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Old 07.09.2014, 19:27
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Choosing Insurance: What does healthcare cost?

I've finally arrived in Switzerland (Lausanne) and am in the process of selecting both statutory and non-statutory health insurance. I think I understand the franchise/deductible and 10% contribution Swiss system, but I still do not understand the amount of coverage I think I will need, aka the costs involved to be treated in Switzerland. I've found some very good threads reviewing various hospitals, but none related to the specifics of the cost of treatment in Switzerland (except to complain that it is expensive ). So in very round figures:

How expensive is a visit to the doctor's office (like for a minor infection needing antibiotics)? How much is an overnight stay in a hospital ward? How about in a semi-private or private room? (For the sake of the exercise, let's not count the cost of the treatment, which would vary wildly.) And how much more would it cost to be treated by the department head, rather than the new guy?

Finally, are you allowed to pay for such "upgrades" out-of-pocket? Like, are hospitals able to divide the billing for a hospital stay such that the insurance will cover the bill (after franchise and the 10% up to 700 CHF are deducted) up to the covered level (say a 4-bed hospital ward) and then the extra would be billed to me? Or would I then have to pay for all of the bill if I were to book myself into the private suite despite the fact that my insurance is only for the ward?

Thanks in advance for your combined wisdom to a relative newbie!
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Old 07.09.2014, 22:34
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Re: Choosing Insurance: What does healthcare cost?

Try reading these first.

Health Insurance - Look here before asking questions please.

Then go to www.comparis.ch and play around with their health insurance tool.

And no, you can't pay for upgrades. If you go for basic insurance, that's what you get. If you want semi-private or private then you add that to your insurance policy when you take it out.
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Old 07.09.2014, 23:11
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Re: Choosing Insurance: What does healthcare cost?

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Try reading these first.

Health Insurance - Look here before asking questions please.

Then go to www.comparis.ch and play around with their health insurance tool.
Yeah, I've read that already and it was useful information, thanks, but not really related to my question about medical costs in Switzerland.

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And no, you can't pay for upgrades. If you go for basic insurance, that's what you get. If you want semi-private or private then you add that to your insurance policy when you take it out.
So at no point in the Swiss health system is there ever an opportunity to pay cash for any medical care? One must pay an insurance company by the month for every detail? Please forgive my disbelief, as I'm not talking about statutory vs. non-statutory insurance policies here, I'm just not sure I want to pay an extra 1800 CHF per year for a premium supplemental insurance with all sorts of bells and whistles that I don't need, but which has one or two small options I might actually want in the event of an unlikely emergency. Especially when a middle-of-the-road policy bundle would do just fine for most things. I just want to know if I could opt for those things on a case-by-case basis at the hospital knowing that I'd have to pay cash for them. Like being able to get a second opinion if I don't like the competence/bedside manner of the doctor that is assigned to me. Or a semi-private/private room if I'm not able to get any sleep because my neighbor snores loudly. What I don't want is to have to pay cash for the entire hospital stay because of one night in a semi-private room. Else what is the point of having the insurance policy in the first place?
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Old 07.09.2014, 23:16
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Re: Choosing Insurance: What does healthcare cost?

www.comparis.ch health insurance is compulsory, it's the law here, just pay up.
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Old 07.09.2014, 23:24
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Re: Choosing Insurance: What does healthcare cost?

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... I'm just not sure I want to pay an extra 1800 CHF per year for a premium supplemental insurance with all sorts of bells and whistles that I don't need, but which has one or two small options I might actually want in the event of an unlikely emergency.
The basis of basic Swiss health insurance (compulsory) is solidarity - people with few illnesses pay as high or low a premium as people with many illnesses, if they are within the same age bracket, live in the same city/vicinity and choose the same insurance model. This way, people pay for each other in a way.

Supplementary health insurance is just that - supplementary (noncompulsory) security. If you want to be sure that you have the possibility to choose doctors/rooms/care etc. in the case that you should you fall ill, take out supplemental insurance.

If you can live without that security and the fact that (I think) some hospitals do not offer the possibility of upgrading your care on a case by case basis, don't go for supplementary insurance and ask if you can pay extra when you fall ill. If you definitely want the "bells and whistles" when worst comes to worst, pay for them.

Also know that all insurances have to cover your basic insurance costs, but they are not obliged to accept you for supplementary insurance.
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Old 07.09.2014, 23:27
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Re: Choosing Insurance: What does healthcare cost?

Okay, maybe I'm not being clear.

(But it would also help if the non-newbies would understand that not every newbie insurance question is easily solved by a link to comparis.)

I understand that I have to buy compulsory insurance. I have no problem with that and want to do at least that minimum. I'm wondering what additional coverage to buy.

My problem is that I've never used the Swiss health system before. Which means a) I don't know how much medical care costs in Switzerland
and b) I don't know if I am allowed to pay cash for any extras that I want to opt for above and beyond the insured care.

This information will dramatically affect which supplemental policies I buy.

Edit: Just to add that many other countries with dual compulsory/supplemental insurance programs allow you to pay cash for such upgrades, so the question isn't so left field.

Last edited by Tox_Rat; 07.09.2014 at 23:31. Reason: Edited to add text to respond to poster who replied while I was writing.
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Old 07.09.2014, 23:35
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Re: Choosing Insurance: What does healthcare cost?

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Okay, maybe I'm not being clear.

(But it would also help if the non-newbies would understand that not every newbie insurance question is easily solved by a link to comparis.)

I understand that I have to buy compulsory insurance. I have no problem with that and want to do at least that minimum. I'm wondering what additional coverage to buy.

My problem is that I've never used the Swiss health system before. Which means a) I don't know how much medical care costs in Switzerland
and b) I don't know if I am allowed to pay cash for any extras that I want to opt for above and beyond the insured care.

This information will dramatically affect which supplemental policies I buy.
Your choosing Halbprivat(semi-private) or Privat(private) supp. insurance will depend on the level of comfort you want in a hospital - this comparis link shows the different options you can take out.

When you are clear about which options you would like, you could call up some insurance companies and ask them to provide you with info regarding their supplemental insurance offers (in English so that you can understand best). I'd sit down and compare the offers, then apply with the insurance which I deem best.
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Old 08.09.2014, 00:47
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Re: Choosing Insurance: What does healthcare cost?

I think the OP would like to have a feeling of the actual prices (from a simple visit to family doctor to a private bed in the hospital).
Since I have not been to a doctor in Switzerland yet, I would also be interested.
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Old 08.09.2014, 04:29
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Re: Choosing Insurance: What does healthcare cost?

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So at no point in the Swiss health system is there ever an opportunity to pay cash for any medical care?
As with everything in Switzerland: it depends.

Some insurers offer a type of 'flex' plan within the supplemental insurance, where one is insured only at the basic hospital level, but one pays for a relatively inexpensive supplemental plan and then has the choice to 'upgrade' per event at your cost.


Now, as this is supplemental insurance it is offered at the insurer's discretion, and will likely be denied if you are older or have any pre-existing conditions.

Additionally, the ability to upgrade for any particular treatment is at the hospital's discretion, subject to availability.

Make sure you understand the finances - when I looked into it, IIRC the flex policy cost something like CHF 80 per month, but the cost of the upgrade for each event would have been IIRC in the 4-5000 range. (I looked into it because the insurer contacted me with an offer for this flex insurance 'as they thought it would fit my profile'. I applied but was ultimately turned down because of age/health history. This was some years ago, and I believe that the specifics of the plans offered have since changed.)

---

Caveat: the following is based on my experience at local hospitals. As we have seen on countless threads on the subject - YMMV, likely significantly so. I would imagine that each hospital would function differently, and you will need to check with those in your area/canton. With this caveat in mind:

Outside of the insurance framework, one might be able to pay out of pocket for upgrades to a better room - but again, this is at the discretion of the hospital. And be aware that even when you book this ahead a private or semi private patient might take precedence. You may find yourself still in the general ward if availability is limited, despite booking the upgrade.

The hospitals in my area seem to hold to the policy that senior physicians only see semi or private patients. I wanted to 'upgrade' for a surgical procedure, as I wanted a surgeon who had a good reputation with this particular procedure. Unfortunately paying an upgrade fee on top of the basic insurance was only allowed for accommodation, not for medical treatment.

One might, however, be able pay the whole thing out of pocket, essentially becoming a private-pay patient outside the insurance system. But be aware of the costs, be aware that you likely have to pay a large deposit upfront. Make sure you get a cost estimate before deciding to go this route.

Again - other posters at other hospitals in other cantons have not encountered this limit on experienced doctors attending a patient with only basic insurance. Make sure you understand the hospitals in your area.

Last edited by meloncollie; 08.09.2014 at 09:40.
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Old 08.09.2014, 09:13
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Re: Choosing Insurance: What does healthcare cost?

About the actual costs of health care:

I'm on an insurance where I'm receiving and paying my medical bills before my insurance then reimburses whatever exceeds the deductible so I know the actual cost.

I'll give some examples of healthcare costs, both illness and accident.

Routine gyno visits: between 110-150 per visit. On top of this typically 15-20 chf for the lab per visit (they process the pap smears).

Injured hand (fall accident): 320 chf at notfall klinik for 2 x xrays and examination - had this drill done twice as the hand didn't heal as desired, so around 650 in total. Then MRI image of same hand: 550 chf, plus 150 for the follow up consultation with the doctor. (Turns out the hand was broken and the x-ray didn't reveal the fracture.)

I'd say visits with my GP run about 100-120 chf per visit but can be more depending. A specific example of this, I had blood taken twice by my GP to check my iron levels and another couple of levels of vitamins. Lab costs were around 220 plus 120 for the GP.

Hopefully this helps.
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Old 08.09.2014, 10:19
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Re: Choosing Insurance: What does healthcare cost?

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About the actual costs of health care:

I'm on an insurance where I'm receiving and paying my medical bills before my insurance then reimburses whatever exceeds the deductible so I know the actual cost.

I'll give some examples of healthcare costs, both illness and accident.

Routine gyno visits: between 110-150 per visit. On top of this typically 15-20 chf for the lab per visit (they process the pap smears).

Injured hand (fall accident): 320 chf at notfall klinik for 2 x xrays and examination - had this drill done twice as the hand didn't heal as desired, so around 650 in total. Then MRI image of same hand: 550 chf, plus 150 for the follow up consultation with the doctor. (Turns out the hand was broken and the x-ray didn't reveal the fracture.)

I'd say visits with my GP run about 100-120 chf per visit but can be more depending. A specific example of this, I had blood taken twice by my GP to check my iron levels and another couple of levels of vitamins. Lab costs were around 220 plus 120 for the GP.

Hopefully this helps.
So these are your out-of-pocket costs, it seems. What portion of these were then covered by your insurance? Thanks.
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Old 08.09.2014, 10:24
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Re: Choosing Insurance: What does healthcare cost?

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About the actual costs of health care:

I'm on an insurance where I'm receiving and paying my medical bills before my insurance then reimburses whatever exceeds the deductible so I know the actual cost.
That's tiers garant, the opposite (where the insurance pays the doctor/hospital directly and then bills the insured person) is tiers payant. See here

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So these are your out-of-pocket costs, it seems. What portion of these were then covered by your insurance? Thanks.
Whatever exceeds the chosen deductible/franchise of CHF 300/500/1000? a year plus 10% of the billed costs (coinsurance/Selbstbehalt, up to 700.- a year). See in glossary linked above, especially here.
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Old 08.09.2014, 11:00
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Re: Choosing Insurance: What does healthcare cost?

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Your choosing Halbprivat(semi-private) or Privat(private) supp. insurance will depend on the level of comfort you want in a hospital
A strongly disagree.

Halbprivat(semi-private) or Privat(private) is MUCH more than the level of comfort. Much more important is the level of attention (read what doctors) you receive.
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Old 08.09.2014, 11:04
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Re: Choosing Insurance: What does healthcare cost?

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A strongly disagree.

Halbprivat(semi-private) or Privat(private) is MUCH more than the level of comfort. Much more important is the level of attention (read what doctors) you receive.
Um, did I say anywhere that "comfort" doesn't include doctor's treatment?

Here: "Supplementary health insurance is just that - supplementary (noncompulsory) security. If you want to be sure that you have the possibility to choose doctors/rooms/care etc. in the case that you should you fall ill, take out supplemental insurance." (taken from my previous post in this thread)
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Old 08.09.2014, 13:24
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Re: Choosing Insurance: What does healthcare cost?

I spoke to a orthopedic surgeon a year or so ago about a knee replacement. He only operates in a private clinic and I would have to pay the amount not covered by the compulsory insurance. He estimated around 10K for my part, but I don't know how much the compulsory insurance would cover. I decided not to have the surgery quite yet, and I didn't like him as a doctor. Moreover, I'd rather not have surgery in a private clinic. In case of an emergency, you're better off in a hospital with all sorts of technology - my opinion, however.

I have only the required insurance, I have private docs for everything, and perhaps because I've lived in Bern and Zurich, I've not seen any degredation of service.

I did spend one night in a hospital in 2010 for a lumpectomy (breast surgery). Everything together was about chf 6000 - on compulsory - I paid 10%.

Visits to my GP run between chf 100 and 200, of which I pay 10% Visits to my gyn, dermatologist, oncologist run chf 150 to 250, plus whatever the cost of the procedure. Those costs can range from an additional 100-200 for imaging or x-rays, blood tests, and more depending on administration of any other treatments. I pay 10%. My husband had an in-office colonoscopy in Bern, that was about chf 1400 including all the meds. Again, we paid 10%

I can also tell you that 36 treatments of radiation to the chest were about chf 17,000 in 2011 - I'd paid my chf 700 by that time.

Cataract surgery (several repeated visits) ran about 2500.

Everything that I've related is paid through the compulsory insurance. I suppose semi private is helpful. If I could get supplemental, I'd get eye stuff - glasses are outrageously expensive here.

And I think you can get upgrades - for hospitalization. But like everything it depends on the Kanton, hospital, procedure and physician. Some hospital floors have nothing but private and semi private rooms and so it doesn't seem to matter.
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Old 08.09.2014, 13:55
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Re: Choosing Insurance: What does healthcare cost?

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I have only the required insurance, I have private docs for everything, and perhaps because I've lived in Bern and Zurich, I've not seen any degredation of service.

That's a very valid point. Choosing the doctors you see can consistently do the job you want (bedside manner, effectiveness of treatment etc.) can really influence how much one cares about having required, private or semi-private insurance coverage.

If I could get supplemental, I'd get eye stuff - glasses are outrageously expensive here.

OP, often people are rejected from supplemental insurance due to preexisting health issues. This should be considered as much as the cost of supplemental insurance. Even if you have tons of money, if you're too sick you can be rejected.

And I think you can get upgrades - for hospitalization. But like everything it depends on the Kanton, hospital, procedure and physician. Some hospital floors have nothing but private and semi private rooms and so it doesn't seem to matter.

OP, perhaps you could call the hospitals in your area and ask them about their floors (if they offer upgrades and if they only have single and double rooms? Of course, which hospitals you end up in depends on your illnesses and a trillion other factors.
Very informative
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Old 08.09.2014, 14:50
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Re: Choosing Insurance: What does healthcare cost?

I was recently hospitalized for 9 weeks, total bill was around 15K. That was a single operation followed by 9 weeks of pretty low-key nursing and midwifery care, so probably the low end of the per-diem scale.

Certain upgrades may be available, e.g. I was offered the option to upgrade to a single room (space permitting) for 65/night. That would have been just the room though, none of the other perks associated with private insurance. (FWIW on the doctor-choice issue, my experience - in cantons St. Gallen and GraubŁnden - has been that although you can't choose, as soon as it's established you have something "interesting" or non-routine wrong with you, senior docs will get involved anyway no matter what your level of insurance cover.)

Note that ambulance rides are quite expensive (mine was 2000 for approximately a 1-hour trip) so it's probably worth taking out supplementary insurance to cover those, especially if you live some distance from the nearest major regional hospital. Basic insurance only pays half, and even that half is subject to your yearly deductible.
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Old 08.09.2014, 15:09
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Re: Choosing Insurance: What does healthcare cost?

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Note that ambulance rides are quite expensive (mine was 2000 for approximately a 1-hour trip) so it's probably worth taking out supplementary insurance to cover those, especially if you live some distance from the nearest major regional hospital. Basic insurance only pays half, and even that half is subject to your yearly deductible.
And I believe that there is a maximum amount per year (500chf) that the basic insurance will contribute towards ambulance costs. ( unless it's as a result if an accident in which case the accident insurance reimburses the ambulance costs.)
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Old 08.09.2014, 15:22
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Re: Choosing Insurance: What does healthcare cost?

As others have said, costs and experiences will vary depending on where you live. At this point I would not get caught up in the minutiae of how much a doctor's visit would cost. Your out-of-pocket for the year is capped anyway. So you're looking at a minimum of just premium payments, a middle ground of premiums plus some level of your franchise, and a maximum of premiums plus full franchise plus 10% of everything else (up to 700 CHF).

Instead, IMO you're really looking at a few basic decisions:

1. Which type of plan works best for you? Only you can decide what works for you with respect to these questions.
- Do they communicate in English if you want?
- Do they handle payment or do you submit for reimbursement?
- Do you need to call a hotline before going to see the doc?

2. What deductible/franchise should you choose for your mandatory coverage?
- If you go to the doctor all the time or have underlying medical issues that need attention, opt for the lower deductible (therefore higher premium).
- If you're generally healthy, you'll save money in the long run by opting for the higher deductible (lower premium).
- The difference between these two is not dramatic, but if you're generally healthy why not save a few bucks?

3. Basic only, half-private, or private?
- You will do fine and still receive good care with basic only.
- The best time to qualify for half-private or private is when you don't need it. After you've got underlying medical conditions the odds of getting approved are pretty slim.
- MathNut made some very good points. Sometimes you can negotiate with the hospital to pay out-of-pocket for a half-private or private room. There's no guarantee of this, though. If you wind up with anything unusual or high-risk, you'll often get a senior doc anyway.
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Old 09.09.2014, 07:31
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Re: Choosing Insurance: What does healthcare cost?

Thanks to all who posted here, this has been really helpful.
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