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Old 06.01.2011, 16:52
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Hospital bill before insurance started

Hello all,

I am banging my head against the wall trying to sort something out. I've just received a letter asking for the name of my previous health insurance company. I don't have one, I'm English. The letter translates something like:

"On the 28th October 2010 you received healthcare at ******* which came to 52.45CHF.

The insurance company you gave us when you were treated (*****) has informed us that you were only insured as of 1st November 2010.

We would therefore ask you to provide the details for your previous health insurer."

When I signed up with my health insurance company, I showed them my B permit which states I was here as of October. I was therefore expecting to pay as of October. Obviously they've made a mistake which I have to clear up. I'm happy to pay the bill out of my own pocket (rather than paying the bill on top of an extra month of health insurance!). What shall I say to the authority who's asking for this information? Ahhhh I've had enough of this now! So frustrating and complicated.

EDIT: At the time I went to the hospital I wasn't insured, so I don't know where all this crap about "the insurance company you gave us when you were treated" came from.
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Old 06.01.2011, 16:56
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Re: Hospital bill before insurance started

Sounds like the insurance company didn't understand (or allow) you to be retroactively insured for all of October. If you started with them after october they probably won't insure you for before.

Probably the simpliest route is to pay it yourself, and tell them you did not have insurance at that time (were the equivalent of a tourist). Most likely this will be the route taken.
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Old 06.01.2011, 17:09
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Re: Hospital bill before insurance started

I physically showed the woman my B permit, starting on the 1st October, so obviously she's just a bit thick.

So should I just draft a letter basically saying I had no insurance, I'll pay it myself? What about the fact that my B permit started in October, meaning that technically I should have had insurance? FFS
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Old 06.01.2011, 18:02
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Re: Hospital bill before insurance started

Just call your the hospital and ask them to send this bill directly to you and then pay it yourself. I think all they really care about is that it gets paid by somebody, they really don't care if it's you or an insurance company.

Easy peasy.
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Old 06.01.2011, 18:13
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Re: Hospital bill before insurance started

If I do that can I then ignore the letter?
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Old 06.01.2011, 18:44
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Re: Hospital bill before insurance started

The letter is simply asking you a question, you don't need to formally respond to it, you just need to sort out the situation. If the the hospital was really up in arms about a 53 CHF bill they'd deliver an overdue notice by registered mail, or send around a collections agent at 8 am.

The hospital doesn't actually care whether you had swiss insurance at the time of treatment or not, they just want someone to pay the bill. Since your normal insurance refused to pay, the hospital assumed you had a different insurer at that time, and sent you a letter asking for their details.

But if you say "just send the bill to me and I'll take care of it", end of story. It is perfectly normal for patients to pay their medical bills directly, I do it for all of mine.

And if you had treatment in the same hospital in November and then gave them your insurance details, I am sure the hospital just lumped all your bills together and sent them off to your insurer without double checking the date of validity of your insurance. Then the insurance company simply refused to pay one of these bills them based on the date of treatment. Hence the slight (but not very serious) mix-up.

You can respond by letter if you prefer, but if there is a phone number or contact person given on the letter you can probably sort this out with a quick phone call.

H.
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Old 06.01.2011, 19:08
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Re: Hospital bill before insurance started

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I physically showed the woman my B permit, starting on the 1st October, so obviously she's just a bit thick.

So should I just draft a letter basically saying I had no insurance, I'll pay it myself? What about the fact that my B permit started in October, meaning that technically I should have had insurance? FFS
It would be pretty unusual for any insurance company to issue insurance retrospectively. That would open them up to massive potential for fraudulent claims.

Showing the lady your B permit with a valid from date of 1 October wouldn't have triggered off the idea of issuing retroactive cover unless you asked her for it specifically - which would most likely have triggered off her explanation of why that could only be done under a few very special circumstances.
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Old 06.01.2011, 19:13
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Re: Hospital bill before insurance started

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It would be pretty unusual for any insurance company to issue insurance retrospectively. That would open them up to massive potential for fraudulent claims.

Showing the lady your B permit with a valid from date of 1 October wouldn't have triggered off the idea of issuing retroactive cover unless you asked her for it specifically - which would most likely have triggered off her explanation of why that could only be done under a few very special circumstances.
Cover should have begun from when you entered the country, even if you arrange it afterwards. See the health insurance FAQ:
Health Insurance FAQs

You could speak to your insurer to correct the situation so that when you pay the bill yourself if counts towards your franchise, but probably not worth it for the amount.
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Old 06.01.2011, 19:17
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Re: Hospital bill before insurance started

I thought the whole point of insurance here was that you have 3 months to find it, and they charge you from the month you arrived i.e. retroactively, no?

The letter asking for my previous insurance details came from "CIGES" (Centre d'Information de Gestion et d'Economie de Santé), not from the hospital itself, and they have provided the envelope to return my form with their address stamped on it. Does this make a difference to whether or not I can ignore the letter if I just pay the hospital directly?

There is a phone number and an email address provided for this "CIGES" organisation, shall I ring them instead of the hospital and ask if I can pay the hospital directly? They don't make it easy for those of us who aren't used to the system, do they?!

EDIT: First sentence was aimed at Chris56, not rachelw.
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Old 06.01.2011, 19:22
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Re: Hospital bill before insurance started

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Cover should have begun from when you entered the country, even if you arrange it afterwards. See the health insurance FAQ:
Health Insurance FAQs

You could speak to your insurer to correct the situation so that when you pay the bill yourself if counts towards your franchise, but probably not worth it for the amount.
It's perfectly normal, and sensible, to arrive with insurance cover already - then, if you wish, to transfer to a domestic insurer. There's no reason for them to assume that you expect retroactive cover when you buy their cover. In fact you sign a contract with them that has the start date of the cover specified as part of what you're signing up for.
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Old 06.01.2011, 19:30
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Re: Hospital bill before insurance started

That pretty much contradicts everything everyone's told me since I moved.
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Old 06.01.2011, 19:40
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Re: Hospital bill before insurance started

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That pretty much contradicts everything everyone's told me since I moved.
That's just what I did and several people I know did - it was necessary for me to justify to the local authorities that my insurance cover (organised through BUPA) was acceptable to them but once I'd done that I was under no obligation to switch to local insurance. I made that switch a year or two later when it was convenient to me to do so. I know a couple of local employers who encourage newly arriving employees to try and take out insurance with somebody like BUPA before they come here because it often works out a lot cheaper than domestic Swiss insurance. I suppose there's a risk that the local authorities might disagree about your foreign based cover and force you to take out local cover instead so it would be sensible to get the process over with as quickly as possible after arrival.
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Old 06.01.2011, 19:53
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Re: Hospital bill before insurance started

But they require you to have insurance of some sort, and the NHS doesn't count, hence why they charge you retroactively, right? To be honest, the whole system still confuses me.

However, getting back to the original problem... has anyone ever had any experience with "CIGES"? I don't really understand who they are, or if they're just the administrative section of the hospital system. I just want to give these frickin' 50CHF to someone so I can forget about it!
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Old 06.01.2011, 19:58
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Re: Hospital bill before insurance started

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That's just what I did
As Rachel posted, normally your Swiss health insurance is dated to your date of entry - unless, of course, you take the route of claiming your current (non-Swiss) insurance is sufficient cover, then you just need to get that unusual situation clarified with the appropriate authorities.

Your point about the contract start date being on the contract is valid, though, Chris - and the lack of paying a month's insurance should have rung a bell, too.
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Old 06.01.2011, 20:03
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Re: Hospital bill before insurance started

I moved to CH back in the day when it wasn't obligatory, and so didn't get any for quite some time (strangely, it WAS obligatory in ZH city, but not the rest of the canton at the time, and since I lived outside of ZH itself, no need for insurance).

Tom
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Old 06.01.2011, 20:23
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Re: Hospital bill before insurance started

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But they require you to have insurance of some sort, and the NHS doesn't count, hence why they charge you retroactively, right? To be honest, the whole system still confuses me.

However, getting back to the original problem... has anyone ever had any experience with "CIGES"? I don't really understand who they are, or if they're just the administrative section of the hospital system. I just want to give these frickin' 50CHF to someone so I can forget about it!
The simplest and safest process would be to reply to the letter saying that you will pay the bill yourself and asking them to address the invoice to you. They'll then send it to you with a payment slip, you pay it and forget about it - CHF 53 is a lot less than one month's insurance regardless of what sort of cover you specified.
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Old 06.01.2011, 20:27
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Re: Hospital bill before insurance started

Thanks, that's basically what I want to do. I guess I can just send her an email tomorrow and ask her to address the bill to me and not give any explanation why...
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Old 06.01.2011, 20:35
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Re: Hospital bill before insurance started

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It's perfectly normal, and sensible, to arrive with insurance cover already - then, if you wish, to transfer to a domestic insurer. There's no reason for them to assume that you expect retroactive cover when you buy their cover. In fact you sign a contract with them that has the start date of the cover specified as part of what you're signing up for.
In Switzerland, most insurers expect that new foreigners will need to be insured as of the date they moved into the country. In fact, I've seen several stories on this forum where people who got insurance were surprised by the fact that they got retroactively billed for the previous 3 months and were unprepared to pay the bill.

When you move to the country, you have 3 months to find insurance, but you are legally obligated to have it applied retroactively to the date you moved here if you didn't already have sufficient coverage. Insurance companies are legally obligated to provide that insurance, even if you've already had treatment. It's not a big deal - just call the insurance company and tell them about the mistake, ask them to adjust your start date appropriately and bill you for it.
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Old 06.01.2011, 20:46
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Re: Hospital bill before insurance started

I suppose the question is more can I just be billed for the hospital trip without adjusting my insurance? As Chris56 has stated, it will be much cheaper to do it that way, and that really is the way I want to do it.
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Old 06.01.2011, 21:03
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Re: Hospital bill before insurance started

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I suppose the question is more can I just be billed for the hospital trip without adjusting my insurance? As Chris56 has stated, it will be much cheaper to do it that way, and that really is the way I want to do it.
Perhaps. And if the authorities find out you were trying to save a buck by not having retroactive coverage? Say, if something serious happens and they compare your insurance start date to your permit date?
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