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  #321  
Old 18.06.2015, 16:43
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Re: Health Insurance FAQs

Is supplementary insurance providing access to a better treatments (newer, less invasive, more effective, etc...) then the mandatory one? ...or it is all about stuff like private room, access to hospital outside your canton, massage, homeopathy, transportation insurance?

Sorry if the question has been already answered but I couldn't find it.
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  #322  
Old 18.06.2015, 19:32
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Re: Health Insurance FAQs

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Is supplementary insurance providing access to a better treatments (newer, less invasive, more effective, etc...) then the mandatory one? ...or it is all about stuff like private room, access to hospital outside your canton, massage, homeopathy, transportation insurance?



Sorry if the question has been already answered but I couldn't find it.

In my experience it's the latter, but others may have different opinions.
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  #323  
Old 18.06.2015, 20:29
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Re: Health Insurance FAQs

They may cover "newer" treatment which has not yet been approved by the Swiss health insurance law. Read the general insurance conditions carefully if you are concerned.

However it also depends very much on the kind of supplementary insurance that you receive. In my experience you are generally treated better if you have semi-private/private insurance.
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  #324  
Old 19.06.2015, 09:40
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Re: Health Insurance FAQs

It's mainly to top up your treatment plans, like homeopathie, private room, etc. Some insurers offer a hospital flex plan, which means you can make a choice if you wish private or general ward, for a cheaper premium. Also some insurers pay towards your fitness abo. Do check very well how much your monthly premium will be, against how much you get back. Part reimbursement for glasses, lensens and even dentist are possible with some insurers. And yes, I work for a health insurer, and no, not here to sell

What does surprise me is that many people take the additional insurance cover and don't send any claims under those covers. Why pay for them I often question
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  #325  
Old 19.06.2015, 11:25
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Re: Health Insurance FAQs

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It's mainly to top up your treatment plans, like homeopathie, private room, etc. Some insurers offer a hospital flex plan, which means you can make a choice if you wish private or general ward, for a cheaper premium. Also some insurers pay towards your fitness abo. Do check very well how much your monthly premium will be, against how much you get back. Part reimbursement for glasses, lensens and even dentist are possible with some insurers. And yes, I work for a health insurer, and no, not here to sell

What does surprise me is that many people take the additional insurance cover and don't send any claims under those covers. Why pay for them I often question
Hi there! I have a question for you. My wife and I are planning to get pregnant in the next year after we get covered by insurance for maternity. We are looking at getting all the nice complimentary stuff but we are confused which franchise to get for basic insurance. She is not a sickly person but how about the pregnancy? Should we get 2500 or 300?
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  #326  
Old 19.06.2015, 11:35
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Re: Health Insurance FAQs

Hi jesuisuntouriste,
We (and I expect all other insurance companies) have a waiting period of one year for using the hospital benefits (private or semi-private) in case of pregnancy when taking out additional cover.

Benefits (co-payment) related to pregnancy are covered from the 13th week under the basic insurance until 8 weeks after confinement.

I always recommend people to take the highest or lowest franchise, the ones in between are just more costly. Don't forget you can only change the franchise once a year, as per 01.01.
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  #327  
Old 19.06.2015, 11:52
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Re: Health Insurance FAQs

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Should we get 2500 or 300?
From pure pregnancy perspective and basic insurance you should take 2500 as there is no franchise for pregnancy related expenses (i.e. the insurance company covers it from the first CHF you have spent, no matter on your franchise)
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  #328  
Old 19.06.2015, 13:39
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Re: Health Insurance FAQs

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Is supplementary insurance providing access to a better treatments (newer, less invasive, more effective, etc...) then the mandatory one? ...or it is all about stuff like private room, access to hospital outside your canton, massage, homeopathy, transportation insurance?

Sorry if the question has been already answered but I couldn't find it.
The supplementary insurance covers things that the basic insurance doesn't cover at all (e.g. homeopathy, osteopathy etc.) or completes the cover that the basic insurance doesn't cover "enough" (subjective, I know).
e.g. hospitals - Basic insurance = only fully covers public hospitals in your canton of residence
Supplementary insurance = public hospitals in the whole of Switzerland or semi-private/private hospitalisation depending on the level you opt for.

Transport costs is the other with the basic insurance only covering 50% of transport costs up to 500CHF. The amount the supplementary would cover depends on the company but you can generally easily get cover up to 10/20'000 or more.
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  #329  
Old 19.06.2015, 13:44
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Re: Health Insurance FAQs

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We are looking at getting all the nice complimentary stuff but we are confused which franchise to get for basic insurance. She is not a sickly person but how about the pregnancy? Should we get 2500 or 300?
The earlier response is correct - there is no franchise/deductible/excess on any bills that are directly maternity related.
N.B. That is directly maternity related.

That means that, say you get a cold or fall ill indirectly because of the pregnancy (changing hormones etc.), any treatment would be subjected to the deductible even though you could argue that you only became ill because of the pregnancy.

It's not easy to talk/think about but, you should also be aware that any costs arising from a miscarriage are considered "illness" and therefore subjected to the deductible. Scandalous, I know.
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  #330  
Old 19.06.2015, 14:30
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Re: Health Insurance FAQs

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planning to get pregnant in the next year after we get covered by insurance for maternity
BTW The supplementary insurance is usually (in case everything goes fine and your wife don't need to spend time in hospital) not needed and useful until the delivery time so it is fine to get pregnant during waiting time as long as the birth itself will be given after it is over.
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  #331  
Old 19.06.2015, 19:30
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Re: Health Insurance FAQs

Thanks everyone for all the help!
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  #332  
Old 16.09.2015, 22:01
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Re: Health Insurance FAQs

I wish I could do without insurance altogether but I found a family doctor one which is a lot cheaper.
Is this open to non swiss people? How does one "sign up" with a family doctor?
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  #333  
Old 17.09.2015, 14:04
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Re: Health Insurance FAQs

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I wish I could do without insurance altogether but I found a family doctor one which is a lot cheaper.
Is this open to non swiss people? How does one "sign up" with a family doctor?
Yes, I'm sure we could all do without insurance! Unfortunately doctors and hospitals cost a lot of money and the Swiss LAMal/KVG system is a system based on solidarity. This is true of most countries to be fair.
As long as you are a resident in Switzerland, all options are open to everyone.
If you wish to change company/method of insurance, you should contact the company you wish to go with or else contact a broker who has dealings with that insurance company.
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  #334  
Old 23.09.2015, 13:44
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Re: Health Insurance FAQs

Re: Health Insurance FAQs
Hello everyone!
It's my first post here even though I have consulted the forum many many times and it has solved me lots of questions

I am in the process of cancelling my supplementary insurance (KZV) with Helsana since the deadline is September 30th. I was reading the General Insurance Conditions (AVB) and I'm struggling with this section:

10.3 " After each claim for which the insurer must render a payment, the policyholder can cancel the relevant insurance policy within 14 days following payment of the claim amount or from the corresponding date of notification. The insurance cover expires 14 days after the receipt of this notification by the insurer."

German version
"10.3 Nach jedem Schadenfall, für den der Versicherer eine Leistung erbringen muss, kann der Versicherungsnehmer innert 14 Tagen seit Auszahlung der Entschädigung oder seit entsprechender Kenntnisnahme die betroffene Versicherung kündigen. Die Versicherungsdeckung erlischt 14 Tage nach dem Eintreffen dieser Mitteilung beim Versicherer.
"

So if I get correctly, I can quit the insurance in the next 14 days after receiving a payment ...But then my insurance is cancelled in the next 14 days .

So since I need to send the letter max. by September 30, I will be out of my supplementary insurance from mid October...But then I still have to pay supplementary insurance until December 31 which is the cancellation date ...Am I missing something?

Thanks in advance for your answer!
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  #335  
Old 23.09.2015, 15:07
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Re: Health Insurance FAQs

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Re: Health Insurance FAQs
Hello everyone!
It's my first post here even though I have consulted the forum many many times and it has solved me lots of questions

I am in the process of cancelling my supplementary insurance (KZV) with Helsana since the deadline is September 30th. I was reading the General Insurance Conditions (AVB) and I'm struggling with this section:

10.3 " After each claim for which the insurer must render a payment, the policyholder can cancel the relevant insurance policy within 14 days following payment of the claim amount or from the corresponding date of notification. The insurance cover expires 14 days after the receipt of this notification by the insurer."


So if I get correctly, I can quit the insurance in the next 14 days after receiving a payment ...But then my insurance is cancelled in the next 14 days .

So since I need to send the letter max. by September 30, I will be out of my supplementary insurance from mid October...But then I still have to pay supplementary insurance until December 31 which is the cancellation date ...Am I missing something?

Thanks in advance for your answer!
No there's been a bit of confusion in what you've read.

There are several ways of cancelling supplementary insurance.
Supplementary health insurance is governed by the LCA/VVG law therefore the following is also true for liability, contents, car insurance etc.

You can cancel LCA contracts in one of the following ways :

- 3 months before the end of the contract
- if there is a change in premium (increase/decrease)
- if you make a claim and there is a reimbursement, you have the right to cancel within x number of days.
In your above example, this is within 14 days. With some companies it's 10, some 14, some 2 weeks etc. etc.

Therefore, you can cancel your supplementary insurance in any of the above ways.
If you send them a registered letter by the 30th of September, it will be cancelled for the 31st of December as long as that is the end of the contract.

Hope that explains it?
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  #336  
Old 23.09.2015, 18:17
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Re: Health Insurance FAQs

Wow, that's was fast! Everything is clear now, I was mixing up options 1 and 3.

Thank you so much Jenny

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No there's been a bit of confusion in what you've read.

There are several ways of cancelling supplementary insurance.
Supplementary health insurance is governed by the LCA/VVG law therefore the following is also true for liability, contents, car insurance etc.

You can cancel LCA contracts in one of the following ways :

- 3 months before the end of the contract
- if there is a change in premium (increase/decrease)
- if you make a claim and there is a reimbursement, you have the right to cancel within x number of days.
In your above example, this is within 14 days. With some companies it's 10, some 14, some 2 weeks etc. etc.

Therefore, you can cancel your supplementary insurance in any of the above ways.
If you send them a registered letter by the 30th of September, it will be cancelled for the 31st of December as long as that is the end of the contract.

Hope that explains it?
It explains e
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  #337  
Old 27.10.2015, 08:39
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Re: Health Insurance FAQs

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HMO (Health Maintenance Organisation)

HMO is a health insurance model. The policyholder is required to consult a certain physician practising in an HMO centre, if he falls ill. This doctor is called a "gatekeeper". Emergencies are exceptions to this rule.

The HMO doctor is paid a flat monthly rate for all treatment his registered patients might need. This flat rate covers all costs for treatment provided either by himself, by specialists or during a hospital stay.

The gatekeeper principle enables the HMO doctor to coordinate his patients' treatment. The flat rate forces him to restrict treatment to what his patient needs. Thus, superfluous services are no longer lucrative. HMO premiums are up to 25% lower than traditional basic health insurance rates for the same extent of benefits.
My question is: this may stop over-prescribing, but what reason is there to think that this method doesn't lead to under-prescribing treatment??? What's to stop the doctor keeping what he has been given for you and not ensuring that you get all the treatment you need?

I can see it is going to save me a lot of money going this route, but my expectation is that the level of care is (greatly?) reduced.
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  #338  
Old 28.03.2016, 18:44
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Re: Health Insurance FAQs

there is something I don't get.

Say I am paying 300 CHF per month for my health insurance, with premium of 2500

per year I am paying for my health insurance 3600 CHF.

Let's imagine, as I usual do I get 1 or 2 colds a year and go to the doctor. It would cost me maybe 200 CHF in consultation and medicine.

and... I have to pay that!!!! How is that an insurance, I pay per year 3600, is that not enough to cover the cost of me going twice to the doctor?

Just moved in and really confused by this 'insurance'
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  #339  
Old 28.03.2016, 18:50
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Re: Health Insurance FAQs

The 2500 is not premium but "Selbsterhalt/Franchise" which means generally you pay that amount yourself before your insurance kicks in
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  #340  
Old 28.03.2016, 18:50
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Re: Health Insurance FAQs

Yep you got it. You could of course choose to have a lower franchise (not premium) but that would cost a lot more.

Out of interest, where are you from and what is the health insurance system there like?
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