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Old 19.08.2013, 13:01
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Tricare Coverage

My mother will be moving to Switzerland soon. She currently receives Tricare for Life which is the health insurance coverage for military families - both active duty, retired, widowed spouse. However, this covers only 75% of her bills and Medicare cannot be used when living overseas.

I'm looking to speak with someone else who is in a similar situation. I would like to know which Swiss Insurance companies would cover the 25% gap in health insurance in such a situation.

Any help would be greatly appreciated.
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Old 19.08.2013, 14:16
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Re: Tricare Coverage

I'm not sure any of them will. Your insurance cover, if not a Swiss company, has to be accepted by the canton authorities and that doesn't happen very often. She will probably need to get full basic coverage from a Swiss insurer, but the best thing to do is ask your canton officials whether it is accepted over here.

Also, just a thought because I don't know anything about Medicare, don't you have to continue to pay into Medicare to get this Tricare service and if so how can you do it from abroad? My understanding is you can't pay in and can't benefit from it unless you're in the US, so not sure the Tricare would be available to her if she can't pay the Medicare side.
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Old 19.08.2013, 16:15
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Re: Tricare Coverage

Tricare and Medicare are separate. My mother is retired so I do not think this is an issue. At least Tricare had never mentioned that she would have to pay for Medicare.

Tricare is actually backed by the US government and is not a private company. I doubt they would consider this an issue as it guarantees coverage of 75% of medical bills. The problem as I mentioned is how to fill the 25% gap. I'll check with the Kanton anyway.

Thanks for the post!!!
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Old 19.08.2013, 16:31
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Re: Tricare Coverage

Yes, finding out if Tricare is acceptable to the Swiss authorities is the first step, then you can work on finding a company to fill the gap if necessary.

Does your mother have any paticular problems healthwise? If so, she can't be refused cover (just in case Tricare doesn't work over here), but she will probably only be able to get the basic insurance and none of the supplementals.
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Old 30.08.2020, 21:35
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Re: Tricare Coverage

I have a similar question - elderly parent moving to Switzerland and would like to know if Geneva Canton accepts Tricare as an exception to compulsory health insurance.
Anyone have any experience with this?
FWIW, you do need to continue with paying Medicare Plan B premiums in order to benefit from Tricare For Life, even though Medicare does not pay out abroad, and Tricare would cover the costs 100%. From what I can tell, Tricare for Life has better coverage than compulsory (basic) Swiss insurance and is slightly cheaper too.
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Old 30.08.2020, 21:58
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Re: Tricare Coverage

Is your mother of UK state pension age? And without income or pension from Switzerland. In which case she would be covered in Switzerland by Form S1 - with a 300.- franchise, and 10% to pay up to 700.- so a max of 1000.- per year- and would be exempt from Swiss health insurance.


She would be covered by NHS in UK, and S1 in Switzerland- but not able to travel anywhere else- as no Swiss insurance will cover abroad and EHIC will become invalid, from January 2021.
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Old 30.08.2020, 22:22
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Re: Tricare Coverage

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Is your mother of UK state pension age? And without income or pension from Switzerland. In which case she would be covered in Switzerland by Form S1 - with a 300.- franchise, and 10% to pay up to 700.- so a max of 1000.- per year- and would be exempt from Swiss health insurance.


She would be covered by NHS in UK, and S1 in Switzerland- but not able to travel anywhere else- as no Swiss insurance will cover abroad and EHIC will become invalid, from January 2021.
This has nothing to do with the UK, it is USA.
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Old 30.08.2020, 22:30
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Re: Tricare Coverage

Thanks, that was not clear at all in the OP.


In which case, I do not believe there is any insurance that will cover the 25% gap.
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Old 31.08.2020, 10:39
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Re: Tricare Coverage

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I have a similar question - elderly parent moving to Switzerland and would like to know if Geneva Canton accepts Tricare as an exception to compulsory health insurance.
Anyone have any experience with this?
FWIW, you do need to continue with paying Medicare Plan B premiums in order to benefit from Tricare For Life, even though Medicare does not pay out abroad, and Tricare would cover the costs 100%. From what I can tell, Tricare for Life has better coverage than compulsory (basic) Swiss insurance and is slightly cheaper too.
Regardless, using TriCare for Life means you pay out of pocket for care, submit the claim yourself, and accept reimbursement according to whatever formula TriCare uses that day. The Swiss medical system does not bill overseas insurance companies directly. Express Scripts (current prescription service for US military) does not ship overseas, so that has to be accounted for. US retired members do not have access to US milbases in Germany or elsewhere for commissary access or medical care.

To be fair, our private Swiss medical insurance turned out to be a better value that the supposedly "premium" health care plan offered through my work/dh's work in the US. You can consider a low cost/high-deductible Swiss plan if TriCare is not considered acceptable in the Canton and submit claims for the gap costs.

Last edited by MegsB; 31.08.2020 at 11:29. Reason: random thoughts
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Old 31.08.2020, 11:02
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Re: Tricare Coverage

As an aside, how easy is it for someone retired from the USA to get permit to come and live in Switzerland? What happens if a person as they get older, requires care in a Senior Care Facility/Home?
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Old 31.08.2020, 11:09
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Re: Tricare Coverage

Not sure where MegsB is living, but it is possible that Geneva Communes will accept it. You need to ask them.
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Old 31.08.2020, 11:11
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Re: Tricare Coverage

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Thanks, that was not clear at all in the OP.


In which case, I do not believe there is any insurance that will cover the 25% gap.
The OP posted the question in 2013 and never returned to update.
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Old 31.08.2020, 11:24
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Re: Tricare Coverage

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Not sure where MegsB is living, but it is possible that Geneva Communes will accept it. You need to ask them.
I'm currently in Zurich (they said no). Absolutely need to contact Geneva commune.
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Old 31.08.2020, 12:57
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Re: Tricare Coverage

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To be fair, our private Swiss medical insurance turned out to be a better value that the supposedly "premium" health care plan offered through my work/dh's work in the US. You can consider a low cost/high-deductible Swiss plan if TriCare is not considered acceptable in the Canton and submit claims for the gap costs.
This.

You really should do the all-in calculation to determine if it is actually worthwhile to try to keep up US/Tricare coverage.

First, as everyone says, you need to get a ruling IN WRITING whether Tricare would even be acceptable and grant you an exemption from Swiss mandatory health care in canton GE.

Until you have that exemption IN WRITING you really can't plan further.

That Tricare only covers about 75% makes me wonder about the waiver. When we moved here a million years ago on an expat contract we were exempt from Swiss insurance (granted by canton ZH) - but the key to getting that exemption was that the global plan provided by OH's company (Cigna and BUPA) covered exactly everything covered by Swiss insurance. But I am no expert, so go directly to the Geneva authorities and get a ruling IN WRITING.

Then...

If keeping Tricare means you still have to purchase Medicare Part B, last time I looked that cost ca. $150/mo.

So the question arises: Cost of Medicare B, plus whatever you might find privately to cover the 25% gap - will that cost more than Swiss basic insurance?

We didn't pay for our private insurance, the company did, but I have a vague memory of something on the order of 500/mo. I don't know if that was individual or for the both of us.

If you run all the numbers you might be surprised at the cost vs benefits of Swiss insurance.

Assuming your mother is of retirement age it is unlikely she will qualify for supplemental insurance - but the basic Swiss health insurance should be sufficient, especially in Geneva which is well-served by health care providers.

Do you think that your mother will remain in Switzerland? If so, Swiss insurance will make her life easier. If she is likely to return to the US at some point, however, you'll want to make sure that she retains eligibility for Tricare.

Hope it all works out for you and your mother.
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Old 31.08.2020, 13:36
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Re: Tricare Coverage

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Thanks, that was not clear at all in the OP.


In which case, I do not believe there is any insurance that will cover the 25% gap.

Groans by the bucketload from St2Leman, as well as regular red rep. Really?


So please, instead or groaning and red repping galore- could you answer the question. Which Insurance, in Switzerland, will cover the 25% excess? That would be really useful.
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Old 31.08.2020, 14:13
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Re: Tricare Coverage

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Which Insurance, in Switzerland, will cover the 25% excess? That would be really useful.
I think the point is, the US tricare, designed to fit the US healthcare system, with promises of it being superb throughout the world is probably much more marketing than substance when you scratch the surface. USA is notorious in all spheres for dictating exterritorially to the rest of the world and rarely/never bending their own system to accommodate. In this case, I really doubt there is any swiss product that would fill such gap. The Swiss system is different, you basically have to have a Swiss plan (very few exceptions). I would doubt there is any gap policy here as there is essentially no market. And as an above poster pointed out, the Swiss policy is probably cheaper and offers better coverage in long run.
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Old 31.08.2020, 14:23
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Re: Tricare Coverage

Agreed- being aware of course, that most people over 60, especially with any pre-existing conditions- will be accepted for basic insurance, and very likely no supplemental. However, so-called 'basic' care is excellent, but will limit choice of doctor or specialist and private facilities.


Apologies for my comment about UK - those of us who are non-USA are not aware of Tricare or what it means.
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Old 31.08.2020, 22:10
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Re: Tricare Coverage

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Do you think that your mother will remain in Switzerland? If so, Swiss insurance will make her life easier. If she is likely to return to the US at some point, however, you'll want to make sure that she retains eligibility for Tricare.
This, absolutely. If your mother likes it here, and gets a permit to stay, great. But you/she should ensure that she doesn't burn that particular bridge when leaving the USA. It would be terrible for her to feel trapped here, just for lack of medical insurance there.

Even if the Swiss require your mother to have Swiss medical insurance, count up the cost of the premums in the USA, and decide whether that's worth paying for her happiness, for, say, the first year, to be sure she has that door open.

Otherwise, she should get it in writing that her policy in the USA can be frozen, such that she will have the option to re-awaken it, and that they will reinstate it without any hurdles (tests, limitations of pre-existing conditions, at the same terms and conditions as now), should she return to the USA.
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