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  #401  
Old 07.11.2016, 08:18
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Re: Health Insurance FAQs

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Great thread - thanks.
I am coming to Switzerland from Germany where I had the AOK-Krankenversicherung. I would like to continue with this type of insurance - could anyone say what the nearest Swiss equivalent of the AOK is?
Quick answer - there isn't. There is no government-run health insurance in Switzerland.
Swiss health insurance is broken up into two categories:
a) Basic insurance, which is mandatory. All companies offering basic insurance offer the same coverage. There are typically 20-30 companies offering basic insurance, the number depends on where you live. The costs for basic insurance vary considerably and also on the amount you are prepared to pay yourself (franchise), which can be from 300 to 2500 CHF. See priminfo.ch for premium comparisons. Insurance companies cannot refuse to insure you.
b) Supplementary insurance. This is on a free market, so a bit of a free for all. Companies do not have an obligation to insure you and can (and will) exclude existing conditions. You do not necessarily need to have supplementary and it doesn't need to be with the same company as the basic.
Note that the basic insurance covers all essential conditions. I haven't made a claim (other than glasses) on my supplementary.
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  #402  
Old 07.11.2016, 09:49
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Re: Health Insurance FAQs

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It shouldn't be a problem BUT I have heard that insurance companies have cancelled the supplementary policy once the patient has cancelled the basic policy.

Then the new insurance company refuses any supplementary insurance, so the patient is left with only the basic.

Maybe a good idea to find the supplementary insurance before cancelling the basic?

The other policies within CSS will not have increased by 17% you could lower your optional level, or take on an HMO /Telmed policy.
.
Cancellations of supplementary because you switch basic insurance did happen indeed, but that's no longer allowed. What may happen instead these days is, you get a rebate on your supplementary removed if you move basic insurance.
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  #403  
Old 08.11.2016, 18:40
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Re: Health Insurance FAQs

So....
I really just want health insurance as it is a legal obligation I have to. I've never been to a doctor in switzerland. If I ever got sick I'd go back to the UK.

That being said though it is good to be marginly covered just in case....

Compact telemed- will I die on hold for some French only phone line?
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  #404  
Old 08.11.2016, 19:53
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Re: Health Insurance FAQs

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So....
I really just want health insurance as it is a legal obligation I have to. I've never been to a doctor in switzerland. If I ever got sick I'd go back to the UK.

That being said though it is good to be marginly covered just in case....

Compact telemed- will I die on hold for some French only phone line?
Yes, probably if you don't speak French. Some companies may have people who speak English in their communications centre, but probably not all. So check and find out first before getting your policy.

You do realise that as you're no longer technically a resident in the UK that free NHS isn't available to you any more. You should pay for any doctor's visits and in an emergency you'd need to use your EHIC card which you'll get from your Swiss health insurer.
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  #405  
Old 06.04.2017, 17:18
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Re: Health Insurance FAQs

So having read through the FAQ - one further question.

Is anyone aware of a (or more than one?) insurance company that speaks English? Meaning policy documents, claim forms, contacts, etc are in English?
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  #406  
Old 06.04.2017, 18:27
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Re: Health Insurance FAQs

SWICA and Group Mutuel were mentioned in the thread as doing most stuff in English, but that was back in 2014. Whether that would include phone/e-mail contact you'd have to check.
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  #407  
Old 06.04.2017, 19:27
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Re: Health Insurance FAQs

Sympany has everything in english if you requested plus a nice app.
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  #408  
Old 07.04.2017, 12:30
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Re: Health Insurance FAQs

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So having read through the FAQ - one further question.

Is anyone aware of a (or more than one?) insurance company that speaks English? Meaning policy documents, claim forms, contacts, etc are in English?
The majority of companies have at least something in English (website, application forms, English speakers on the phone, brochures etc.).
Not every company has English set up as an actual correspondence language though.

As mentioned further up in the thread - Groupe Mutuel, Swica and others have English as a correspondence language option.
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  #409  
Old 11.04.2017, 09:24
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Re: Health Insurance FAQs

Thanks - but I think I'm good, got four quotes (three from comparis and one from a company that has discounts for my employer). Emailed all of them and asked them to confirm that they could offer all documents and contact in English.

Two replied by email, and two called me to confirm that. I've asked them to confirm in writing (yes, I'm that paranoid).
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  #410  
Old 25.05.2017, 02:52
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Re: Health Insurance FAQs

Hi all,

I've been in Switzerland for almost one month now and need to decide on the health insurance. I wonder if it's best to use the same insurance company as my Swiss fiance (he's insured with Concordia)? Would there be any complications if I use a different provider, considering we will want kids later?

Thanks.
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  #411  
Old 25.05.2017, 07:43
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Re: Health Insurance FAQs

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Hi all,

I've been in Switzerland for almost one month now and need to decide on the health insurance. I wonder if it's best to use the same insurance company as my Swiss fiance (he's insured with Concordia)? Would there be any complications if I use a different provider, considering we will want kids later?

Thanks.
Not at all, it will make no difference. It would make sense to insure kids with the same insurer as one of the parents just to avoid dealing with three different companies but it's not essential.
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  #412  
Old 25.05.2017, 08:18
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Re: Health Insurance FAQs

You might want to play around with www.comparis.ch (change the language setting at the bottom of the page for English, French or Italian) to see if being insured as a couple gives a bit better value or not, but otherwise it's up to you. I would just make sure that whatever company you pick, they will pay doctors/hospitals directly and then bill you after for your share rather than you having to pay everything first and then claim it back.
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  #413  
Old 25.05.2017, 09:08
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Re: Health Insurance FAQs

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You might want to play around with www.comparis.ch (change the language setting at the bottom of the page for English, French or Italian) to see if being insured as a couple gives a bit better value or not, but otherwise it's up to you. I would just make sure that whatever company you pick, they will pay doctors/hospitals directly and then bill you after for your share rather than you having to pay everything first and then claim it back.
Whether insurers will pay first and bill you depends on the kanton as well as the company, and the particular type of doctor so it may be out of your control to some extent.
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  #414  
Old 25.05.2017, 10:00
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Re: Health Insurance FAQs

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You might want to play around with www.comparis.ch (change the language setting at the bottom of the page for English, French or Italian) to see if being insured as a couple gives a bit better value or not, but otherwise it's up to you. I would just make sure that whatever company you pick, they will pay doctors/hospitals directly and then bill you after for your share rather than you having to pay everything first and then claim it back.
For basic insurance there are no advantages to being insured as a couple but there may be some reductions for complimentary insurance if they decide to take that.

As for the billing situation as edot says there are a lot of factors coming into play. Our insurers will pay the doctors directly if they bill them and the pharmacy bills go directly to them but many doctors bill the patient directly and the patient has to reclaim the costs and this depends on the doctor rather than the insurance company.
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  #415  
Old 01.06.2017, 15:41
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Re: Health Insurance FAQs

I just wanted to add some pieces of information that might complement this already great Q&A:

Franchise + “Selbstbehalt”/ participation aux coûts:

Note that you have three costs for your health insurance: your monthly rates (regular sum each month, depending on the deductible/franchise you picked – Prämien in German or Primes in French); your franchise/deductible: the higher the franchise (I think CHF2500 is the highest), the lower your monthly rates will be, but it means that your insurance will not cover costs until you have paid your first CHF2500 out of pocket. Then there is an additional cost: the Selbstbehalt. This is confusing as the online translation is also deductible or excess: once you have paid your franchise amount out of pocket, you still need to pay 10% of the remaining costs, up to CHF700 per year as your "cost participation". So, this means that in effect, you continue paying 10% of each bill until you have paid your Selbstbehalt/cost participation amount. So as an example: you pay a monthly rate of 300 with a franchise of 2500, and you have medical costs worth of 5000 that year, the insurance will cover only the 5000 – 2500 – 700 = 1800, you pay the rest (and your monthly payments don´t count towards this either). The first year I had huge medical bills I assumed they would cover anything beyond my franchise value, but I was in for a surprise. The fun part of this Selbstbehalt is also that you can get bills and paperwork for anything from CHF 2.5 – 10!

Travel insurance:

As mentioned above, if you are independent or your employer does not provide an accident insurance, you can (actually, have to!) take one out through your health insurance. The costs are reasonable per month, and in principle it also covers accidents abroad. And this being Switzerland, you have to take one out in Switzerland, despite there being perfectly good value international insurances available. But beware if you are travelling to countries where health/accident costs are very expensive: I found out just before going to the US that Assura covers only double the costs covered in Switzerland. Rather than risk sitting there with a calculator in the case of an accident, I ended up taking a second international travel insurance that covered 100% of treatment costs.

Medical bills:

Itemised bills:
The health insurance law states that the provider (ie the doctor, lab or hospital) needs to send the patient a detailed copy of the bill. Most smaller practices and labs do this automatically when they send you a bill. Hospitals usually send their bills to the insurers, who in turn send you a bill, but this is only the amount and date of treatment, no further details; at the same time hospitals should send you a detailed copy for your information. Despite the law, I have dealt with three cantons and only in one did the hospital proactively send these to me. With the rest, I had to “set up an alert” in their system as a patient who wanted to receive copies.

Please review your bills!
Why does it pay to look at these bills? Because in the form of errors I would have ended up paying around CHF500 extra over three years and another CHF1000 for not chasing a double payment; errors have ranged from an ultrasound and X-ray that I never had, explanations given before an intervention (never had one planned) and a demonstration on how to use equipment and provide care (for a session where I just sat at a doctor´s desk). The bill format is a nightmare, but if you search online for the code (third column), there are usually explanations for what is understood under these. Sometimes getting bills adjusted takes a longer fight, sometimes it is just a phone call and they will send out a new one. If you read French, here is a link on how to read bills:
https://www.monsieur-sante.ch/fr/2013/02/21/facture-du-medecin-un-vrai-casse-tete-le-tarmed-demystifie/
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  #416  
Old 01.06.2017, 16:17
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Re: Health Insurance FAQs

Travel insurance - nonsense. You're not obliged to get travel insurance via your Swiss health provider at all. I bought mine for a trip to the US last year from a completely different company, not even based here. Accident insurance yes, that should be added to your health insurance cover if you're self-employed or don't work, but not travel insurance.

As far as I know all Swiss insurers only cover up to double the amount of Swiss costs for countries outside the EU. Given that 30+ years ago the advice for the US was coverage of at least a million, you definitely need to have additional cover if travelling there.
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  #417  
Old 01.06.2017, 17:20
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Re: Health Insurance FAQs

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Travel insurance - nonsense. You're not obliged to get travel insurance via your Swiss health provider at all. I bought mine for a trip to the US last year from a completely different company, not even based here. Accident insurance yes, that should be added to your health insurance cover if you're self-employed or don't work, but not travel insurance.

As far as I know all Swiss insurers only cover up to double the amount of Swiss costs for countries outside the EU. Given that 30+ years ago the advice for the US was coverage of at least a million, you definitely need to have additional cover if travelling there.

Yes, Medea Fleecestealer, you are fully right, I stand corrected, my Freudian slip, apologies: accident insurance. This all came to light as I was travelling and was asking about coverage in the case of an accident abroad, specifically in the US where I was going. I ended up taking an additional travel insurance (which you can get wherever, as you say) to make sure this limitation of the accident insurance was covered too. My point is that now I have a good international travel insurance that covers 100% of any accident costs, but still have to have the Swiss accident insurance, which is compulsory.
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  #418  
Old 01.06.2017, 19:54
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Re: Health Insurance FAQs

Travel insurance wouldl not cover you in Switzerland because you're a resident here, it's only for tourists.
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  #419  
Old 02.06.2017, 10:00
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Re: Health Insurance FAQs



True, but this is the first country of 5 where my health insurance has not covered accidents. Effectively, I have three insurances here: my health insurance, my accident insurance and an additional international travel insurance (see point below about Mobiliar Swiss travel insurance). Elsewhere I have needed only a health insurance for in country and a travel insurance that covers accidents/health abroad. My Swiss accident insurance allegedly covers accidents abroad, but if you ask they will tell you it only covers double the cost of treatment in Switzerland (I´m not sure about drugs/treatments not approved in Switzerland, this could be another issue). If you read the small print of Mobiliar travel insurance for example, it says it will cover drugs and repatriation, but only CHF4000 treatment costs, as it assumes the Swiss accident insurance kicks in if you are hospitalized abroad.


So back to my point: you will need an accident insurance in Switzerland as it is compulsory; they will say this covers accidents abroad. Please check this – there is a limit to how much this will cover and so you might need additional travel insurance that also covers accident costs, even if you are not interested in the usual travel insurance benefits like flight cancellation or lost luggage reimbursements. I have met a number of people happily travelling on the Swiss accident insurance and they are not aware of the coverage limit.

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  #420  
Old 23.10.2017, 00:49
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Re: Health Insurance FAQs

"Accident Insurance"
The insured person has ordered insurance together with Accident insurance. And he/she starts to work and the employer starts to pay this Accident Insirance, but money has been paid already by this person.
1. Is it possible to refund the prepaid money for this Accident Insurance?
2. Is it possible to update the insurance and stop to pay for this Accident Insurance?

Details:
I'm preparing new Insurance for my wife (Assura, Ärztenetzwerk). She doesn't work now, so I'm ordering insurance with Accident Insurance.
Assura has a discount if I pay full 1 year in January (I save approx 56 CHF per year). So, I want to pay a full 2018 year together in January.
For example, my wife finds the work in February. The accident insurance is already paid by us for full year, and an employer also pays this money?
What I can do? to ask money refund from Assura? Or just forget about this money (approx.180 CHF per 11 months)?

Or I just should pay monthly and to ask insurance contract's update as soon as conditions are changed?
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