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-   -   Confusion with basic insurance cover - help please, (https://www.englishforum.ch/insurance/126844-confusion-basic-insurance-cover-help-please.html)

Nicalf08 27.09.2011 17:10

Confusion with basic insurance cover - help please,
 
Hi all, just wondering if someone can help me as my insurance company have so far not been able to. My son who has accidental insurance cover along with his health insurance had an accident at the park last month and a Swiss woman called an ambulance for him. We were billed the shocking amount and have paid it a few days late I have just realised, sending the bill off to insurance company tomorrow. Can they refuse to pay out because I stupidly didn't pay on time? I know they say to notify them immediately but what exactly does this mean because they have still not sent out t&c to us.

Also will they cover 50% or something different?

A separate question - we are wanting to try for a baby soon...as in now but have been here nine months and I hear you need to be insured for a year before being covered for hospitalisation etc. Does this mean that scans, tests etc will not be covered if I get pregnant before the year is up? I also will need a c-section - is this covered and by how much? Do we pay 10% of everything?

Many thanks in advance for info :msngrin:

fatmanfilms 27.09.2011 17:24

Re: Confusion with basic insurance cover - help please,
 
Quote:

Originally Posted by Nicalf08 (Post 1354702)
Hi all, just wondering if someone can help me as my insurance company have so far not been able to. My son who has accidental insurance cover along with his health insurance had an accident at the park last month and a Swiss woman called an ambulance for him. We were billed the shocking amount and have paid it a few days late I have just realised, sending the bill off to insurance company tomorrow. Can they refuse to pay out because I stupidly didn't pay on time? I know they say to notify them immediately but what exactly does this mean because they have still not sent out t&c to us.

Also will they cover 50% or something different?

A separate question - we are wanting to try for a baby soon...as in now but have been here nine months and I hear you need to be insured for a year before being covered for hospitalisation etc. Does this mean that scans, tests etc will not be covered if I get pregnant before the year is up? I also will need a c-section - is this covered and by how much? Do we pay 10% of everything?

Many thanks in advance for info :msngrin:

I am not sure that the ambulance will be covered with basic insurance, paying a few days late wont be a problem, not paying is not a reason to avoid a pay out for legally required insurance.

Blonaybear 27.09.2011 17:54

Re: Confusion with basic insurance cover - help please,
 
The basic insurance pays 50% of the ambulance cost. Full details of the basic cover can be found here.

Nicalf08 27.09.2011 18:55

Re: Confusion with basic insurance cover - help please,
 
Thank you for the link, so even though he has accidental insurance cover this doesn't mean he's covered for the ambulance?

27.09.2011 19:33

Re: Confusion with basic insurance cover - help please,
 
Quote:

Originally Posted by Nicalf08 (Post 1354887)
Thank you for the link, so even though he has accidental insurance cover this doesn't mean he's covered for the ambulance?

Ambulances here are very expensive! If he has supplementary insurance, the full cost of the ambulance might be paid,

http://en.comparis.ch/krankenkassen/...sicherung.aspx

Next time try and phone your local doctor. Ambulances are usually only really necessary with choking or breathing difficulties. Is the Swiss lady who called the ambulance going to pay the missing 50% of the cost?

anowheels 27.09.2011 19:39

Re: Confusion with basic insurance cover - help please,
 
For your pregnancy question - I think it's that you have to be covered by supplementary insurance for a year (or whatever your particular contract stipulates) before it will cover pregnancy related expenses - not basic insurance. If you arrived here 8 months pregnant, got the basic health insurance, and then went into labor, you'd be covered for pregnancy related expenses under your basic insurance - you wouldn't be allowed any supplemental cover though.

Here's an overview of what's covered by basic health insurance for maternity: http://en.comparis.ch/krankenkassen/...g.aspx#punkt23

Quote:

Originally Posted by Nicalf08 (Post 1354702)
Hi all, just wondering if someone can help me as my insurance company have so far not been able to. My son who has accidental insurance cover along with his health insurance had an accident at the park last month and a Swiss woman called an ambulance for him. We were billed the shocking amount and have paid it a few days late I have just realised, sending the bill off to insurance company tomorrow. Can they refuse to pay out because I stupidly didn't pay on time? I know they say to notify them immediately but what exactly does this mean because they have still not sent out t&c to us.

Also will they cover 50% or something different?

A separate question - we are wanting to try for a baby soon...as in now but have been here nine months and I hear you need to be insured for a year before being covered for hospitalisation etc. Does this mean that scans, tests etc will not be covered if I get pregnant before the year is up? I also will need a c-section - is this covered and by how much? Do we pay 10% of everything?

Many thanks in advance for info :msngrin:


Nicalf08 27.09.2011 20:00

Re: Confusion with basic insurance cover - help please,
 
No she won't as I never saw her again, feel like going out looking for her with my bill in hand though! As I'd previously called out an ambulance for yet another accident my son had I knew how expensive they were so I would have just got a taxi to the hospital because he was fine but needed checking over as he'd fallen off a climbing frame. However while I was comforting him she called them and they sent out an ambulance and a doctor in a separate car so I have to pay for both :msnshock: I guess I will just have to wait until I hear from the insurance company how much I will actually get back...wish me luck!

And thanks to the last poster (forgotten your username now) as that makes it a lot clearer now.

EPMike 04.10.2011 17:59

Re: Confusion with basic insurance cover - help please,
 
Quote:

Originally Posted by Nicalf08 (Post 1354991)
, feel like going out looking for her with my bill in hand though!.

No offense but I wonder if your son got in a serious accident and the same lady would not call the ambulance for fear that someone would hand her a bill, would you still say the same?

Nicalf08 05.10.2011 09:33

Re: Confusion with basic insurance cover - help please,
 
That would be a different situation. He was fine and walking around wanting to go back and do what caused the accident in the first place!


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