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Old 08.08.2018, 16:20
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Re: Health insurance question

Hi. Just a recap/update my daughter is a student working and living in France since March. We only just found out from the British EHIC helpline the reason she has to have Swiss insurance this is because she gets a small salary to cover her rent from the companies Swiss HQ and they take out some contributions and because she is paying contributions into Switzerland she comes under Swiss law for health and therefore should have had insurance and also because of this can no longer claim from EHIC.
I know some people have said this was the reason all along but most have said this was not the reason very confusing for me.
The KVG did not explain this to us they just kept sending letters demanding she had insurance which she now has.
Because of exemptional circumstances her being a student and not earning a wage as such they gave her a discount but the insurance was not backdated so she can not claim for the hospital bill.
I think THEY waited for her to get insurance then this was used as admittance that she was Swiss worker and sent her the hospital bill. Very sneaky they could have explained this to her right at the beginning at least then we could have decided within the 3 months limit to have bought student insurance that you get at a reduced rate.
The whole thing is really complicated and after lots of calls and letters in Switzerland it was explained by EHIC.
We have have asked the University to see if she is covered but this will take some time. Fingers crossed.
And yes your correct if she had not visited a Swiss hospital she and the authorities would be non the wiser.
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Old 08.08.2018, 17:44
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Re: Health insurance question

First the entity in Switzerland you are dealing with is not called KVG, it is Gemeinsame Einrichtung KVG. KVG alone is simply the law (KrankenVersicherungsGesetz can be found here https://www.admin.ch/opc/de/classifi...073/index.html) which regulates health insurance.

There is no abbreviation for the Gemeinsame Einrichtung KVG, you may use "GE KVG" but that is weird as well as GE in Swiss context means the canton Geneva.

As said previously the law (the KVG) and some associated ordinance, and treaties governs if one needs Swiss health insurance.

The law also governs if the insurance can, or actually must, be backdated or if this is not possible. Specially has she has been here in since March.

If the start of the insurance can or must be backdated depends on type of work, permit, regulations etc. In some cases it can only be backdated when you sign up for health insurance in good time, in others it must always be backdated.

As previously told you (or your daughter) must know under what EXACT rules she has or had take up Swiss health insurance (See one of my previous post where I listed all the regulation she-bangs, and whatsnot). The request must be sent by registered letter to the Gemeinsame Einrichtung KVG and the HR (also registered) of your daughters employer.

I think in one case are you wrong and angry for nothing, if she needs Swiss health insurance than a claim made through the EHIC scheme could be denied by NHS regardless if she had Swiss insurance or not. Because simply, in such a case NHS does no longer have to provide coverage. In addition to that, if she is not subject to Swiss health insurance she most likely would be subject to French health insurance, which apparently she has neither.

How and if French health insurance can be backdated is beyond my knowledge.

PS: According to your initial post in this thread, they first wanted to back date the begin of insurance to March. In that case all would have been covered w/o any issues. It was YOU who waited with signing up with proper insurance.
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Old 08.08.2018, 20:43
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Re: Health insurance question

Hi, to aSwissInTheUS

Firstly, I apologise for calling the Gemeinsame Einrichtung KVG. the KVG ignorance on my side.
Secondly, I know on my first thread I did say they were demanding payment from march 2018 but this is where there was a delay, the letters were sent to her English address written in German she didn't get them until she returned to England and by then the 3 months had already passed and then not being able to understand the letters she had to take them back with her so she could get them translated.
The 3rd thing was actually trying to find out why she needed the insurance living and working in France just didn't make sense. I was convinced they had made a mistake hence all the letters phone calls and emails without getting a clear answer there was a lot of conflicting replies.

The EHIC did say paying contributions in Switzerland was the reason for her having to pay for Swiss health insurance and that's why they would not accept her claim.

She does have insurance that covers her fully while in France, we are just waiting for a reply from the University to see if the insurance covers Switzerland as well.

I am going to take your advice and write to Gemeinsame Einrichtung KVG to them for the EXACT RULES and explanation to why she needed Swiss health Insurance. I want to know a definite answer as this whole process has been so confusing. will send registered.

I know you are extremely knowledgeable and I do thank you for your help. I think some of the information given has been a little hard for me to follow and that I need to go over it again and again.

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