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Old 10.05.2011, 23:23
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Franchise, Quote-Part and Hospital Contributions

Hello,

I have posted here about the changes to the daily hospitalisation charge increase.

Despite the fact that I have been hospitalised four times in Switzerland, I have only just noticed a discrepancy.

I was hospitalised between mid-December 2009 and March 2010. During my stay, I passed my 'quote-part'. The bill that tipped me over that figure, I did NOT get charged the daily hospitalisation rate. But then the next month, I did.

Fast forward to this year, I was hospitalised (again) between late January and early March. Again, I passed my 'quote-part'. But this time, I DID get charged the daily hospitalisation rate. And, as I have said in the other thread, it was quite large.

So which one is right? Do you still pay the hospital contribution rates after you have passed your quote-part, or not?

The really puzzling thing? The bill that didn't charge me the rate and the bill that did were both dealt with by the same person!

Any ideas?
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Old 12.05.2011, 16:58
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Re: Franchise, Quote-Part and Hospital Contributions

I wonder if asking the person who billed you would clear things up. There might be some obligatory assessment meetings involved, of independent insurance docs reviewing your case and deciding if you still qualify. I have a feeling there was one right after your 1st hospitalization that decided you qualified, than the meeting after 2nd hospitalization didn't find the reason to have you qualified for their cover (I have no idea who calls these assessment meetings, but somebody had to apply for you). Worth giving the insurance company a call/the hospital billing center and your social worker might also know about this. I would also ask your psy, since he/she had to give the independent insurance committee some kind of testimony. In case that your psy thinks that you should be reinserted into working environment and your disability allowance cut, these things may be linked and used to motivate the patient get off the disability support and find work. I really am not sure about this, though. It seems to me, that somewhere between your 2 hosp stays something might indicate of you becoming better, perhaps. Maybe the first bill was supposed to get reimbursed fully, the 2nd one partially? Or fully but you still have to pay and then send it to your insurance to have it reimbursed? Good luck, either way.
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Old 16.05.2011, 14:56
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Re: Franchise, Quote-Part and Hospital Contributions

Hospitalisation fee is 15 CHF per day even if you passed your franchise and the 10% excess
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Old 19.05.2011, 21:21
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Re: Franchise, Quote-Part and Hospital Contributions

Finally got to the bottom of this...

It seems that Assura made a mistake in January 2010 and should have charged me the hospitalisation contribution.

Interestingly, I was told the hospitalisation contribution doesn't actually go to the hospital! (I found this out because I rang up the hospital to query the number of days they'd charged me for - I'd had several days leave - and the lady there explained that the hospitalisation contribution is nothing to do with them, and said she hadn't even known that it went up in January this year.)

This is rather puzzling as my social worker tells me the hospitalisation contribution is based on what you would spend on food each day... so I would have thought the hospital, as providers of that food, get the money!

The really frustrating fact is that social aid doesn't cover the hospitalisation contribution. No-one thought to mention that fact to me, so now I need to find 615 CHF... Thankfully my insurance company have agreed a payment plan.

The really bizarre thing is that when you are hospitalised for more than a month your social aid is cut. Because you are in hospital and are being fed! But you still have to pay the hospitalisation contribution... because you are in hospital and being fed!!! Can someone explain the logic of that please?

(If anyone is wondering why I never noticed this before... a) the hospitalisation contribution has increased by 50% this year, and b) I am very appreciative for getting social aid, but I it happens quite often that I submit for various things at the end of the month and the amount I receive is subtly different, and you don't get a breakdown. I've given up trying to figure out why. It just so happened that I made a claim at a different time of the month and it was only for my contribution towards a hospital bill... so when I got less than I was expecting I spotted it.)
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