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Old 21.02.2021, 22:22
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Maternity insurance: hospitals, upgrades, doctors

In about 4 months we expect a new member in our family, and after digging the various threads for a couple hours, i still have some questions. Tbh i didn't click every single search result, so if i missed something that answers my questions, please let me know.

Now, some info about the context of our case.

- Insurance: Basic with Visana, Flex (Switch) with Innova. The latter means that we pay 200 CHF per day and have Private level insurance for the days we need it. We also have a money payback option with Visana, which means they start paying 200 CHF after the first day of hospitalization, so in end we pay only the first 200 CHF from our pocket.

- We would like to have Private cover both for free choice of doctor (probably going for a scheduled C-section) and to be alone in the ward (if possible, based on availability).

- There's a catch when it comes to some hospitals that are covered and to what extend, I attach Innova's "Maximaltarif. The hospitals that are not listed there have full cost coverage. The prerequisite is that they are listed on the cantonal hospital list.

- The reason i mention this list is because our gynecolosit operates only in Hirslanden im Park and Bethanien in Zurich, and Innova doesn't cover the full costs of a Private birth there. So, we were looking for the Kantonsspital Zug and Andreas Clinik in Cham, which based on the opinions here, are equally well-equiped and comfortable (plus it's also a peace of mind for me, easier to "fly" to Baar/Cham than Zurich in case of emergency).

Here come the questions:

1) Is the "upgrade Basic to Private" in Andreas clinic the same as going from Basic to Private insurance? Or is it only the room upgrade? When I contacted them directly, their answer was:
"Most health insurers do not pay for the upgrade, but for admission to the private section according to the insurance. This is intended for people who do not have additional insurance so that they can enjoy the birth benefits from our clinic. You need to find out whether your insurance company pays for an upgrade or only for entry according to the insurance in the private ward. With Inova Insurance you have to pay the costs yourself in advance before the birth."

2) Is it the same for the Kantonsspital? In their brochures they clearly write about "(Semi-) or (Private) Insurance" room services, not upgrades. I'd guess it's the same thing, but this terminology is already confusing.

3) I've read in some posts that you canNOT choose the doctor in the Kantonsspital. Is this true, even with Private insurance?

4) If you choose a Private ward, but end up to have one more mother in the room, do the hospitals (both Andreas and Kantons) refund you? Or are you eligble to be refunded by the insurance?

5) Could you recommend some doctor(s) both from Andreas and Kantons for the birth (you could pm me the recommendation)?

Sorry for the wall of text and Thanks in advance
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Old 21.02.2021, 23:13
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Re: Maternity insurance: hospitals, upgrades, doctors

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3) I've read in some posts that you canNOT choose the doctor in the Kantonsspital. Is this true, even with Private insurance?

4) If you choose a Private ward, but end up to have one more mother in the room, do the hospitals (both Andreas and Kantons) refund you? Or are you eligble to be refunded by the insurance?

5) Could you recommend some doctor(s) both from Andreas and Kantons for the birth (you could pm me the recommendation)?
I don't know the answers I'm afraid but;

3 & 5 ..... Do you really need to choose a Dr? What happens if you choose a Dr, then they are not on shift when you go into labour?

4 ... Why would there be another mother in a private room with you? It's a private room (ie 1 bed).
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Old 22.02.2021, 01:10
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Re: Maternity insurance: hospitals, upgrades, doctors

- Private insurance and choice of doctor means that the doctor is obliged to be there. That's why you pay after all. For him/her is a scheduled operation, he cannot opt out. There are always redundancies of course, but there has to be a reason for not showing up (accident, weather conditions etc). But if he doesn't show up for no reason, I think you could even move legally against him/her. But that's not the point here. The point is that with general, it's up to whoever has a shift - which can be a student, as others mentioned in posts, and good luck with that...

- It depends on the available beds of a hospital. It's not guaranteed like in hotels. If someone needs a bed, they won't put a temporary one in the hallways (at least not in Switzerland)
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Old 22.02.2021, 03:43
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Re: Maternity insurance: hospitals, upgrades, doctors

I have flex insurance with another company and that's what we did, chose private. And everything was according to private insurance.

Hospital has nothing to do with your insurance and cannot answer you that question. What they do is check with the insurance that someone will pay for the costs. Insurance checks with you that you are willing to pay whatever you've agreed to with them.

The extra upgrade option is something completely else and that is for people who do not have private insurance or the insurance upgrade options.

You can call the hospital or beter directly contact your insurance company.

4: I don't expect you to be refunded because other services will be per private but is rather low likelhood to happen anyways. I don't think Andreas has non-single rooms

p.s. you may want to chose your hospital based on a doctor because doctors usually have agreements with 2-3 hospitals only. What I did was call hospitals I was interested in, asked for doctor recommendation, decided on doctor and then on hospital.

Last edited by minimimi; 22.02.2021 at 04:05.
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Old 22.02.2021, 03:52
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Re: Maternity insurance: hospitals, upgrades, doctors

Also you may be aware already that most of doctors in Switzerland are not too flexible and will be there only for the final stage. If you are at 9cm at 3am they'll probably head to the hospital, but if you are at 5cm they may not even if you have a history of quick deliveries in family (it is rare but in my family there are multiple people who went from 5cm to delivery in less than an hour).

My doctor was early enough there but I am not sure if she would have been if it was night. My sister's first delivery was early morning and her doctor was with her pretty much the entire night (in another country )
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Old 22.02.2021, 08:42
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Re: Maternity insurance: hospitals, upgrades, doctors

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- Private insurance and choice of doctor means that the doctor is obliged to be there. That's why you pay after all. For him/her is a scheduled operation, he cannot opt out.
Bit of a difference between a scheduled operation and going into Labour. Ok, fair enough & different if you have scheduled a c-section with them before your due date. But if an obs/gyn is required to come to the naturally timed birth of every patient and can’t leave it with their colleagues ... they would never ever be able to guarantee a day off, holiday or even rest time between shifts.
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Old 22.02.2021, 09:31
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Re: Maternity insurance: hospitals, upgrades, doctors

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Bit of a difference between a scheduled operation and going into Labour. Ok, fair enough & different if you have scheduled a c-section with them before your due date. But if an obs/gyn is required to come to the naturally timed birth of every patient and can’t leave it with their colleagues ... they would never ever be able to guarantee a day off, holiday or even rest time between shifts.
they usually have a back-up doctor for that case and one can ask who that doctor is. But I'd say likelihood of that is <10% if not much lower. Doctors in Switzerland don't have too many patients in parallel, work in at most 3 hospitals usually and Switzerland small so distances are small.
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Old 22.02.2021, 20:28
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Re: Maternity insurance: hospitals, upgrades, doctors

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I have flex insurance with another company and that's what we did, chose private. And everything was according to private insurance.

Hospital has nothing to do with your insurance and cannot answer you that question. What they do is check with the insurance that someone will pay for the costs. Insurance checks with you that you are willing to pay whatever you've agreed to with them.

The extra upgrade option is something completely else and that is for people who do not have private insurance or the insurance upgrade options.

You can call the hospital or beter directly contact your insurance company.
Did you use your flex insurance for pregnancy or another medial issue? Did you use such an upgrade? Or what you are saying is that, if you use such a flex insurance for Private, then you don't need an upgrade?
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Old 22.02.2021, 21:04
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Re: Maternity insurance: hospitals, upgrades, doctors

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Did you use your flex insurance for pregnancy or another medial issue? Did you use such an upgrade? Or what you are saying is that, if you use such a flex insurance for Private, then you don't need an upgrade?
for delivery only, yes I used the upgrade to private via my insurance (klinik im park, also a member of hirslanden group) (i.e. I did not ask the hospital for the upgrade they offer)

so when registering for the delivery (done via my doctor) I said it will be private. later I was contacted by the hospital to confirm it is private and also by the insurance company to confirm.

all the bills (except some for food) were handled between the insurance company and the hospital and I got to pay something between 2000-3000fr to the insurance company (don't remember the exact figure) because that's what I pay according to my insurance policy

btw, be aware that regardless of opting to go as a private patient part of the costs will be covered by your basic insurance. In my case both were the same insurance company so can't tell you more about that but on the cost break-down some things were marked as according to basic and some as according to private

Last edited by minimimi; 22.02.2021 at 21:49.
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Old 22.02.2021, 21:06
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Re: Maternity insurance: hospitals, upgrades, doctors

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As to starting legal proceedings against a doctor... that is seldom done in Switzerland, and as far as I know with few successes on the part of the patient sueing.
Would second this. A friend had a very strong case (serious doctor mistake) but noone wanted to testify against the doctor.
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Old 22.02.2021, 23:56
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Re: Maternity insurance: hospitals, upgrades, doctors

Today the Kantonsspital Zug had the Info-Abend, and they answered my main question about the doctor; so with Private insurance, they try to have the Head Doctor do the C-section / delivery, if he cannot then it's his deputy, if the deputy cannot either, then it's a Senior Physician ......... I would ask if a Senior Physician is a doctor and can do C-sections, but i'll mail them directly.
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Old 23.02.2021, 02:22
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Re: Maternity insurance: hospitals, upgrades, doctors

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Today the Kantonsspital Zug had the Info-Abend, and they answered my main question about the doctor; so with Private insurance, they try to have the Head Doctor do the C-section / delivery, if he cannot then it's his deputy, if the deputy cannot either, then it's a Senior Physician ......... I would ask if a Senior Physician is a doctor and can do C-sections, but i'll mail them directly.
So basically they're telling you the most senior person available at the time will perform the surgery. Senior Physician should definitely be a doctor (they probably mean Oberartz, i.e. somebody who already finished their specialisation).

Btw, my sister is a doctor and she claims c-section is a very simple procedure from surgeon's perspective. Of course anything can happen with anything but I have an impression you may be worrying too much. I am a person who prefers to know as many details in advance as possible, but be calm. There's plenty of time and you'll most likely get all the info you need
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Old 23.02.2021, 08:35
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Re: Maternity insurance: hospitals, upgrades, doctors

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if the deputy cannot either, then it's a Senior Physician ......... I would ask if a Senior Physician is a doctor and can do C-sections, but i'll mail them directly.
Of course they are a doctor and can do C-Sections. Do you really think they will drag someone unqualified into theatre to do the procedure?
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Old 24.02.2021, 00:43
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Re: Maternity insurance: hospitals, upgrades, doctors

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- Private insurance and choice of doctor means that the doctor is obliged to be there. That's why you pay after all. For him/her is a scheduled operation, he cannot opt out. There are always redundancies of course, but there has to be a reason for not showing up (accident, weather conditions etc). But if he doesn't show up for no reason, I think you could even move legally against him/her. But that's not the point here. The point is that with general, it's up to whoever has a shift - which can be a student, as others mentioned in posts, and good luck with that...
No students on duty. Whoever mentioned that? There may be a student tagging along, but there is always at least a resident in public hospitals. Of course, if your luck is off that doctor may have to be in several places at once, so you may end up seeing just the student for some period of time. The midwife is more important anyway, except in case of complications. And if the resident is overwhelmed, chances are there will be one or more consultants in the house or on their way.
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Old 24.02.2021, 01:01
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Re: Maternity insurance: hospitals, upgrades, doctors

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Today the Kantonsspital Zug had the Info-Abend, and they answered my main question about the doctor; so with Private insurance, they try to have the Head Doctor do the C-section / delivery, if he cannot then it's his deputy, if the deputy cannot either, then it's a Senior Physician ......... I would ask if a Senior Physician is a doctor and can do C-sections, but i'll mail them directly.
There are oodles of competent, enthusiastic surgeons who - being decent persons, and maybe having a family - are just not all that interested in becoming Chefarzt, which is a merciless existence only suited to the most extreme of workaholics. Indeed, it is not surgical competence that gets you the most prestigious leadership jobs e.g. at university hospitals, but stuff largely irrelevant to the individual patient, such as academic publications. Moreover, we all know that top dogs are more narcissistic than average workers. Some of the best surgeons I know are happy to remain Oberärztin or even just Spitalfacharzt because anything higher up would take them away from patients and the OR for large parts of their working hours, dealing with administrative issues they were never interested in. I suggest asking your own (preferably non-surgical) gynecologist for a recommendation. Seasoned practitioners know whom to go to as well as whom to avoid, and are not replaceable, especially not by internet forums.
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Old 24.02.2021, 03:55
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Re: Maternity insurance: hospitals, upgrades, doctors

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No students on duty. Whoever mentioned that? There may be a student tagging along, but there is always at least a resident in public hospitals. Of course, if your luck is off that doctor may have to be in several places at once, so you may end up seeing just the student for some period of time. The midwife is more important anyway, except in case of complications. And if the resident is overwhelmed, chances are there will be one or more consultants in the house or on their way.
Here's the post i've read that, from the "Is Semi-Private Hospitalization Necessary? For Pregnancy?" thread:
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There is a big difference :

Private or semi-private : you can choose your doctor.

Basic insurance : you get whatever doctor is there. My wife did not even get a doctor, she got a student (he had to learn...) who butchered her. It's only when everybody realised that things were getting bad that the "real doctor" showed up.

Conclusion : if you can, go private/semi-private.
Thanks for all the suggestions and info, the thing is our baby (as every baby ) is special to us, and i wouldn't like the wrong hands in such a special moment. I mean, if i broke a leg or arm i wouldn't mind some "training material" on me, but i'd never want this for my wife and especially during her (first) delivery.

I will ask our gyn later today for recommended doctors, if you know anyone, not only in the Kantonsspital Zug or Andreas Clinic but anywhere, feel me to pm me - and then i'll check with the insurances.
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Old 27.02.2021, 01:00
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Re: Maternity insurance: hospitals, upgrades, doctors

You can refuse the student and see what happens. Usually the „real doctor“ will come out of the woodwork. Rarely, there is just too much going on at once. I‘d be interested to hear what „butchered“ means. In the places I‘ve worked, it was the midwives who did the episiotomies and the residents on call who sewed them back together. Admittedly, the sewing-up followed the principle of „see one, do one, teach one“ - but we were expected to know our limits and get help if necessary, which seemed to work fairly well. This was 25+ years ago and I‘m sure (and glad) that supervision and reglementation has not become looser since.
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Old 27.02.2021, 01:53
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Re: Maternity insurance: hospitals, upgrades, doctors

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You can refuse the student and see what happens. Usually the „real doctor“ will come out of the woodwork. Rarely, there is just too much going on at once. I‘d be interested to hear what „butchered“ means. In the places I‘ve worked, it was the midwives who did the episiotomies and the residents on call who sewed them back together. Admittedly, the sewing-up followed the principle of „see one, do one, teach one“ - but we were expected to know our limits and get help if necessary, which seemed to work fairly well. This was 25+ years ago and I‘m sure (and glad) that supervision and reglementation has not become looser since.
This may be more or less common but NOT the must. In my case the doctor was in charge of almost everything, did most of the things and whenever was a decision to be made midwives called the doctor for the decision. The midwives were more of support personal giving emotional support, telling where to go, filling in the pool, help with shower, asking how things progress, etc. I did not have an episiotomy but I am sure a midwife wouldn't have been in charge if there was need for episiotomy/ies. There was minor tearing and sewing was done by the doctor.
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Old 27.02.2021, 09:35
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Re: Maternity insurance: hospitals, upgrades, doctors

Given that there is no way to gain experience at delivering babies (via whichever method) except by delivering more and more babies:

Q1: whose baby *should* a qualified-but-not-yet-senior doctor/midwife deliver? In your view, is there a particular reason that should be someone else's baby and not yours?

Q2: is that reason nonmedical? Because the hospitals here will certainly "upgrade" you to a more senior doctor if medical considerations warrant it. I had the head of gynecology at 8am on a Sunday - on basic insurance.

-----

I guess I find the whole "only the chefarzt for ME" business just a bit ethically squishy, a sort of medical NIMBYism. But I guess people who do it help keep the insurance companies afloat and premiums low for the rest of us, so there's that.
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Old 28.02.2021, 04:42
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Re: Maternity insurance: hospitals, upgrades, doctors

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Given that there is no way to gain experience at delivering babies (via whichever method) except by delivering more and more babies:

Q1: whose baby *should* a qualified-but-not-yet-senior doctor/midwife deliver? In your view, is there a particular reason that should be someone else's baby and not yours?

Q2: is that reason nonmedical? Because the hospitals here will certainly "upgrade" you to a more senior doctor if medical considerations warrant it. I had the head of gynecology at 8am on a Sunday - on basic insurance.

-----

I guess I find the whole "only the chefarzt for ME" business just a bit ethically squishy, a sort of medical NIMBYism. But I guess people who do it help keep the insurance companies afloat and premiums low for the rest of us, so there's that.
While I partially agree it also depends on how you want to spend your money. I pay for extra insurance but don't dine out, don't own a car and spend way less on holidays than people of comparable income for example. We are both (as most in Switzerland) lucky to have enough to choose between our luxuries.
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