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  #21  
Old 31.05.2017, 16:47
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Re: SWICA Insurance

I've used them for 15 years and have had no issues.

They communicate in writing in English and have been flexible and helpful when required.
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  #22  
Old 31.05.2017, 17:23
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Re: SWICA Insurance

We have the telmed model - no complaints. To be clear, we have the telmed version where you do not have to follow the advice, but you have to call for new appointments.
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  #23  
Old 31.05.2017, 17:39
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Re: SWICA Insurance

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Hi everybody,
I know this is and old thread but I thought I would Ask if the ppl who commented here, still recommend SWiCA, especially the telmed model.
Also can somebody confirm that all swiss insurances Automatically provide coverage (equivalent to the coverage in CH) in countries of the EU? Also if my insurance is from Zurich, am I covered in other kantons?
Thanks in advance
First question - no. You are only covered for emergencies in EU countries.

Second question - usually it's canton specific I believe, but may depend on the model of cover you choose. For this I'm talking general coverage. If you have an emergency and are admitted to hospital in Vaud for example you should be covered. But visiting a doctor or specialist in Vaud probably not, unless you get permission from your insurer.
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  #24  
Old 31.05.2017, 17:55
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Re: SWICA Insurance

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First question - no. You are only covered for emergencies in EU countries.

Second question - usually it's canton specific I believe, but may depend on the model of cover you choose. For this I'm talking general coverage. If you have an emergency and are admitted to hospital in Vaud for example you should be covered. But visiting a doctor or specialist in Vaud probably not, unless you get permission from your insurer.
Actually, you have it backwards. For non-emergency hospitalization outside your kanton of residence, you have to have permission from your insurer. In many cases, if the service is less expensive outside your kanton, it might not even be a problem. If more expensive, you could be asked to pay the difference. If it's a service not available in your kanton of residence, you can go outside, no problem.

Outpatient procedures, visits to doctors are generally covered outside your kanton. For example, my oncologist and gynecologist are both in Bern and I live in Zurich. I get my mammogram and bone density in Bern. No problem with coverage. I have only basic.

But, like everything else, check and make sure, inform your isurerer.
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  #25  
Old 31.05.2017, 22:09
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Re: SWICA Insurance

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We have the telmed model - no complaints. To be clear, we have the telmed version where you do not have to follow the advice, but you have to call for new appointments.
Thanks. Iīm checking but it seems to be only one type of TELMED. I will ask the guy from Nacora.
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  #26  
Old 31.05.2017, 22:24
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Re: SWICA Insurance

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Thanks. Iīm checking but it seems to be only one type of TELMED. I will ask the guy from Nacora.
Favorit telemed is the one we have
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Old 08.01.2018, 11:40
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Re: SWICA Insurance

Only 280?
How did you find it?
I am trying to look for an affordable health insurance. Comparis.ch gives me SWICA which is at 303.
I looked up KPT CPT, it was 345
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If you gave me CHF 800.- a year I'd be ready to fund your fitness club membership to a level of CHF 600.- too.

TBH I have not looked into it in detail but my mother is with Swica and I can't believe it when she tells me how much she pays (something like CHF 600.- per month) while I pay something like CHF 280.- per month (with KPT /CPT). True she has extra private options but still, it seems much too expensive.
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  #28  
Old 08.01.2018, 11:50
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Re: SWICA Insurance

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Only 280?
How did you find it?
I am trying to look for an affordable health insurance. Comparis.ch gives me SWICA which is at 303.
I looked up KPT CPT, it was 345
Check out the date of that post. Although many prices don't move that much in Switzerland, health insurance certainly does.
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  #29  
Old 08.01.2018, 12:00
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Re: SWICA Insurance

Oops. thanks.
I am a bit disappointed by SWICA Lausanne. I am new but have been here since Oct 9. I went to their office in Dec and they said they were busy. They kept my information on a paper with detailed notes of my needs and promised to call me back. Still nothing today...

Should I go to them again?
their damn phone is always going to auto-voice message....

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Check out the date of that post. Although many prices don't move that much in Switzerland, health insurance certainly does.
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  #30  
Old 22.03.2018, 23:25
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Re: SWICA Insurance

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We have the telmed model - no complaints. To be clear, we have the telmed version where you do not have to follow the advice, but you have to call for new appointments.
You're talking about swica FAVOURITE TELMED.

I wonder, if this model allows you to visit a specialist without consulting a GP first? Such important info should be hidden in small print, but so far I haven't found any.

It only says "free choice of doctors" for favourite telmed, however it doesn't say whether under term "doctor" it's meant a specialist or a GP.
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  #31  
Old 23.03.2018, 00:56
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Re: SWICA Insurance

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You're talking about swica FAVOURITE TELMED.

I wonder, if this model allows you to visit a specialist without consulting a GP first? Such important info should be hidden in small print, but so far I haven't found any.

It only says "free choice of doctors" for favourite telmed, however it doesn't say whether under term "doctor" it's meant a specialist or a GP.
Any doctor, specialist included. I continue to see my oncologist in Bern without referral from my GP, and I made an appointment with an orthopedic surgeon in Winterthur last year. He did my knee replacement four weeks ago.

As far as SWICA is concerned, as long as i inform them of the appointment, they are fine. However some physicians require referral from another physician independent of insurance.

Also, if you have an issue requiring repeated appointments, SWICA (and other insurers with telmed models) may open a ďwindowĒ for that issue so that during the year, all appointments for the same issue at the same facility are permitted. So everything involving my left knee at kantonal Spital Winterthur is allowed in 2018. Itís easy enough to call, however.
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  #32  
Old 23.03.2018, 01:13
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Re: SWICA Insurance

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Any doctor, specialist included. I continue to see my oncologist in Bern without referral from my GP, and I made an appointment with an orthopedic surgeon in Winterthur last year. He did my knee replacement four weeks ago.

As far as SWICA is concerned, as long as i inform them of the appointment, they are fine. However some physicians require referral from another physician independent of insurance.

Also, if you have an issue requiring repeated appointments, SWICA (and other insurers with telmed models) may open a ďwindowĒ for that issue so that during the year, all appointments for the same issue at the same facility are permitted. So everything involving my left knee at kantonal Spital Winterthur is allowed in 2018. Itís easy enough to call, however.
Great, so direct visits of specialists are included as well (for comparison: Helsana's telmed with free choice of doctors apparently excludes direct visits of specialists. If you do this, you breach the contract and they assign you to standard model).
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  #33  
Old 23.03.2018, 09:45
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Re: SWICA Insurance

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Great, so direct visits of specialists are included as well (for comparison: Helsana's telmed with free choice of doctors apparently excludes direct visits of specialists. If you do this, you breach the contract and they assign you to standard model).
Huh. Did not know that. Thanks.
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  #34  
Old 23.03.2018, 13:34
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Re: SWICA Insurance

I didn't notice anyone mentioning a key aspect in the question - if you are arriving new to Switzerland, it is probably the best option to take the insurer of your husband's company, especially if you consider complementary insurance.


Most of the insurers will request you to fill in a medical questionnaire and based on it, they will exclude from complementary coverage your current issues / potential issues or even they will simply refuse you a complementary insurance which is quite useful (dental is the most important in my opinion). There is high probability that your husband's company I assume quite big multinational) has a special contract with SWICA according to which any new hire from abroad gets a full coverage without exceptions for him(her)self and his/her family.


I suggest you check this aspect before taking any decision.


Btw. I am with SWICA for 2 years and never had special issues. I am rather satisfied. My company had contracts with CSS and Groupe Mutuel before and both were top as well. I believe that you get also a slightly different service level if you are under a company contract and you have a dedicated/separated Customer Service team.
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  #35  
Old 23.03.2018, 15:07
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Re: SWICA Insurance

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I didn't notice anyone mentioning a key aspect in the question - if you are arriving new to Switzerland, it is probably the best option to take the insurer of your husband's company, especially if you consider complementary insurance.


Most of the insurers will request you to fill in a medical questionnaire and based on it, they will exclude from complementary coverage your current issues / potential issues or even they will simply refuse you a complementary insurance which is quite useful (dental is the most important in my opinion). There is high probability that your husband's company I assume quite big multinational) has a special contract with SWICA according to which any new hire from abroad gets a full coverage without exceptions for him(her)self and his/her family.


I suggest you check this aspect before taking any decision.


Btw. I am with SWICA for 2 years and never had special issues. I am rather satisfied. My company had contracts with CSS and Groupe Mutuel before and both were top as well. I believe that you get also a slightly different service level if you are under a company contract and you have a dedicated/separated Customer Service team.
Thatís assuming itís your husband with the big company job, and the company is contracted to offer complimentary plans. Neither is always the case.

My husband works for one of the kantonal universities, so no company contract.
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  #36  
Old 23.03.2018, 19:35
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Huh. Did not know that. Thanks.
Helsana's premed24 is in the same tier as swica's favorite telmed.

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With the PREMED-24 insurance model, if you experience a medical problem you always phone the free medical advice hotline on 0800 773 633 for non-binding advice. If necessary you can make an appointment with a doctor of your choice afterwards
and then under FAQ section for PREMED-24 model:

Quote:
What happens if I go directly to a specialist?
By choosing the PREMED-24 advice hotline model, you agree to receive an initial phone consultation for all health problems. If you then still need to see a specialist, you can make an appointment with a doctor of your choice.

If you consult a specialist directly without having called the advice hotline, you are breaching your obligations under this alternative basic insurance model. As a result, Helsana may switch you to the standard model of basic insurance. This will result in you losing the discount on your basic insurance premium associated with the advice hotline model.
THE DETAILS.

Actually no, I am wrong. Apparently you can go directly to specialist, but have to call the first, as in all telemed models.

Last edited by 3Wishes; 15.04.2018 at 21:36. Reason: merging consecutive replies
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  #37  
Old 23.03.2018, 20:43
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Re: SWICA Insurance

I have given up with SWICA as seemingly every time we have needed anything, it has been problem after problem to deal with even everyday requests.
Even dealing with the boss - itís always terrible. Nice guy but just ineffective.

The final straw is a claim for 300chf - a Neighbour is completely accepting full fault - and but SWICA are putting us in the position to claim 120chf of this amount from the 3rd parties insurance, despite this not being an excess or anything. They tell us itís normal. But having paid a decent lump to insure the family each month I expect them to claim back this and deal with the paperwork for me - well they are for 180chf so whatís the difference? Has anyone experienced that? Is that even correct?

So moved to Sanitas and already we are seeing the benefit - they are now paying for 50% of a hospital upgrade to full private for a birth, something SWICA donít do. So the insurance has paid for itself for the next couple of years.

Thanks Sanitas
Adios to disorganized SWICA
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  #38  
Old 23.03.2018, 20:54
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Re: SWICA Insurance

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I have given up with SWICA as seemingly every time we have needed anything, it has been problem after problem to deal with even everyday requests.
Even dealing with the boss - itís always terrible. Nice guy but just ineffective.

The final straw is a claim for 300chf - a Neighbour is completely accepting full fault - and but SWICA are putting us in the position to claim 120chf of this amount from the 3rd parties insurance, despite this not being an excess or anything. They tell us itís normal. But having paid a decent lump to insure the family each month I expect them to claim back this and deal with the paperwork for me - well they are for 180chf so whatís the difference? Has anyone experienced that? Is that even correct?

So moved to Sanitas and already we are seeing the benefit - they are now paying for 50% of a hospital upgrade to full private for a birth, something SWICA donít do. So the insurance has paid for itself for the next couple of years.

Thanks Sanitas
Adios to disorganized SWICA
Uh... huh.

Why would your health insurance pay at all for something where your neighbor is at fault? Are you talking about an optional accident insurance or something?

In no case will an insurance company make claims on your behalf to another insurer. In Switzerland, youíre expected to take responsibility for yourself.

Iíve been a happy Swica customer for twelve years. No complaints, and not anything like disorganized (which adjective, by the way, doesnít actually apply as youíve told the story). I suspect you just havenít understood your contracts.
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  #39  
Old 23.03.2018, 21:03
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Re: SWICA Insurance

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Uh... huh.

Why would your health insurance pay at all for something where your neighbor is at fault? Are you talking about an optional accident insurance or something?

In no case will an insurance company make claims on your behalf to another insurer. In Switzerland, youíre expected to take responsibility for yourself.

Iíve been a happy Swica customer for twelve years. No complaints, and not anything like disorganized (which adjective, by the way, doesnít actually apply as youíve told the story). I suspect you just havenít understood your contracts.
Maybe I was not explaining very well - true.
The Neighbour admitted full fault, provided their insurance info for a small claim, Swica are now invoicing us 120chf and telling us we must claim that back from the 3rd party/their insurance.
It took Swica 1 entire year to pay my dentist for their work. He was not too impressed either.

I was with them a long time too - paying premiums happily - till I needed anything that worked.
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  #40  
Old 24.03.2018, 09:27
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Re: SWICA Insurance

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In no case will an insurance company make claims on your behalf to another insurer. In Switzerland, youíre expected to take responsibility for yourself.
I disagree. With a car accident for instance insurers usually deal directly with one another, the drivers don't need to deal with the other's insurance at all.
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