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Old 23.02.2021, 19:22
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Over-using health insurance?

This question might come off a bit strange. But I wanted to pop it out anyway.

I am a cross-border worker and pay about 200CHF per month for health insurance. I was wondering if there is any risk or consequences for using your health insurance in high amounts.
I am asking this as for this year, I had already several medical problems and I was surprised how fast the bills pile up. Just to name some bills (are these prices even standard?):
15-30 Min doctor visit 120 CHF
Blood test + doctor analysis 300 CHF
MRI scan - 580 CHF
Overall already got bills in a sum of 1200 and it only February
I am wondering if there is any risk/consequences of having a big sum of medical bills? As it looks like I could easily go over my yearly contributions+excess this year.
I don't do anything out of the ordinary in my view, but the numbers just don't add up.
Sorry again if this question is a little bizarre. I am just a little confused with the Swiss health system.
Thank you for any info
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  #2  
Old 23.02.2021, 19:32
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Re: Over-using health insurance?

There is only a risk for supplemental or voluntary insurances, where an insurer could reject you. For mandatory health insurance, there is no risk at all.
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Old 23.02.2021, 19:40
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Re: Over-using health insurance?

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This question might come off a bit strange. But I wanted to pop it out anyway.

I am a cross-border worker and pay about 200CHF per month for health insurance. I was wondering if there is any risk or consequences for using your health insurance in high amounts.
I am asking this as for this year, I had already several medical problems and I was surprised how fast the bills pile up. Just to name some bills (are these prices even standard?):
15-30 Min doctor visit 120 CHF
Blood test + doctor analysis 300 CHF
MRI scan - 580 CHF
Overall already got bills in a sum of 1200 and it only February
I am wondering if there is any risk/consequences of having a big sum of medical bills? As it looks like I could easily go over my yearly contributions+excess this year.
I don't do anything out of the ordinary in my view, but the numbers just don't add up.
Sorry again if this question is a little bizarre. I am just a little confused with the Swiss health system.
Thank you for any info
You have to be given the same price regardless of your claims & prior medical history. it's not 'insurance' in the true sense as there is no underwriting & premiums are based on age or risk for basic insurance.
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Old 23.02.2021, 20:14
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Re: Over-using health insurance?

Thank you both for the answer!
Could you tell me if the prices that are paid are standard?
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Old 23.02.2021, 20:21
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Re: Over-using health insurance?

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Thank you both for the answer!
Could you tell me if the prices that are paid are standard?
For basic insurance you pay the same premium aged 25 or 80 regardless of anything else. The young subsidise the old, especially younger workers who work in CH during their younger years & leave for somewhere more exciting. If you arrive aged 60 with loads of ailments you are subsidised by everybody else. Socialism in action.
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Old 23.02.2021, 20:22
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Re: Over-using health insurance?

Prices seem about right to me, but medical prices are not very transparent. I rely on the insurance company to reject anything unreasonable. But Iíve never seen that.

Just make sure that all the treatments are covered by the insurance. Not everything is. The clue, usually, is when they ask you to sign something that says you will pay if the insurance company doesnít.
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Old 23.02.2021, 20:33
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Re: Over-using health insurance?

Now I know why my premium is so high.
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Old 23.02.2021, 21:32
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Re: Over-using health insurance?

I'd just like the thank those who subsidise my health costs. I do appreciate your assistance.

For the OP: for the foreseeable future my insurer will pay far more for my healthcare costs than I do. I'd rather I didn't have the issues. There is no penalty for this. I simply can't change my supplementaries to any other insurer. They're stuck with me.
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Old 23.02.2021, 21:32
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Re: Over-using health insurance?

Truly sorry for that
Last year I paid a lot and didn't use any services. This year has started on the wrong foot. Let's hope the rest of the year I will not need any insurance.
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Old 23.02.2021, 21:46
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Re: Over-using health insurance?

What is your deductible?

Tom
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Old 23.02.2021, 22:57
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Re: Over-using health insurance?

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For basic insurance you pay the same premium aged 25 or 80 regardless of anything else. The young subsidise the old, especially younger workers who work in CH during their younger years & leave for somewhere more exciting. If you arrive aged 60 with loads of ailments you are subsidised by everybody else. Socialism in action.
You are planning on coming back to Switzerland?
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Old 24.02.2021, 01:33
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Re: Over-using health insurance?

I wouldn't call it socialism but I know what you mean. It's an insurance, a national insurance. The total amount of all premiums and self/co-pays needs to cover the total cost of the services provided. (Same applies for example to car insurance except there's probably a higher profit element). Some will make use of the services and some won't. Some will benefit more than their contribution. If costs go up and/or more people run-up costs then the premiums have to go up, as had been happening in previous years.



The charges listed don't seem unreasonable but until the costs (plus admin) exceed your premium and self-pay you're not being subsidised by anyone else.
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Old 24.02.2021, 10:26
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Re: Over-using health insurance?

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You are planning on coming back to Switzerland?
No, however I have to take compulsory Swiss health insurance when I claim my Pillar 1 so from in 4 years time if I take my Pillar 1 aged 63. I suspect it will become cheaper than my BUPA policy with a 2k excess, yet only have a 300 excess.
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I wouldn't call it socialism but I know what you mean. It's an insurance, a national insurance. The total amount of all premiums and self/co-pays needs to cover the total cost of the services provided. (Same applies for example to car insurance except there's probably a higher profit element). Some will make use of the services and some won't. Some will benefit more than their contribution. If costs go up and/or more people run-up costs then the premiums have to go up, as had been happening in previous years.



The charges listed don't seem unreasonable but until the costs (plus admin) exceed your premium and self-pay you're not being subsidised by anyone else.
It's not the same with car insurance. Car insurance can refuse to renew the insurance after a single claim, they can price & reprice based on actual risk, claims history & nationality.
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Old 24.02.2021, 14:34
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Re: Over-using health insurance?

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No, however I have to take compulsory Swiss health insurance when I claim my Pillar 1 so from in 4 years time if I take my Pillar 1 aged 63. I suspect it will become cheaper than my BUPA policy with a 2k excess, yet only have a 300 excess.
Thanks for that. I'm in roughly the same predicament as you though i have a GBP 5,000 deductible with BUPA and I'm wondering if I'll save any money.
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Old 24.02.2021, 15:58
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Re: Over-using health insurance?

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It's not the same with car insurance. Car insurance can refuse to renew the insurance after a single claim, they can price & reprice based on actual risk, claims history & nationality.

I know, but the fundamental fact that the total income from premiums and excess payments needs to exceed the costs still stands.It's the fundamental idea behind insurance, hence the Swiss health insurance is insurance.
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Old 24.02.2021, 16:16
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Re: Over-using health insurance?

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I am wondering if there is any risk/consequences of having a big sum of medical bills? As it looks like I could easily go over my yearly contributions+excess this year.
No, no such risk. Quite the contrary, from an individual (egotistic) POV it's recommended to concentrate what's plannable in the same year.

Here's how it works, let's assume your deductible (Selbstbehalt) is 2500, the maximum, going by your (fairly low) premium that seems the most likely. That's a good choice, you want either the highest or the lowest deductible.
- you pay the first 2'500 in costs in any calendar year (less if your deductible is less)
- of the next 7'000 you pay 10%
- anything beyond that, if it's covered by the insurance, is paid by the insurance

The applicable timeframe for this calculation is the calendar year. It's performed each year on its own, even if a given treatment is split among more than one calendar year.

While it's your choice when you send the bills to your insurance (mind, your claim lapses after two years), you may want to send them in as they come along, that way you won't forget or lose any. Most insurances will automatically reimburse what they owe, if any. That said, some insurances pay the bill you send in and then bill you for your share of the bill. You may want to enquire about this before sending in the bills to avoid confusion.
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Old 24.02.2021, 16:37
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Re: Over-using health insurance?

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I know, but the fundamental fact that the total income from premiums and excess payments needs to exceed the costs still stands.It's the fundamental idea behind insurance, hence the Swiss health insurance is insurance.
The concept of insurance is the pooling of risk, investment returns added to gross premiums should make a profit. Swiss Basic insurance is not for profit & premiums are not based on the risk, so it's more of a socialist version of a capitalist scheme. Many insurance companies are not profitable premiums will normally not cover claims, thats where Warren Buffet has had the edge as he invests the pool more profitably. He also prefers not to write business if the competition cuts the premium too much, unlike other companies who want to do business regardless of price.
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Old 24.02.2021, 16:43
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Re: Over-using health insurance?

Back when it wasn't compulsory, it was a far better deal.

Prices have quadrupled since then, with no increase in cover.

Tom
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Old 25.02.2021, 22:16
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Re: Over-using health insurance?

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Back when it wasn't compulsory, it was a far better deal.

Prices have quadrupled since then, with no increase in cover.

Tom
Premiums would depend on your age back then, and your age made you a far better risk statistically speaking.
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