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Old 24.04.2020, 05:47
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Health Insurance exclusions - would these be excluded does anyone know?

Hi,

We are considering moving back to Switzerland (we are Swiss) and I am trying to figure out what we will have to face in terms of insurance costs/issues etc. if we do make the move.

We now have 4 kids and I know it is going to be much more expensive to insure us than it was when we left - I am just trying to navigate what kinds of things to be prepared for.

I've been trying to read up on this and find out things online via insurance websites etc... but its been a bit tricky and was wondering if anyone has any experiences to share or know-how about this...

My youngest has congenital strabismus (lazy eye) and she has been followed by an optometrist/opthalmologist since birth pretty much - and will most likely need surgery at some point to help correct it...we have been putting it off because we have had such conflicting levels of care/advice for her in NZ and AUS that we don't trust their recommendations. Now though if we return to Switzerland I am wondering whether it would even be an option - as wouldn't her condition be excluded in the health insurance policy since it is pre-existing?

Does anyone know if the insurance excludes EVERYTHING to do with the condition or only parts?

My son hasn't been diagnosed with anything yet, but we suspect he has ADHD or Aspergers or something and just wondering if he would be able to get assessed as part of insurance once we are in Switzerland? Or would that have to be out of pocket for us?

I'm assuming my husband's damaged knee (totally shattered, from a motorbike accident 20 years ago, but is functioning fine now) would be excluded? Does that mean even if he developed damage in the future to the knee it would be excluded automatically and he would have to pay everything out of pocket, or only in relation to anything to do with the original accident?

Thanks for any advice on this...its a pretty big minefield trying to navigate all the details we will have to sort out before we come back ;-)
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Old 24.04.2020, 06:44
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Re: Health Insurance exclusions - would these be excluded does anyone know?

Existing conditions are not excluded from the basic health care..
Only from the supplementary.
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Old 24.04.2020, 08:02
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Re: Health Insurance exclusions - would these be excluded does anyone know?

Everything is a big word.
Health insurance covers the direct medical intervention costs of a condition. Policies vary in what they cover with regard to possible long term corrective treatments -for instance, I could have had corrective surgery for sleep apnea but a personalised corrective brace is not covered -in general it is much easier to get surgery here than in other places -I ended up taking a CPAP machine which is covered.
If you need support structures with regard to education etc that is a different matter -you would need to ask people in a similar position.
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Old 24.04.2020, 08:05
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Re: Health Insurance exclusions - would these be excluded does anyone know?

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Existing conditions are not excluded from the basic health care..
Only from the supplementary.
Whats more important is premiums are not based on risk, everybody form 25-80 will pay the same premium from the same insurance company for basic insurance.
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Old 24.04.2020, 09:44
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Re: Health Insurance exclusions - would these be excluded does anyone know?

As a real life example for pre-existing conditions....the late Mr HH had active cancer when we moved here. He was accepted for basic insurance without question (as is required by law) and there was not one single bill or treatment that was questioned.

So not only does the law say "pre-existings are covered", but it works in practice too.
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Old 24.04.2020, 09:52
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Re: Health Insurance exclusions - would these be excluded does anyone know?

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Everything is a big word.
Health insurance covers the direct medical intervention costs of a condition. Policies vary in what they cover with regard to possible long term corrective treatments -for instance, I could have had corrective surgery for sleep apnea but a personalised corrective brace is not covered -in general it is much easier to get surgery here than in other places -I ended up taking a CPAP machine which is covered.
If you need support structures with regard to education etc that is a different matter -you would need to ask people in a similar position.
A lot of this comes down to your doctor too no?
Similar to your example, I snore like an absolute pig.. This leads to mild apnea. My generalist sent me to a specialist and I was offered a range of things to try. Septoplasty, tonsils out, a cpap, a jaw brace thing.. All of these were covered because the specialist recommended them and so were not elective. If I just decided I wanted it then it wouldn't be covered.

I went with the septoplasty by the way. I still snore but I can actually breath through my nose now, great result

In most circumstances insurance will cover what a doctor recommends for good medical reasons - most times.
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Old 24.04.2020, 11:04
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Re: Health Insurance exclusions - would these be excluded does anyone know?

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Existing conditions are not excluded from the basic health care..
Only from the supplementary.
And just in case the OP isn't fully aware, supplementary insurance is all about 'extras' - from private rooms in hospitals to quack treatments, so is in no way required.
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Old 24.04.2020, 11:53
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Re: Health Insurance exclusions - would these be excluded does anyone know?

Use comparis.ch to come up with a few candidates to cover you and then bargin hard with them for the cost of supplemental coverage.

With two children having dental coverage (Not covered by basic) is likely to be a benefit, perhaps for the adults as well (but note they expect the teeth to be perfect before you sign up, so if you can get any work done at low/no cost before you come, you should.) Also ask your local dentist for a written evaluation, which will aid you in getting coverage) If you can bring your medical/dental files with you, then do so!

Eyeglasses (etc) is not covered by basic (but special glasses for your daughter’s condition likely would be) so have your eyes checked before you leave and get new glasses (etc). Again everywhere is cheaper than Switzerland. Get an extra pair or two for the adults.
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