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Old 10.07.2011, 00:40
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Epilepsy and Health Insurance - please help!

I am in the process of looking through the Health Insurance "minefield" and am totally confused

My son has Epilepsy and currently receives his medications on the NHS in the UK.

Am I right to think that he will be covered under the compulsory insurance in Switzerland? Will his condition have a bearing on acceptance for the additional health insurance?

He will need monthly prescriptions from the doctor. Will we need to pay for any portion of these - I don't quite understand the franchise and deductible costs........

Whist I would never put a price on my sons health and well-being it would be good to be able to budget for costs for these medications - are they expensive? Are they covered in any part?

Thanks for your help in advance - I would be grateful to hear of others experiences.
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Old 10.07.2011, 09:42
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Re: Epilepsy and Health Insurance - please help!

hi

the swiss basic health insurance does not exclude any pre existing condition so your son will be covered and able to get his medication.

basically you can choose what deductible (excess) you pay, the higher the deductible, the lower the monthly premiums. so if you choose a deductible of 300CHF, once you have exceeded this limit then you can claim back all costs minus 10% so you get back 90%.

my husband has an pre existing condition and requires regular medication so we always have his deductible at 300CHF as this is most cost effective for us.

i am sorry but i have no idea as to the costs of epilepsy medication.

hope this helps
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Old 10.07.2011, 10:07
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Re: Epilepsy and Health Insurance - please help!

kerillumsden>

It's safe to assume that in the worst case scenario (insurance with a 300chf deductable) and lots of bills in each given year, you will not exceed a grand total of 5000chf. That is 4000 CHF in monthly premiums, 300 CHF deductable and 700 CHF own conribution (10% of all bills, but never more then 700 CHF a year). Prescribed medicine is included, you don't pay extra (as long as it is on the list of refunded medicaments, most are).

Your son might still be able to get supplementary insurance if you want one, but it will exclude coverage for any issue which can be connected to his preexisting conditions.
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Old 10.07.2011, 10:15
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Re: Epilepsy and Health Insurance - please help!

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I am in the process of looking through the Health Insurance "minefield" and am totally confused

My son has Epilepsy and currently receives his medications on the NHS in the UK.

Am I right to think that he will be covered under the compulsory insurance in Switzerland? Will his condition have a bearing on acceptance for the additional health insurance?

He will need monthly prescriptions from the doctor. Will we need to pay for any portion of these - I don't quite understand the franchise and deductible costs........

Whist I would never put a price on my sons health and well-being it would be good to be able to budget for costs for these medications - are they expensive? Are they covered in any part?

Thanks for your help in advance - I would be grateful to hear of others experiences.
No company can deny coverage for the basic insurance. What they may do, is deny you coverage if you try to get any of the perks.

The first company I went to, Sanitas, had me fill out a "pre-existing conditions" disclosure. I was overly honest about my health history, and they ended up denying me any supplementary coverage.

I told Sanitas to suck an egg, and that I didn't want their basic coverage. Once I got confirmation that the deal was off, I went to Swica. Swica covered me for basic and supplementary without any hassle. I didn't have to do a prehistory either.

Don't get discouraged. You will find the right insurance company. None of them can deny you basic coverage. But if you want supplemental the right company for you is out there.
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Old 10.07.2011, 10:32
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Re: Epilepsy and Health Insurance - please help!

It's possible that they'll also re-direct you to Invalidity Insurance (AI) which covers some medical expenses for people with a medical condition since birth.

http://www.epi.ch/_files/Versicherun...ich__franz.pdf

Here's info regarding insurances from the Swiss League Epilepsy (sorry it's in French though).
There's a phone number, surely somebody will be able to help you in English.

Also check out the Swiss association of parents of epileptic children (at the end of the manual)
You might get lots of help from other parents dealing with the same issues.


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Old 11.07.2011, 14:26
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Re: Epilepsy and Health Insurance - please help!

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kerillumsden>

It's safe to assume that in the worst case scenario (insurance with a 300chf deductable) and lots of bills in each given year, you will not exceed a grand total of 5000chf. That is 4000 CHF in monthly premiums, 300 CHF deductable and 700 CHF own conribution (10% of all bills, but never more then 700 CHF a year). Prescribed medicine is included, you don't pay extra (as long as it is on the list of refunded medicaments, most are).

Your son might still be able to get supplementary insurance if you want one, but it will exclude coverage for any issue which can be connected to his preexisting conditions.
This is almost right, but in fact with a combined family policy the monthly payment on a 300 excess could cost more than 500 per month, depending on perks. Also the payment scheme is going to change this year and all premiums will be increasing.

It is important to know exactly the type and severity of his condition and the exact medication required. As glinna rightly says the drugs might not be a specific approved list and then extra cover is required, different companies have very different cover and some will allow extras with certain pre-existing and some won't.

OP: I would gladly help you with all this if you want to send me a PM, we could look into the possibilities and tailor a cover to suit you. When do you arrive in CH?

Best,
David.
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Old 11.07.2011, 14:29
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Re: Epilepsy and Health Insurance - please help!

KeinFranzosich, are you sure there is nothing in small print in the Swica cover that excludes pre-exisiting conditions from supplementary cover? I'd be genuinely interested as we have been excluded from extra cover due to pre-exisiting conditions.
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Old 11.07.2011, 21:53
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Re: Epilepsy and Health Insurance - please help!

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It's possible that they'll also re-direct you to Invalidity Insurance (AI) which covers some medical expenses for people with a medical condition since birth.
Very true! In certain circumstances it is possible for the insurance company to exclude certain pre-existing conditions if they were diagnosed or should have been diagnosed in childhood. In such cases the AI or the Kanton have to come up with the cover instead.

I don't know the details, but it is what happened with my son, who has Asperger syndrome and was diagnosed before he was 12. In our case the medical expenses are paid directly by the Kanton.

How this works for a child coming to Switzerland, I've no idea, but perhaps the health insurance company will be able to explain it, as I'm sure it will not be the first time for them.

Jim.
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Old 11.07.2011, 23:43
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Re: Epilepsy and Health Insurance - please help!

Hi there - my son also has epilepsy. He was born here so it is slightly different. All his epilespy costs are covered by the IV (Invalid-versicherung) none of it by his personal health insurance.

You are going to have to be careful. Epilspy medication costs vary enormously depending on the drug/s your child is on. My son was on 3, the most expensive one was hundreds of CHFs per bottle, a bottle lasted under a month. The other two were cheaper, but it all adds up.

BUT many of these medications are not approved for use in children. Obviously children use them, but my understanding is that they havent been tested (who is going to allow their child to take these medications just as a test) and as such are not "approved" although of course many many kids have taken them. So you will need to check with your provider that they do pay for them. I believe some may claim the medication is not "approved" and therefore they don't cover it. I may be wrong, but that is what I have been told.

We looked at changing health providers last year. And even though the IV covers all his epilepsy related costs, the new provider wanted an exclusion on any epilepsy related costs that may occur in the future. Our existing provider had been the same since birth so he didn't have any exclusions and so we didn't change.

Hope that helps. Please let me know if you have questions.

Jo
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