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Old 08.12.2007, 00:34
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Medical costs for diabetics

I've been living and working in Zurich for just over a year. I'm engaged, my partner is still living in the UK but we're hoping to settle here in Zurich after we marry. He has late-onset type one diabetes, and I'm trying to find as much information as I can about the system here, in terms of treatment and costs.

At the moment, in the UK, he has regular health checks, eye tests etc, and is currently using tablets, although he will probably have to change to insulin injections in the near future. Are all of these covered by basic medical insurance? Or will he need supplementary insurance?

I've read in other threads that medical insurers have to accept people with pre-existing conditions, but I'm wondering whether the premiums are higher? Also, I understand that insurance only covers 90% of medical costs, is this correct? Are diabetes drugs expensive in Switzerland?

If anyone could give me any information about any of my questions, I'd be really grateful. Any links to useful resources would also be much appreciated.

Thank you!
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Old 09.12.2007, 15:01
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Re: Medical costs for diabetics

The insurance will cover you, once your,'selbstbehalt' is covered 300chf, then 10% of your bill will be down to you.
Tip take out the lowest franchise,ie 300chf.
Yes the medication is much much higher than everywhere else,but that is being shortly taken care of.

Am diabetic myself so know what I'm talking about.

more info. SEKTION DER SCHWEIZERISCHEN DIABETES-GESELLSCHAFT
forchstrasse 95,8032 zurich.


E-MAIL sdg.asd@swissonline.ch
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Old 28.10.2008, 14:31
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Re: Medical costs for diabetics

Hi Holly,

I know my reply is a tad late(1 year!) but I was only searching for this particular info today.
My girlfriend is coming over to Zurich to live also and is a Type 1 diabetic on a pump.
Some questions:

How much do viles of insulin(human) cost over here?
What process did you go to in order to get the prescriptions?
What are the Diabetic depts like in Zurich/Switzerland?
Did you have to contact the manufacturer of that particular insulin for any further info?

Thank you so much in advance for any useful tips etc you may have.
Kindest Regards
Adam
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Old 28.10.2008, 15:00
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Re: Medical costs for diabetics

Hi AJLondon,

I am also a Type I diabetic and use an insulin pump. I've started using my Swiss insurance fairly recently to cover my diabetic meds and so far I have been VERY impressed. As I understand the system here, pre-conditions don't factor into your insurance coverage. Diabetic supplies are covered by the basic mandatory coverage, even pump supplies (but let me get a few more bills before I really say that with 100% conviction...it's almost too good to be true!)

When you sign up for health insurance, you decide how much of a deductible you are willing to pay, which is usually the first 300 CHF in medical expenses (you get lower rates if you agree to pay more). Once you've spent the first 300, or whatever you've agreed upon, insurance covers the rest. Having already spent my deductible, I now go to the pharmacy, let them swipe my card, and then walk out with my medications.

The medications generally come under different names here, but the endocrinologist or pharmacist should know what the equivalent is. In the States, I used Humalog or Novolog for my pump (one is brand name, the other generic). Here, the same thing is called NovoRapid.

Once you're covered, get in and see an endocrinologist. I went to the University Hospital in Zurich and was VERY impressed. They were very prompt, very thorough, very nice...bloodwork was done the same day and the doc called me that evening to tell me everything was wonderful...I am very, very impressed.

Feel free to ask if you have any more questions- it definitely makes a big difference to talk to someone in the same position!

Erin
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Old 28.10.2008, 15:02
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Re: Medical costs for diabetics

BTW...I still haven't figured out how eye and dental examinations work here. Does anyone else know? If my endo refers me to an eye doctor, does that take care of the insurance issue? Dental???
Thanks!
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Old 28.10.2008, 16:09
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Re: Medical costs for diabetics

Hi,

wanted to add my son is Type 1 diabetic and we have recently arrived.

Here's what I've found out so far -

Kids normally see a Paediatrician for anything here (rather than a GP as we would in Australia) - we were recommended a local Paed by his teacher - he was highly recommended and speaks excellent English.

He did say that our son *could* see the diabetes doctor at the Kinderspital for all his checkups (so avoid having two doctors) but I would prefer to have all my kids see the local doctor for routine stuff and then see the endocrinologist/diabetes clinic only for diabetes... so that's what we are doing...

He wrote me a script for the glucose test strips so that those will be covered by the medical care, and I didn't have to pay up-front for his first appointment - they said they will send me a bill in about a month after it gets processed and lodged with the health insurance company.

The other thing we did was contact via email the maker of our glucose meter (Abbott) and they sent out, free of charge, two replacement glucose meters for us as the Swiss ones are slightly different to Aussie ones (they said the batches of strips are coded so they theoretically need a Swiss meter for Swiss strips)... We asked for two meters because our son carries his everywhere with him and he is *only* 6 years old so we wanted a back-up just in case! I can give people the details if they need them of the person who I contacted in Switzerland...

We paid 50chf up-front for a box of needles, which we needed pretty soon after we arrived, and before we had our health insurance sorted, but I believe these will be covered by our insurance in the future (and probably can get some of the money back if we tried)...we didn't need a script for this, and whilst it was very costly, we didn't mind at the time...

I believe pumps are widely used in Switzerland, I was told by our specialist in Australia that we might be *expected* to go to a pump by our Swiss specialist, as that is the preferred approach...and to consider this (In Australia it's just catching on now)...

We joined the Diabetes association in Zurich, and they have sent us some great info (all in German) about events for kids for Christmas etc. They could also correspond via email in English, and the joining fee was quite low. The cost of meds seems very high (double of the 'full' price in Australia)...but with health insurance I guess people just don't really notice the cost...

Can someone comment on how/what cost the following with insurance, and do I need a prescription ?

Needles
Insulin
Glucose Test Strips
Keytone Test Strips

Also, we use Levimir and NovoRapid, and I believe they are both easily available...I also haven't had any trouble finding a pharmacist who speaks english, although I recommend you take the packet from whatever you are trying to get so they can check it and ensure they give you the exact same item...

I believe you can also purchase your supplies via the diabetes association if you prefer...
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Old 28.10.2008, 21:00
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Re: Medical costs for diabetics

hi

just to let you know if he is controlled on tablets he is a type 2 diabetic not type 1, if in the future he goes onto insulin he will still be a type 2 diabetic but insulin dependent. they never transfer over to type 1. this may be quite important for his insurances etc
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Old 10.03.2010, 23:54
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FYI for diabetics

To add to this most useful post based on now-firsthand experience...

I'm a type1 diabetic using an insulin pump from Minimed (Medtronic). They have branches in Switzerland, and the pump supplies that I use even have the same item numbers to order by as in the U.S. (and with similar retail prices).

I have also gotten my Humalog insulin under the same name here as in the US... maybe not too surprising given it's manufactured by Eli Lilly. The base retail cost is about 55 chf for a 10 mL vial, i.e. about half the price I was paying in California. Oddly I haven't paid exactly the same amount twice for the three times I've filled that prescription now, and have no clue why. Also don't know if the prices vary by canton, or are standardized nationally, etc.

A few more tidbits :
- glucose readings on Swiss meters are in mmoL/L, not mg/dL (cf. US), so if you start talking to a Swiss-trained endocrinologist about blood sugar levels there may be a momentary look of confusion and/or shock before you both realize the need for unit conversions
- the Swiss use insulin pumps on a rental system(!?), or so I'm told by my doctor here...which bothers me profoundly as I tend to think of my pump (which I had to buy) as a necessary extension of myself, just plastic and not squishy. I should probably refrain from further comment, though, not having used this system at all...

Hope that helps someone !
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Old 11.03.2010, 00:13
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Re: Medical costs for diabetics

I am Type 1 and so far have been very impressed. I have been told that the basic insurance covers most diabetic treatment, including eye tests (not dental). I have seen my doctor 3 times now and received all the supplies I need. I use insulin pens. (Still haven't had a bill to claim yet)

He does blood tests inc. HBAlc from a finger not a whole blood sample from the arm. The results are there in 30 mins, not 2 weeks like in the UK. I am not knocking the UK because I thought the treatment there was superb too compared to Asia where I have lived for many years.

So in Switzerland I don't think you need to worry!

Good luck.
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Old 23.01.2011, 18:45
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Re: Medical costs for diabetics

Hi, What a helpful website this is...thank you!

This is my first post on the forum but I have been using it frequently to familiarize myself with the changes that will occur once we relocate to Switzerland from Northeast, USA in August, 2011.

Can someone update me on the current specifics relating to diabetes coverage.

Several have posted early in their process & I would like to get as much detail as possible once they have been in the system for a while as well as what I should do prior to arriving.

I have (3) Type-1 diabetics in our immediate family. My husband - 44, my 2 sons - 13 & 10. All using an insulin pump -- 1 using the JNJ Animas PING Pump and the other 2 using Medtronic.

So, as you can imagine, the cost of our medical is always high but I want to get specifics for Switzerland.

Not sure if it matters where we will be living, but right now we are focusing our housing search in Thalwil, Ruschlikon and the immediate areas.

Specifically, would like to know:
  • Insurance Coverage - does it matter which insurance we use
  • What specifically is covered and is it all at 90% (i.e. test strips, insulin, pump supplies, glucagon, ketone strips, syringes etc).
  • How much are the cost of the above (so I can determine the amount we will need to pay)
  • Any recommendations for pediatric & adult endocrinologists (we will want to keep a specialist for their diabetes).
  • Hospital coverage (hopefully not needed).
  • Retinologist recommendation (if needed)
  • Does insurance cover all doctor visits (we currently see the specialist every 3 months, which includes blood work)
  • Testing Meters - do they need to be changed for Switzerland
  • Any specific requirements as it relates to the children in the school systems (we are hoping to get the kids in ZIS)
  • Podiatrist recommendation (if needed)
Any insight you can provide would be much appreciated.

Thanks!!!
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Old 23.01.2011, 20:53
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Re: Medical costs for diabetics

Quote:
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Hi, What a helpful website this is...thank you!

This is my first post on the forum but I have been using it frequently to familiarize myself with the changes that will occur once we relocate to Switzerland from Northeast, USA in August, 2011.

Can someone update me on the current specifics relating to diabetes coverage.

Several have posted early in their process & I would like to get as much detail as possible once they have been in the system for a while as well as what I should do prior to arriving.

I have (3) Type-1 diabetics in our immediate family. My husband - 44, my 2 sons - 13 & 10. All using an insulin pump -- 1 using the JNJ Animas PING Pump and the other 2 using Medtronic.

So, as you can imagine, the cost of our medical is always high but I want to get specifics for Switzerland.

Not sure if it matters where we will be living, but right now we are focusing our housing search in Thalwil, Ruschlikon and the immediate areas.

Specifically, would like to know:
  • Insurance Coverage - does it matter which insurance we use
  • What specifically is covered and is it all at 90% (i.e. test strips, insulin, pump supplies, glucagon, ketone strips, syringes etc).
  • How much are the cost of the above (so I can determine the amount we will need to pay)
  • Any recommendations for pediatric & adult endocrinologists (we will want to keep a specialist for their diabetes).
  • Hospital coverage (hopefully not needed).
  • Retinologist recommendation (if needed)
  • Does insurance cover all doctor visits (we currently see the specialist every 3 months, which includes blood work)
  • Testing Meters - do they need to be changed for Switzerland
  • Any specific requirements as it relates to the children in the school systems (we are hoping to get the kids in ZIS)
  • Podiatrist recommendation (if needed)
Any insight you can provide would be much appreciated.

Thanks!!!

I also am an insulin dep. diabetic. So, I can provide some insight which might be of service!

Insurance: It does not matter which you choose. All will cover Diabeties as far as I know. I currently use Sympany. I like them because when I go get my Medications, I do not have to pay upfront. The insurance company sends the bill. However, some you have to pay upfront and then send them the reciepts by Post.

Coverage: They cover all but 10% BUT you have a deductable which you have to pay upfront. I have a 200CHF deductable. You have to decide this when you sign up with the company of your choosing. Then, of course, every month you make your payments to the insurance company. For me, I pay more per month than most (which I am certain you will also!).

Amt. per month: I am certain it will vary depending on what medications you require, dr. visits, etc.
After you spend your deductable, it should not be so much. You can message me privately. I can give you more details!

Doctors: I have always gone to the University Hospitals. I lived in Lausanne, Zürich and now Basel. So, I have my Endocrinologists, Kidney, Podiatrist and Eye doctors there.

Hospital coverage: Is covered by insurance. I have been in the hospital a couple of times. No problems.

Insurance coverage of Dr. visits: Yes, covered.

Testing Meters: The hospital has always given them to me for free. I do not know if the pharmacy here, would sell the test strips you would need for your U.S. machine!

I hope this is of some help!

Stacey
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Old 23.01.2011, 21:57
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Re: Medical costs for diabetics

My answers are similar, our son has Type 1, he's 9 now, he's had it for 3 years...

Insurance coverage - type 1 diabetes is covered on the basic (compulsory) insurance, and you will pay a 10% gap for the kids meds, and for the adult you should choose a low deductible. They might knock you back for 'halbprivate' cover - which you pay extra for, and would typically include things like a private room in hospital...that's what happened to us...

We end up budgeting 50chf a month for 'extras' for our whole family. This is the gap on test strips, the clinics at the kinderspital every three months and the general paediatrician visits..

The Zurich Kinderspital seems to have a 'Roche' shop, but we use a blood glucose meter from Abbott and they have been very happy to provide us with a new pump twice since we got here (we always have two, and our son has lost one per year)...we email them with the tale of how it got lost, and they post us one within 24 hours - obviously it means we keep using their test strips!

For three diabetics in the family, I'd probably budget a bit more per month - maybe 100chf, for the gaps, so that you don't get caught out...

We see Prof. Dr. Schoenle at the Kinderspital, but that's because our specialist in Australia gave us his name, and the Paediatrician we saw managed to get us onto his list - normally he's not easy to get on the list for because he is actually the Professor ! - but I can recommend Dr Belvedere at Witikon (Paediatrician)- very organised and my biggest advice is to get a Paed who is open on Saturdays! - it's really bad to pull kids out of school to go to the doctor here!

I am quite sure you will be referred to the endocrinology clinic at the Kinderspital and I am yet to find a staff member there who doesn't speak English enough to refer you in the right direction - the diabetes staff have no problem communicating. Sometimes they can seem a little blunt, but it can simply be a translation issue. They will probably also get you to see a diabetes dietician at the hospital, and I'm quite sure they have psychologists etc if needed.

I recommend you join the diabetes association - you will get all the info in German, but they run a kids diabetes camp every year for a whole week in the summer and our son had an awesome time! - he was barely 7 when he went, the youngest kid on camp, and he came home self-injecting, we were very impressed! They taught him heaps about his meds, how to calculate, and also other 'hypo' food options that are 1 carb serve, and healthy too!

I'm guessing you'd also get a Retinologist through the hospital.

Blood work is done at your clinic days, you get the HBA1C on the spot (takes a few minutes) and we have also requested things like a coeliac screening blood test (our son has coeliac) and for them to do general blood tests at the clinic, and they were happy to do that (actually, the Paediatrician suggested doing it that way so only one lot of blood gets done and it's all via the hospital system)...

Meters we did have to change for Switzerland, but we came from Australia, so it's a different region. Try the website for your meter, see who the supplier is in Switzerland, and email or phone their help line and I'm sure they will answer your question. Of course, we hold onto our old meters and strips for when we travel!

School-wise that was the hardest part. You will have to set up a structure for your kids via the school. If meals are provided, you will have to educate someone on how to measure the meals (are your boys on pumps or injections?)

The other thing is that the endocrinologist you see may well want to change your regime. Professor Schoenle's team actually do the clinical testing on the insulins such as Levimir, and so he was quite adamant that the regime we had was flawed. We were more than happy to trust his judgement, and the results were impressive - our son is 10 times healthier here than he was when we left Australia - partly also because we decided not to get a car, and he gets a lot more exercise than he used to!

We decided at this stage to not pump, because our son isn't old enough to measure his dosages or handle the adjustments, and we didn't want to have to train the staff to do it - he's on a system where he has two insulins in the morning which cover breakfast and last until lunch time, and then he has one before dinner and one after to cover overnight. It works really well with regular meals, and the swiss mealtimes which are basically 6:30am breakfast, 9am snack, 11am snack, 12-1pm lunch, and 5-6pm dinner....

Feel free to PM me. And maybe our kids will meet at diabetes camp - for us it's the only break we get from his diabetes care too, all year, so it's a special time for our other kids to eat wherever/whenever/whatever for a whole week ! (and our son's german didn't improve much at camp because everyone wanted to practice their english on him instead!)...

Last edited by swisspea; 23.01.2011 at 21:59. Reason: typos...
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Old 24.01.2011, 06:18
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Re: Medical costs for diabetics

Stacy & Swisspea,

Thank you for your quick & detailed response. It was very helpful. It's similar to the US process. The only thing I'll need to find out is the cost of the medical suppplies so I know what my 10% will be. I currently pay over $100USD / person/ month now.

Swisspea- tried to pm you but it said I couldn't because your inbox was full. Wanted to get some details about the diabetes camp (i.e. how early do you enroll, what ages, is it sleepaway camp, etc.

Thanks again!
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Old 24.01.2011, 08:03
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Re: Medical costs for diabetics

Well, the cost of compulsory health cover adds up, but it sounds like the 'gap' won't be any worse than what you are paying in the US...

You might also be pleasantly surprised that it's unusual to wait for long at appointment with doctors here - appointments are efficient...in Australia a family member takes a whole day off to go to diabetes clinics...it takes most of a day....here in Zurich we can be at the hospital in 20 minutes (walking!) and then we are rarely at the hospital more than 1 hour...

For diabetes camp it's 7 days residential! - I think saturday to Saturday. The volunteer helpers are all diabetics, and they take nurses, educators and doctors from the kinderspital with them - so I think it's extremely well organised...when our son turned up they knew straight away who he was, that he spoke mostly english, and that he was from Australia - although he is known at the hospital anyway, as the 'Australian' kid...

The camp is from age 7 to about 14. After that they become 'volunteers' and can come as helpers...

I've fixed my inbox so you can PM me now...

I don't know the cost of sets and insulin for the pumps, but I can't imagine it's much more expensive than needles, pens and tips... the gap would be maybe 5chf on a vial on insulin - so the gap fee might be cheaper than your US costs-you may be pleasantly surprised...

The cost of compulsory medical cover is around 80chf per month for kids, and you get around 150chf tax rebate per child per month on your salary...so it balances out... adult cover might be 350chf per person per month, with all the extras and a low deductible...
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Old 02.02.2011, 11:58
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Re: Medical costs for diabetics

hi guys,,,
I have read your whole post.In my view for diabetes camp it is rounding of 7 days residential.I was just diagnosed on 9/9/07. I do not have insurance, and I am finding out that this is pretty expensive.
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Old 02.02.2011, 12:07
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Re: Medical costs for diabetics

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hi guys,,,
I have read your whole post.In my view for diabetes camp it is rounding of 7 days residential.I was just diagnosed on 9/9/07. I do not have insurance, and I am finding out that this is pretty expensive.
If you are living in Switzerland you will have insurance from the day you enter the country.
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Old 02.02.2011, 13:26
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Re: Medical costs for diabetics

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If you are living in Switzerland you will have insurance from the day you enter the country.
Porsch1909 - in Switzerland you have to have Insurance from day 1 in the country - but it is up to you, or your employer perhaps to organise this. It does not happen automatically. We moved at the very end of March, and when we organised our Insurance in April, we had to pay back right to the beginning of March. We were accepted for basic Insurance only, as we both have pre-exisitng conditions- which means we have no choice of specialist or hospital, etc. I have Type 2 diabetes and a thyroid disfunction, + a bad knee due to an old car accident. Metformin and Thyroxine are quite cheap, and we did not get anywhere our franchise last year. One of my OH's drugs is very expensive, so he gets it on a private prescription in the UK when we visit, as it is about half price there.
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Old 02.02.2011, 13:31
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Re: Medical costs for diabetics

Olaf, are you an adult with diabetes, or is it a child with diabetes ?

That makes a difference on the costs, but either way the compulsory health system covers your diabetes care in Switzerland, and you will pay 'gaps' but from others who have discussed the situation in the USA, the cost may be lower in Switzerland...
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Old 02.02.2011, 14:04
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Re: Medical costs for diabetics

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Porsch1909 - in Switzerland you have to have Insurance from day 1 in the country - but it is up to you, or your employer perhaps to organise this. It does not happen automatically. We moved at the very end of March, and when we organised our Insurance in April, we had to pay back right to the beginning of March. We were accepted for basic Insurance only, as we both have pre-exisitng conditions- which means we have no choice of specialist or hospital, etc. I have Type 2 diabetes and a thyroid disfunction, + a bad knee due to an old car accident. Metformin and Thyroxine are quite cheap, and we did not get anywhere our franchise last year. One of my OH's drugs is very expensive, so he gets it on a private prescription in the UK when we visit, as it is about half price there.
What I meant was even if you get treatment before you organise you insurance you are still covered by that insurance because you pay from the first day that you enter then country, not from the start of your policy.

So regardless of it being done automatically or manually, one is covered from the first day they enter Switzerland to live.
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Old 02.02.2011, 15:48
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Re: Medical costs for diabetics

I'm confused. Since my 3 family members are diabetic, which is pre-existing, does this may they will ONLY be able to get the basic insurance & not have the ability to select their specialists?

I was under the impression that I would be able to get the more comprehensive insurance for my family members (which I realize I would have to pay more) but that I would still be able to get this extra insurance.

I would hate not to be able to select the best doctors in case of complications or any problems.

Thank you...
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