor an asthma attack.

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Oops. You are right - we are 10%. However the 700 CHF over the franchise is new to me. We've been over that for our children (set at 0 CHF) and we still had to pay the 10%.

However, that is Assura, and although cheap, they are cheap for a reason. So maybe a difference between suppliers.
No, this is set in stone - sounds like you got ripped off .

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Don't get this one. You may be able to choose the franchise, but for young children, I believe it is better to take 0 CHF franchise, so in practice there is no real "choice".
Agree for very young but as they get older upping the franchise can be beneficial.

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I don't get your comment regarding the retention - can you clarify?
Maximum retention after franchise is all used up: adults 700 CHF. children 350 CHF.
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Old 30.08.2010, 16:23
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Re: Health cost questions

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Not in my neck of the woods. Neither is kidney failure nor an asthma attack.
Odd, as my wife has been treated in A&E for an asthma attack (albeit during pregnancy)... I think you may need to differentiate between an acute episode and chronic condition.

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No, this is set in stone - sounds like you got ripped off .
If it is so set in stone, it is more likely I didn't notice.
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Old 30.08.2010, 16:23
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Re: Health cost questions

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I belive you should cal an ambulance only if it is an emergency, on sundays and other holidays there is always a doctor available. It is not very smart to walk in in a hospital and use their recource when you can get a treatment at some GP.
It is well known that foreigner like to walk in the hospital to get a treatment. Be aware that costs are much higher than at some GP who provides sunday and even emergency service.
Also consider that only some hospitals provide a GP service. When you got a problem on a Sunday cal your GP you usually go to, on the answer machine you usually get the phone number from the doctor you can go to.
blah blah blah. last time i walked into our local hospital which is NEXT DOOR to our house there were three doctors there, two were on facebook and one was looking pretty pleased to see me and have something to do.

Perhaps I should have added "using your common sense".

So to be completely clear so that people cannot pedantically point out the slightest syntactical error, you follow the same path as in the UK, i.e. if you were feeling unwell on a sunday you would get a GP to look at it if you had both legs cut off by falling under a train you would call an ambulance even though it would be more expensive than ringing a GP and asking them if they can reattach them first.
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Old 30.08.2010, 16:31
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Re: Health cost questions

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Odd, as my wife has been treated in A&E for an asthma attack (albeit during pregnancy)... I think you may need to differentiate between an acute episode and chronic condition.
Thinking about it, maybe it depends on which medical card you present at the time. When I had my bike accident it all started out on my med insurance because that's the card I had in my wallet - it got changed to accident ins. once I came down off the morphine .
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Old 30.08.2010, 16:33
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Re: Health cost questions

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Thinking about it, maybe it depends on which medical card you present at the time. When I had my bike accident it all started out on my med insurance because that's the card I had in my wallet - it got changed to accident ins. once I came down off the morphine .
LOL - you might have got the morphine for longer if it had been the other way around!
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Old 30.08.2010, 16:42
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Re: Health cost questions

Surely heart and asthma attacks etc. are emergencies though not accidents...
The "E" of the "A&E" so to speak...
If they are life threatening then you should get to the hospital any way you can.
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Old 30.08.2010, 17:05
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Re: Health cost questions

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Oops. You are right - we are 10%. However the 700 CHF over the franchise is new to me. We've been over that for our children (set at 0 CHF) and we still had to pay the 10%.

However, that is Assura, and although cheap, they are cheap for a reason. So maybe a difference between suppliers.
I'm not sure what this means either. I'm with Assura, but last year was with Visana/ Vivacare - something beginning with V, anyway - and both companies have worked in the same way:

My franchise is 2,500 chfs, so I pay ALL bills up to this amount. Once I hit the magic number, I then only have to pay 10% of anything above 2,500 chfs.

At least, this is how I've understood it - in practice, my annual medical bills usually total about 100-150 chfs or so for asthma inhalers, so I've never actually seen what happens once I go over the franchise. In fact, I don't even bother sending them in - just keep them in a clip so that should I have a major illness towards the end of the year, I can get them credited. Otherwise it's just wasting a stamp.
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Old 30.08.2010, 17:08
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Re: Health cost questions

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I'm not sure what this means either. I'm with Assura, but last year was with Visana/ Vivacare - something beginning with V, anyway - and both companies have worked in the same way:

My franchise is 2,500 chfs, so I pay ALL bills up to this amount. Once I hit the magic number, I then only have to pay 10% of anything above 2,500 chfs.

At least, this is how I've understood it - in practice, my annual medical bills usually total about 100-150 chfs or so for asthma inhalers, so I've never actually seen what happens once I go over the franchise. In fact, I don't even bother sending them in - just keep them in a clip so that should I have a major illness towards the end of the year, I can get them credited. Otherwise it's just wasting a stamp.
OK, so I'm not going mad then...

Like you, I hoard all mine and my wife's receipts to the end of the year and send in as needed. Those for my children, I send periodically when the amounts owed to me are more than 1000 CHF.
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Old 30.08.2010, 17:48
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Re: Health cost questions

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!
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