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Old 05.09.2017, 13:35
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deductible reset question

Hi all, Iím in the process of taking a new basic insurance franchise (with free doctor choice) starting in November. The insurance agent told me that the deductible is from November 2017 to November 2018. Is this true? Information in the forum suggests that deductible resets at the end of the calendar year. I need to visit a specialist due to a prior appointment a few days after the start of the policy. I donít know how much the whole treatment will cost. I donít know how much I should choose as a deductible.
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Old 05.09.2017, 13:37
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Re: deductible reset question

Calendar year.

Tom
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Old 05.09.2017, 14:00
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Re: deductible reset question

It resets at the end of a calendar year, but if you want to change insurers then this must be done before the end of November iirc for the new policy to start in January. Which is why you get a lot of insurance junk mail in October-November.
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Old 05.09.2017, 16:01
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Re: deductible reset question

The replies above assume you already have Swiss mandatory health insurance, intend to replace it. This process indeed follows the calendar year.

Since you say "new" your situation may be different in that you don't have mandatory health insurance yet, typically because you immigrated and registered recently e.g. in early August or so. If that's the case the agent may intend to have your insurance start three months after you registered. I think this is legal and will work, however the deductible is always per calendar year including in such cases. Depending on your arrangement, contract conditions will either be for the remainder of the year, or (if that's possible) for the first 14 months, after which they will follow the calendar year cycle as usual.

If in doubt ask your insurance you signed the contract for.
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Old 05.09.2017, 16:57
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Re: deductible reset question

The agent said 12 months. November 2017 to November 2018. That made it confusing. That's why i needed a second opinion. Thank you for making it clear
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Old 08.09.2017, 14:22
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Re: deductible reset question

Agent is shamelessly lying. Welcome to CH. The insurance sector is full of crooks here. The glossy brochures and "high-quality" Swiss healthcare are mere marketing ploys to get as much money out of your pocket as possible. If you have an impending treatment, get the lowest possible franchise. I'd also advise free choice of doctor and avoiding crook intermediaries like Medgate and such.

Last year, they basically exhausted all my franchise doing unnecessary tests, and precisely at the time when I had burned my franchise (own cash), they prescribed some useless "alternative" treatment which wasn't covered. Very good coincidence with timing! Next year, I lowered my franchise to 300 and they didn't know about that "in their system". Their staff was visibly upset because I didn't tell them about this very crucial change. I asked, "Does diagnosis and treatment depend on it?" They ignored the point in my question and just kept saying "doctor needs to know.. doctor needs to know".. Yeahhhh.. sure! They just had to face music from their boss because something expensive was prescribed at the expense of their mother "kasse".
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Old 08.09.2017, 14:41
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Re: deductible reset question

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Last year, they basically exhausted all my franchise doing unnecessary tests, and precisely at the time when I had burned my franchise (own cash), they prescribed some useless "alternative" treatment which wasn't covered. Very good coincidence with timing! Next year, I lowered my franchise to 300 and they didn't know about that "in their system". Their staff was visibly upset because I didn't tell them about this very crucial change. I asked, "Does diagnosis and treatment depend on it?" They ignored the point in my question and just kept saying "doctor needs to know.. doctor needs to know".. Yeahhhh.. sure! They just had to face music from their boss because something expensive was prescribed at the expense of their mother "kasse".
Interesting to hear. I was never asked what deductible I have
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Old 08.09.2017, 15:11
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Re: deductible reset question

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Interesting to hear. I was never asked what deductible I have
Me neither.. Quite the opposite in fact, some professionals have offered "nice to have" treatments after checking with me that it would be the insurance paying and not my deductible.
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Old 08.09.2017, 15:36
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Re: deductible reset question

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Me neither.. Quite the opposite in fact, some professionals have offered "nice to have" treatments after checking with me that it would be the insurance paying and not my deductible.
That's what happens when you are decent to people, they are decent back and everyone is happy.

Or you can go around being horrible and suffering under the weight of the chip on your shoulder, like a previous poster, and people tend not to go out of their way to help you.

Sometimes human nature is pretty obvious, but some people can still be oblivious.
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Old 08.09.2017, 16:08
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Re: deductible reset question

Yeah.. the sticker holders are back again with their "chip" cheap talk . Of course, they love to defend anything against their lovely "Switz", oblivious to all the corruption and malpractice. Those who got "nice-to-have" treatments, good for you! Would they care to clarify what model they had? Call-first via intermediary or free choice? It shouldn't take too much brain to realize that the intermediaries are there precisely to lower the cost to the insurance company, which is why the premiums are lower. If anyone gets "nice-to-have" treatment via an intermediary, it'd be very surprising.
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people tend not to go out of their way to help you
However horrible I may be, their behavior wasn't "unhelpful", it was downright corrupt and immoral. In some advanced countries, this would classify as medical malpractice.
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Interesting to hear. I was never asked what deductible I have
Simply go to Medgate or any intermediary healthcare point. It's the first question they ask after policy no, etc.
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Old 08.09.2017, 16:12
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Re: deductible reset question

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Yeah.. the sticker holders are back again with their "chip" cheap talk . Of course, they love to defend anything against their lovely "Switz", oblivious to all the corruption and malpractice. Those who got "nice-to-have" treatments, good for you! Would they care to clarify what model they had? Call-first via intermediary or free choice? It shouldn't take too much brain to realize that the intermediaries are there precisely to lower the cost to the insurance company, which is why the premiums are lower. If anyone gets "nice-to-have" treatment via an intermediary, it'd be very surprising.
A fair point once I got through all the bile and unpleasantness.

Yes the intermediaries are there to reduce cost, by avoiding referals to expensive specialists as the first step. They may also review proposals to ensure value for money, I don't know.

Of course, as you chose this model, in a free market, it's hard to see how that is either corruption or malpractice.

And I stand by my view that yes, probably anyone you deal with just wants to get rid of you as quickly as possible and ignores you after that. As I am now doing.
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Old 08.09.2017, 16:15
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Re: deductible reset question

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Interesting to hear. I was never asked what deductible I have
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Me neither.. Quite the opposite in fact, some professionals have offered "nice to have" treatments after checking with me that it would be the insurance paying and not my deductible.
I have been asked, but it has no bearing on anything, least of all the treatment.
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Old 08.09.2017, 16:20
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Re: deductible reset question

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it has no bearing on anything, least of all the treatment.
Was this at an intermediary? With your policy no. and personal details, it's quite straightforward for them to fetch this from the insurer. And there's no way of knowing whether it affected your treatment. It's not like the doc gives you clear options with pricing. OP, as everyone, is free to choose whichever model that fits his needs/budget best. I simply stand by my view that intermediary/gate-check models are best avoided, especially when a treatment is expected. Of course, I also stand by my lowly view of sticker holders. If anyone wants to rid of me, they can ban me, along with all Indian IT contractors that are stealing their fragile jobs. In case of Medgate, their interactions with me lasted 2 years. Never again!

Last edited by makas; 08.09.2017 at 16:33.
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Old 08.09.2017, 16:30
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Re: deductible reset question

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Yeah.. the sticker holders are back again with their "chip" cheap talk . Of course, they love to defend anything against their lovely "Switz", oblivious to all the corruption and malpractice. Those who got "nice-to-have" treatments, good for you! Would they care to clarify what model they had? Call-first via intermediary or free choice? It shouldn't take too much brain to realize that the intermediaries are there precisely to lower the cost to the insurance company, which is why the premiums are lower. If anyone gets "nice-to-have" treatment via an intermediary, it'd be very surprising.
Interesting. I've had intermediaries, as you call them, for 10 years and have never been asked for the value of my deductible.

For the years where I required regular treatment, i was told to call the intermediary for the first visit in the calendar year, and then, no need to call again that year. Was never offered anything by the intermediary. Lots of variation in Switzerland, I guess.
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