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Old 23.02.2011, 13:58
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health insurance exclusion of cover

I have received my offer of health insurance with an exclusion of cover for 'overweight, adiposity, including causes and consequences'. Seems to me this could exclude just about anything. I had this problem in the States where I couldn't get insurance. I am a large woman, but I am not what the popular conception of 'obese' would be. I am tall, big feet, big wrists etc and I'm heavy - than or fat I am heavier than the average woman. And yes, I am about 28lbs overweight, but not more. I'm also reasonably fit as I am a regular yacht racer and was a regular gym goer before I moved here (December) where I have yet to find one. I;m very strong, the muscle structure for which probably contributes to the weight. Basically, like many women, I am not properly accounted for on the BMI tables. I feel tied, I have to have the policy legally - in the US I went without - but I don't think its going to be worth the paper its written on.

And please, no personal weight related insults as replies. Thanks.
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Old 23.02.2011, 14:05
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Re: health insurance exclusion of cover

my mistake, it was just on the top up cover. An I;m told if I hit a BMI of 28, they will remove the exclusion, so not as bad as it sounds
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Old 23.02.2011, 14:12
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Re: health insurance exclusion of cover

Which insurance company please, and which policy: the compulsory basic general insurance, or the extra "Luxury" additions.

I was under the impression the only variables allowed on basic insurance were age and sex.

I have been with Visana for 20 years, and with their HMO policy it is "very" good value (I must first visit the named Doctor or Practise ) .

Maybe you should find a second offer http://en.comparis.ch/versicherung.aspx
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Old 23.02.2011, 14:24
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Re: health insurance exclusion of cover

It's Swica who I went to because they are happy to deal in English. It was a reasonable offer. And yes, they have explained to me that the basic is ok but its the top up that is subject to the exclusion. Still, it gives me a goal
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Old 23.02.2011, 15:44
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Re: health insurance exclusion of cover

I definitely had a BMI of over 28 when I came here 9 years ago. I was (and still am) insured by SWICA, and there were no conditions even on the top up. Must be a new thing.
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Old 23.02.2011, 16:10
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Re: health insurance exclusion of cover

I couldn't get insurance in the US. I have lost 100lbs in the last 4 years, so it is especially annoying. But at least they're prepared to drop the exclusion if I drop the weight - which is my plan anyway.
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Old 23.02.2011, 17:37
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Re: health insurance exclusion of cover

My husband was about 5kg overweight, and faced this same thing.

The exclusion was on the supplemental insurance, not on the basic. While he would still be treated under basic policy, his supplemental cover - which allowed him to be treated in any hospital, or see an out-of-canton doctor, or have access to more highly qualified doctors would not pay for anything that could be related to his weight. And you are right - as it was explained to us, that exclusion could be invoked for pretty much any condition, as weight can influence most things.

The weight requirement is strictly BMI - no exceptions made.

So it was salads and boot camp, until he lost the 5kg. He then had to have his doctor certify that he had lost the weight. Once that was done, the exclusion was removed.
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Old 23.02.2011, 17:44
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Re: health insurance exclusion of cover

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My husband was about 5kg overweight, and faced this same thing.

The exclusion was on the supplemental insurance, not on the basic. While he would still be treated under basic policy, his supplemental cover - which allowed him to be treated in any hospital, or see an out-of-canton doctor, or have access to more highly qualified doctors would not pay for anything that could be related to his weight. And you are right - as it was explained to us, that exclusion could be invoked for pretty much any condition, as weight can influence most things.

The weight requirement is strictly BMI - no exceptions made.

So it was salads and boot camp, until he lost the 5kg. He then had to have his doctor certify that he had lost the weight. Once that was done, the exclusion was removed.
Out of interest, what is the borderline BMI? Did they give specific exclusions as to be will be weight related?

We are about to apply for supplementary insurance.
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Old 23.02.2011, 18:28
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Re: health insurance exclusion of cover

Marie, I can't seem to find the documents (this was years ago) but IIRC, it was at the point where you move from übergewicht to stark übergewicht - so maybe 30?

We were not given an exact list of excluded conditions, simply 'anything related to weight'. Which left me very worried... hence, putting the husband on short rations.

But as above, getting the exclusion removed was pretty simple once the weight was gone.
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Old 24.02.2011, 08:07
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Re: health insurance exclusion of cover

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...

So it was salads and boot camp, until he lost the 5kg. He then had to have his doctor certify that he had lost the weight. Once that was done, the exclusion was removed.
....and back to deep fried kebabs?

If you go over again, does the exclusion come back?
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Old 25.02.2011, 08:54
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Re: health insurance exclusion of cover

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If you go over again, does the exclusion come back?
Good question.

Looking through the current policy, I don't see any mention of what happens if he gains the weight back. I would think if there was such a clause it would have to be in the policy, oder?

There must be many people who are no longer as slim and fit as they were when they took out a policy 10, 20 years ago. I would doubt that there is an automatic loss of cover if one gains weight, but I honestly don't know - and am not inclined to stir that pot by asking the agent.
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