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Old 14.05.2017, 19:09
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Filing claims with Assura Mondia insurance

I have my health insurance with Assura, including the travel supplementary plan Mondia. Last month I traveled to the United States for a conference and needed health care there. I followed the procedure: called to notify Assura of the incident, paid for the cost out of pocket, and got and brought the medical record with me back to Switzerland. Now I want to file a claim to get a reimbursement for my expenses, apparently within the Mondia plan. This is where I am stuck. I couldn't find a form or instruction for filing such a claim. I know how to file a reimbursement for medical expenses in Switzerland with Assura, but I think medical expenses abroad with Mondia will follow a different procedure. And is there a franchise just like the basic plan? I called to ask Assura but unlike their travel hotline, they didn't speak English at all, while my French is only good for asking names.

I would appreciate any pointer on how to file my claim, or how to find more information.

P.S: I know that Assura is not good, but as a postdoc with a family to support, it's the best option for me.
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Old 14.05.2017, 19:55
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Re: Filing claims with Assura Mondia insurance

To obtain a reimbursement of medical expenses, see the below link.
The last sub-link on the page is allows the policyholder to obtain a form to submit the expenses:

https://fr.assura.ch/assurance-malad...frais-medicaux

https://fr.assura.ch/assurance-malad...-personnalisee
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Old 14.05.2017, 21:11
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Re: Filing claims with Assura Mondia insurance

Not with the same company, but just to share my recent experience about claiming for care in the U.S. while on holiday.

Be sure to keep copies of everything - including bills and receipts. Keep notes on what you send any phone conversations with reps. Keep names, dates, and times.

I needed to send my original bills and receipts to the insurer, not just copies.

Also be aware if you had urgent/emergency care, there might be more bills to come. Often the clinic and the doctor bill separately. In my case, I wound up with bills for the hospital, the doctor that took care of me that day, the radiologist that read the x-ray, and the 3rd party that contracts with the hospital to provide things like crutches.
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Old 14.05.2017, 21:12
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Re: Filing claims with Assura Mondia insurance

As someone who does this activity quite frequently for my young kid, the procedure below has worked well for me all the time:

1) From the first webpage Mullhollander has provided, Go to Formulaires et documents utiles section and click on the "Document vous permettant de lister vos dépenses" link to download a pdf.

2) Enter all the medical expenses in this pdf as per the invoice date and once the total amount of expenses has exceeded your insurance plan's yearly deductible/franchise, you can move forward to the next step.

3) Attach all the original invoices (if you have just one set of originals, take a copy for your records) along with the duly completed pdf from step 2. As suggested in this pdf, don't use staples etc. and keep the documents untied one after another.

4) Download the pdf from the second weblink that Mullhollander has provided and fill-in all the requested details of the policy holder. Once you click submit, you should get a personalised pdf that you need to attach as the first page before the insurance claim documents.

5) Ship all the documents to the address for reimbursement (address is provided in the section Nous envoyer des factures in the first weblink).

6) In a few days time, you should get an email from Assura that your documents have been successfully delivered for processing. The processing could take 3 weeks or so depending on the time of the year that you apply for reimbursement. I hope you have provided the bank account details in your online account for reimbursement.

Hope this helps.
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Old 15.05.2017, 12:06
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Re: Filing claims with Assura Mondia insurance

Thank you so much for your answers and useful information. As far as I understand from the answers, the reimbursement process for medical expenses overseas is the same as for domestic expenses (in CH), and is subject to the same deductible (franchise).

I did go to the ER in the US and had two blood tests. The only bill I had at the hospital was for just $212, but I guess more will come. I heard that the bills will be in the thousands. However, I am leaving Switzerland next month, and not sure how the bills will find me (I have no intention to avoid them).
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Old 15.05.2017, 23:14
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Re: Filing claims with Assura Mondia insurance

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...I did go to the ER in the US and had two blood tests. The only bill I had at the hospital was for just $212, but I guess more will come. I heard that the bills will be in the thousands. However, I am leaving Switzerland next month, and not sure how the bills will find me (I have no intention to avoid them).
Did you provide a U.S. or a Swiss address at the hospital? I used my mom's address because the gals behind the counter didn't seem very confident trying to deal with a foreign address. They did tell me to expect additional bills, although I didn't expect a bill for $33 for a flimsy ankle brace!

Do you have an itemized bill from the hospital? If so maybe the doctor was included but odds are he/she was not. If it was just two blood tests and a doctor I can't imagine you'll pay thousands. Healthcare is expensive in the U.S. but it's not that silly.

If it helps compare, total of all bills for my ankle adventure was about $400 and that includes all docs and stuff mentioned above.

In terms of how the bills get to you, maybe contact the hospital billing department and give them an updated address? Most of the bills I got came within 2 weeks of the main event, but the 3rd party bill for the ankle brace came 1 month after. HTH and hope you're feeling better.
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Old 16.05.2017, 02:12
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Re: Filing claims with Assura Mondia insurance

A happy Assura client here, OT, no experience with Mondia whatsoever.

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As someone who does this activity quite frequently for my young kid, the procedure below has worked well for me all the time:

1) From the first webpage Mullhollander has provided, Go to Formulaires et documents utiles section and click on the "Document vous permettant de lister vos dépenses" link to download a pdf.

2) Enter all the medical expenses in this pdf as per the invoice date and once the total amount of expenses has exceeded your insurance plan's yearly deductible/franchise, you can move forward to the next step.

3) Attach all the original invoices (if you have just one set of originals, take a copy for your records) along with the duly completed pdf from step 2. As suggested in this pdf, don't use staples etc. and keep the documents untied one after another.

4) Download the pdf from the second weblink that Mullhollander has provided and fill-in all the requested details of the policy holder. Once you click submit, you should get a personalised pdf that you need to attach as the first page before the insurance claim documents.

5) Ship all the documents to the address for reimbursement (address is provided in the section Nous envoyer des factures in the first weblink).

6) In a few days time, you should get an email from Assura that your documents have been successfully delivered for processing. The processing could take 3 weeks or so depending on the time of the year that you apply for reimbursement. I hope you have provided the bank account details in your online account for reimbursement.

Hope this helps.
The above is indeed what Assura encourage us all to do. In practice, all one really needs to do is a simplified step 5, shipping the invoices. There is no need to fill out any extra form or to attach any printout.

Assura even ask us to write down the number of the insurance policy on every single invoice. There is no need to do that either. An invoice typically carries all the necessary information, the computers at Assura are well able to figure it all out.

Of course, it makes sense for Assura to discourage us from sending invoices they would not have to reimburse at all if the total stays below the deductible. On the other hand, it is the job of Assura to help keep track of the health-care expenses.

We are a family of four, all on the lowest possible deductible. I cannot be bothered to keep multiple piles of invoices and several partially completed tables, or to write the respective policy number on every single document.

When an invoice arrives, we pay it, scan in for our records and mail it. Our only optimization is that we combine the invoices of several family members in a single envelope.
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Old 17.05.2017, 11:19
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Re: Filing claims with Assura Mondia insurance

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Did you provide a U.S. or a Swiss address at the hospital? I used my mom's address because the gals behind the counter didn't seem very confident trying to deal with a foreign address. They did tell me to expect additional bills, although I didn't expect a bill for $33 for a flimsy ankle brace!

Do you have an itemized bill from the hospital? If so maybe the doctor was included but odds are he/she was not. If it was just two blood tests and a doctor I can't imagine you'll pay thousands. Healthcare is expensive in the U.S. but it's not that silly.

If it helps compare, total of all bills for my ankle adventure was about $400 and that includes all docs and stuff mentioned above.

In terms of how the bills get to you, maybe contact the hospital billing department and give them an updated address? Most of the bills I got came within 2 weeks of the main event, but the 3rd party bill for the ankle brace came 1 month after. HTH and hope you're feeling better.
I gave them my Swiss address. It has been 1.5 months since that incident and I haven't received any other bills from them; so it's very strange. Perhaps I should follow your suggestion and ask their billing department.

In terms of cost, I once had a friend who took his son to the ER of a major hospital in the US for asthma, who was given some spray (that's it, nothing else), and was later billed more than $2000.
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Old 22.05.2017, 13:21
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Re: Filing claims with Assura Mondia insurance

I can't help but post a small update here. So I called the billing department of the US hospital. The bill was for more than $3000 (not shockingly given the inflated health care cost in the US). However, and this is ridiculous, they can't send the bills to my address or to my Swiss insurance, because apparently their billing system only accepts US addresses, not foreign addresses??? I asked if she could manually write the address to send the bills to, but no. I asked if she could email the bills to me, but no because there is some law prohibiting that. She told me that she could give me a 30% discount if I pay over the phone without any bills sent to me; but I politely declined as it meant I would not be able to claim anything from my insurance.

What a ridiculous system! Let's see what they can do.
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Old 22.05.2017, 15:02
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Re: Filing claims with Assura Mondia insurance

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I can't help but post a small update here. So I called the billing department of the US hospital. The bill was for more than $3000 (not shockingly given the inflated health care cost in the US). However, and this is ridiculous, they can't send the bills to my address or to my Swiss insurance, because apparently their billing system only accepts US addresses, not foreign addresses??? I asked if she could manually write the address to send the bills to, but no. I asked if she could email the bills to me, but no because there is some law prohibiting that. She told me that she could give me a 30% discount if I pay over the phone without any bills sent to me; but I politely declined as it meant I would not be able to claim anything from my insurance.

What a ridiculous system! Let's see what they can do.
Why ridiculous, no bill, no pay, fairly simple as far as i can see.
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