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Old 27.03.2008, 16:37
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Health insurance: evacuation and repatriation cover

Hi - I'm about to move to Geneva from the UK for 1 year, to work at WHO (seconded from the NHS). I'm continuing to be paid by the NHS into my UK bank account, and will continue to pay full UK PAYE tax and NI contributions for the year. I've worked out this means I can still use the EHIC card (though I appreciate I will have to pay the costs up front, which in a worst case scenario would be impossible for me). WHO have worded my contract in a way that excludes them from giving me accident cover (which i guess is reasonable, since they won't be deducting anything from my salary because they're not paying my salary, if you see what I mean).

I've read posts on this site and others about BUPA insurance not being acceptable in Switzerland. So I thought, that's fine, I'll get Swiss insurance when I arrive. BUT: I want to have health insurance that covers evacuation and repatriation costs - the BUPA insurance will give me this, whereas I imagine that Swiss health insurance won't.

Any thoughts/advice/help? Am I just going to have to take out a Swiss health insurance policy AND one from BUPA? (ouch)
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Old 27.03.2008, 23:17
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Re: Health insurance: evacuation and repatriation cover

Perhaps you can simply take Swiss supplementary insurance, as many of those cover the costs you mention.

Check out comparis.ch or www.sumiswalder.ch, I am with them and recall, wait I will have a look. Yes they offer it in their hospital insurance, which might be useful anyway since you can choose which kanton to be hospitalized in, if required.

Spitalversicherung Allgemein Kombi 1

Transport- und Rettungskosten Transport-. Such-, Rettungs- und Bergungskosten:
90% max. Fr. 25'000.-- pro Ereignis in Ergänzung zur Abt. A
Auslandsaufenthalte
Weltweit volle Deckung der ambulanten und stationären Behandlungen auf der allgemeinen Abteilung in Ergänzung zu den Leistungen der Grundversicherung.
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Old 27.03.2008, 23:44
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Re: Health insurance: evacuation and repatriation cover

Thanks, that's helpful. Though I wonder if this covers evacuation/repatriation of a UK national back to the UK? I suppose I'm imagining the worst case scenario, which is I somehow manage to fall off a mountain and need to be transported back to the UK, either in a terrible mess needing air ambulance etc, or dead. (I'm actually quite a cheery person normally, honest!). My German is very rusty, and between that and Babelfish I wasn't quite sure if the sumiswalder insurance only covers evacuation/repatriation back to switzerland if you take out the insurance and happen to have an accident while abroad (ie not in switzerland)?
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Old 27.03.2008, 23:52
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Re: Health insurance: evacuation and repatriation cover

I do not know. Perhaps in the worst case, i.e., death, they would consider that a foreigner probably will have to go back to his/her origins, as it were.

In terms of repatriation, when you are acutely and severely injured (in contrast to long term serious illness), an air ambulance needed to save your life while in Switzerland will put you first in a Swiss hospital in any case, and recuperation and revalidation when you are unable to travel is likely here then as well. In which case I do not know how much BUPA covers, but supplementary insurances (as well as the main Swiss insurance) would cover this circumstance quite well.

Lastly, perhaps this is of interest. www.rega.ch offers worldwide repatriation to Switzerland for 30 chf per year, it also applies to us foreigners in CH. They provide the widest cover of air ambulances in CH, so if you go hiking or skiing they are the people who rescue you, and if you are a member, you do not have to pay the prohibitive rescue costs. They also claim to rescue you abroad but I have never understood how this works. Perhaps it means they pay the Royal Flying Doctors bill if you get rescued in the desert of Australia? They'd certainly organize and pay transport back though. (Air Glacier is a similar company, they cover the (French) Swiss mountains I think). Sorry about this ramble, I guess what I mean is that the supplementary insurance and Rega is not so expensive, and that they might provide a good extra cover, for things BUPA won't refund in case of serious trouble.

You could also get a UBS credit card, as it includes travel insurance. This may have repatriation costs, but I cannot remember if you need to upgrade, as UBS has a basic and fee based credit card travel insurance. (See UBS web site).
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Old 28.03.2008, 21:43
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Re: Health insurance: evacuation and repatriation cover

Thanks for your advice - I'll check things out when I get to Geneva next week. And thanks for the tip about REGA - sounds like a great idea.
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Old 28.03.2008, 21:54
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Re: Health insurance: evacuation and repatriation cover

My husband & I have REGA. They will cover us in Switzerland if we have any problems but as we are UK resident and Tax payers they will not cover repatriation. However as you are working for a year I would send them a email. I did that and they were very helpful and answered all my questions in english.
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Old 29.03.2008, 19:03
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Re: Health insurance: evacuation and repatriation cover

Maybe the tale of my son is of help here, because it covers virtually all aspects of your question in "active use".

Situation: my 9 year old son lives with my ex in London. I took a Rega family patronage since I arrived here so that he had cover too. I did that more because I thought it was a cool concept rather than plan dangerous sports (I didn't even have plans to learn skiing at that time :-).

About 6 weeks ago we are skiing and my son breaks his leg. I call in the slope emergency team (tip: store the emergency number of the slope you ski on - it saved a lot of time). We're at 2000 meter, taking him down by sled isn't an option because a broken femur is not something you want to bump around for half an hour. Rega is called in and the heli appears a bit later.

We're on a 45 degree slope, so the heli hovers and they climb out. They give my son morphine, get him onto a stretcher and stick him in the heli which has returned, hovering for pickup. I get to climb in on the other side. The slope emergency staff start gathering our other belongings, helmets, skis (etc) for storage, we bank sideways, then forwards and are soon cruising the 250 km/h the heli is capable of. My son's being monitored and talked to by the nurse.

Side note: from arrival to treatment to take-off was 15 mins or less, on a 45 degree angled slope - these people are awesome. And very nice to boot.

We fly to Chur Kantonal hospital (detour due to cloud covers), where they do the usual (stabilise, strip, x-ray) and he's lucky, he only needs a cast and painkillers. No surgery, and it's so cleanly snapped it hasn't even broken the bone membrane . So, Friday 15:30 accident, 17:00 x-ray done, 19:00 I'm commandeered to help with the cast, 23:00 he's asleep and I'm retrieving my car and our gear. Saturday I pay for crutches (CHF 40), he gets physio twice. He's cleared in the evening, and I have discussed with the doctor that driving him back is better than trying to get him on a plane (also because of the security check hassle etc).

Here's what it costed, and who paid for what.
  • Slope emergency service: CHF 180. Directly paid, reclaim from travel insurance.
  • Crutches: CHF 40. They're special child crutches so very colourful - kids at his school love them. Directly paid, reclaim.
  • Hospital: approx CHF 4500. Paid by the NHS via EHIC scheme (European Health Insurance Card - I had him registered for that quite a while back for travel purposes). I have to pay CHF 12 (my meal at the hospital).
  • Rega: approx CHF 3500. NHS pays 50%, the rest Rega will bill travel insurance or, in absence of that, absorbs the costs if you're a member. I pay a CHF 33 processing fee.
To summarise, I'm giving you an overview from who does what. If you have a decent insurance you probably won't even be involved in the bill handling. Kindly note I'm no expert - I've only just been through it all..
  1. Transport off Swiss accident site to nearest hospital: Rega. The NHS should cover 50% of the costs, you pay an admin fee, insurance would pick up the rest. In absence of insurance, Rega would waive the remainder if you're a member. Interestingly, the membership conditions do not appear to require Swiss residency as a condition.
  2. Hospital treatment: you should register with EHIC and make sure you have your card with you. If it's not a private hospital the NHS will cover the costs under European healthcare exchange rules - they work in Switzerland too. What's more, you're not involved so no paying and hoping to see it back some day - the Swiss do it for you and it only takes a week.
  3. Repatriation to UK: via your insurance. Be aware that airlines do not like injured people because it creates extra liabilities for them - they may refuse to fly you on a regular ticket.
As for my son, his cast came off Thursday
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Old 29.03.2008, 19:28
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Re: Health insurance: evacuation and repatriation cover

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Repatriation to UK: via your insurance. Be aware that airlines do not like injured people because it creates extra liabilities for them - they may refuse to fly you on a regular ticket.
As for my son, his cast came off Thursday
As long as you have a fit-to-fly certificate, they do not mind. Flying less than 48-72 hours after a fracture is not good and will generally not be accepted by airlines - if the limb swells within the cast, you're in a world of pain (or worse, depending on the flight duration).

Airlines only require extra tickets when you have to fly on a stretcher and hence you need 9 seats...
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Old 29.03.2008, 19:35
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Re: Health insurance: evacuation and repatriation cover

Excellent - thanks for that, learned something new again!
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Old 29.03.2008, 20:50
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Re: Health insurance: evacuation and repatriation cover

The evacuation/repatriation cover on a Swiss policy is for repatriation back to Switzerland.

The BUPA policy is not acceptable in the place of a normal compulsory Swiss insurance but, as you will not be using it instead of a normal Swiss policy, there is no reason why you can’t have their cover for repatriation to the UK.

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Old 11.04.2008, 10:31
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Re: Health insurance: evacuation and repatriation cover

Hi all

Thanks very much for all your posts - it's really helpful. Sorry for the delay in responding, I'm now in Geneva and caught up in starting work and trying to find somewhere to live (it feels like I barely have time to eat at the moment! I'm knackered but so far it's all good).

Cheros I'm really interested in what you say about the EHIC - I do have the card, but I thought if something happened i would have to pay up in advance then reclaim. Good to hear I wouldn't have to do that! (and that your son is doing well)

As for flying with broken limbs - I had to fly back from the US a few years ago with a broken wrist (snowboarding ) and there were no problems at all - it was only the day after I broke it and it wasn't even in a fixed cast at the time - maybe that's why it was OK, because if there had been swelling I could have removed the splint)

Anyway I now just have to sort out the insurance (and find somewhere to live, but that's another whole post in itself )
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Old 14.04.2008, 10:57
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Re: Health insurance: evacuation and repatriation cover

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if there had been swelling I could have removed the splint

I now just have to sort out the insurance
Re swelling, when they put the cast on my son's leg they cut it along the length so it could accomodate swelling - it was kept closed with elastic bandage. That's one of the benefits of the material they use these days - plain plaster doesn't flex at all. Only a week after he got to London did they fully close it.

When it comes to insurance I can recommend a guy I know in Zürich. He uses 28 years in the industry to pick an insurance that really matches your needs and budget and is value for money. Let me know if you need his details via private message.

As for quality, I suspect he's liable to potentially downright refuse to sell you something that he thinks is wrong but so far I haven't found reason to doubt his choices. It's rather unusual to be able to trust an agent, but that's exactly what I ended up doing - maybe because he stubbornly works like me (let me do it right or don't bother me ). He gets the insurances to work for you.

Oh, and as so many Swiss he speaks fluent French as well. We talk in both German and English because we need the practice :-).

As for my son, his cast came off 2 weeks ago and like any decent 9 year old he already has to be slowed down . It appears at his school there has been a bit of "changing of the guards" - he came out of a cast and a friend of him had the same thing happen in France (break, airlift, the works). I'm working with a few people on Swiss awareness campaigns for next season - there is an increasing level of accidents and injury on the slopes which needs addressing.

Anyway, enough waffle. Time to get some work done, only have half a day today..
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