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-   -   Humira (https://www.englishforum.ch/insurance/264537-humira.html)

ficozver 04.01.2017 05:18

I'm going to work in Geneva in Switzerland,for a longer period of time (about more than a year).I have a pre-existing condition Ankylosing spondylitis,and I need to get a medication monthly (Humira) which is fairly expensive(1000 $ per month).Will any insurance cover this and which one should I get ? Thanks everyone

Merci :D

heckenhocker 04.01.2017 06:05

Re: Humira
Humira is covered by the basic insurance under certain conditions for Rheumatoide Arthritis - polyartikuläre juvenile Arthritis - Psoriasis-Arthritis - Morbus Bechterew ( Ankylosierende Spondylitis) - Crohns Disease - Ulcerative Colitis

Ankylosierende Spondylitis is only covered if previous conventional treatments were not successful.

The treating specialist has to submit a request to the insurance company for the OK.

Info here (in German)....I guess there's a French version somewhere

Our experience with the "request" process is very positive. Mr HH is currently on his third expensive chemotherapy and all requests have been quickly approved.

I suggest you get a letter from your current doctor outlining the history of treatment and the reasons you are on Humira rather than whatever "conventional" treatments are. Then your doctor in Geneva can use that to submit with the request.

Medea Fleecestealer 04.01.2017 08:17

Re: Humira
Yeah, under the Français version. ;)


Guest 04.01.2017 11:55

Re: Humira
I have basic insurance and this was covered for me. It's 730CHF a pop here (the self injecting model).

The specialist first cleared it with my insurance company, once it was confirmed that they would support this I was ok to start ordering this (and you do have to order it well ahead of time, and get a few in at a time).

Mine though wasn't a pre-existing illness, but a new diagnosis. I presume there would be a cost implication on your insurance payments.

Medea Fleecestealer 04.01.2017 13:12

Re: Humira
I would advise when arranging your Swiss health insurance to go for a lower franchise and accept higher premiums. The franchises range from CHF300 up to CHF2,500 and this is the amount you have to pay first before the insurance kicks in. With a pre-existing condition such as this I'd advise either the 300 or 500 option. That would be all you have to pay before the insurance starts to cover the medical bills. After that you pay 10% of the next 7,000 costs, the insurance covers the rest and if it goes beyond that you pay nothing, the insurance covers it all. These are annual figures so each January would start a new cycle of payments.

Also make sure the insurance company is one where all invoices are sent directly to them - doctors, hospitals, etc - and then they will bill you for what you owe them. Otherwise you could still end up having to pay the invoice first and then sending it to the insurance company to claim back.

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