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Old 12.04.2010, 15:42
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Mental Health Coverage

Shopping for health insurance www.comparis.ch and speaking to an insurance company it seems that mental health is not taken very seriously. What if a person wants to have mental health coverage following a pregnancy? Does anyone know of a company offering a good policy?
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Old 12.04.2010, 15:50
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Re: Mental Health Coverage

Some insurances provide additional Insurance called "Natura" and/or "Diversa" which covers some treatments by a psychiatrist. But there is a limit.
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Old 12.04.2010, 16:03
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Re: Mental Health Coverage

Thank you - Are these marketing terms for the supplemental insurance for a particular company. If so, which companies?
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Old 12.04.2010, 16:12
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Re: Mental Health Coverage

The basic insurance covers Psychiatric therapy. Full details here.
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Old 12.04.2010, 16:19
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Re: Mental Health Coverage

Here:https://www.sanitas.com/pub/ServiceBroker?PAGEID=1185
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Old 12.04.2010, 16:25
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Re: Mental Health Coverage

Very helpful information from you both!
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Old 12.04.2010, 16:37
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Re: Mental Health Coverage

hi,

its worth bearing in mind that most of the swiss insurers will only cover pschaitry (however you spell it) costs and will cover nothing to do with pschology or counselling or other therapies. Its a very medical/pharma view on mental health here unfortunatly.

gs
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Old 12.04.2010, 16:37
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Re: Mental Health Coverage

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Very helpful information from you both!
What about some thanks to polish up our reputation? thank you

But i think there are much better things to do than to see a trick cyclist if you fell into a depression. No one can change the circumstances you live in, for you.
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Old 12.04.2010, 16:54
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Re: Mental Health Coverage

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hi,

its worth bearing in mind that most of the swiss insurers will only cover pschaitry (however you spell it) costs and will cover nothing to do with pschology or counselling or other therapies. Its a very medical/pharma view on mental health here unfortunatly.

gs
Swiss health insurances indeed cover also for psychologists! I would first get a referral from your GP if you feel that you need counseling. Usually, every insurance has a list of therapists you can choose from.

If your psychologist recognises the need of counseling (e. g. depression etc.) the basic insurance will cover the costs. BUT if you want to see a psychologist only for a 'identification process' you have to pay it on your own.

Best is to check directly with your insurance - I'm sure they'll be glad to give you detailed information.

Good luck!
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Old 07.01.2018, 16:50
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Re: Mental Health Coverage

Before moving in Switzerland a psychiatrist in my home country told me, that I show symptoms strongly suggesting the adult AD(H)D case. I was advised to undergo testing in order to confirm condition. Unfortunately I've run out of time to do that as I had to relocate in CH.

Now I'm in CH and I have to pick health insurance, tailoring it around my unconfirmed, but very likely present mental health problem.

Based on the info on this forum, all health insurances - to some extend - cover the mental health treatments , but from what I am able to see, these health insurance companies have their own selection of doctors. As I think that adult ADHD is a very specific topic that many psychiatrists/psychologist don't have much of expertise about , it may be very important to select a specialist with good credentials specialized in adults with ADHD, and then choose health insurance, that cooperates with this specialist ( I live in Zurich).

That being said, how can I find which health insurance companies cooperate with a selected specialist?

Then the franchise/deductible. Apparently mental health treatment is VERY expensive in Switzerland, so the highest monthly premium and the lowest deductible are a must (just in case I didn't write it right - I mean the highest monthly payment for health insurance and the lowest end-year remaining representing the out-of-pocket costs).

And, does AHDH treatment also require a psychologist, and not only psychiatrist?

If that's the case, then I might need a supplemental insurance, as psychologist seem not to be covered by a basic health insurance packages.

In any case, I would appreciate input from anybody who has some experience with mental health, or specifically ADHD condition in adults.

merci
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Old 07.01.2018, 18:20
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Re: Mental Health Coverage

A couple of comments.

Yes, you want to have a low deductible (CHF 300/yr is the lowest).

Best to go with the lowest cost "plain vanilla" plan. This means no tele-med, HMO style offerings or anything that restricts you to see a doctor before going to the psychiatrist or other specialists. You also want to go to any regular doctor rather than one on the company's list. This way you get someone you choose.

Once you are in the system for a couple of years and know your way around, you can look at other options to save money.

In CH you go to a psychiatrist for a diagnosis. They may then "prescribe" a psychologist for a treatment program. This is all covered by the basic health insurance (LaMal).

You may get to the psychiatrist directly or via a referral from your "family doctor".

Clear?
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Old 07.01.2018, 20:55
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Re: Mental Health Coverage

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A couple of comments.

Yes, you want to have a low deductible (CHF 300/yr is the lowest).

Best to go with the lowest cost "plain vanilla" plan. This means no tele-med, HMO style offerings or anything that restricts you to see a doctor before going to the psychiatrist or other specialists. You also want to go to any regular doctor rather than one on the company's list. This way you get someone you choose.

Once you are in the system for a couple of years and know your way around, you can look at other options to save money.

In CH you go to a psychiatrist for a diagnosis. They may then "prescribe" a psychologist for a treatment program. This is all covered by the basic health insurance (LaMal).

You may get to the psychiatrist directly or via a referral from your "family doctor".

Clear?
Well, I don't have a problem with restriction regarding the choice of GP (it's just one visit needed to get a referral), as long as I can later freely choose specialist. So if "free choice of doctor" is the only model allowing me to choose specialist, then so be it.

Also, would be an option to have psychiatrist/psychologist in Konstanz? Choosing standard model with highest premium over cheapest model with lowest premium which I would choose otherwise, adds CHF2500 of cost minimally. Maybe it's better to outsource specialist in Germany since traveling costs might not be that much (CHF50 two-way from Zurich, with halb tax abbo)
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Old 07.01.2018, 21:01
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Re: Mental Health Coverage

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Also, would be an option to have psychiatrist/psychologist in Konstanz? Choosing standard model with highest premium over cheapest model with lowest premium which I would choose otherwise, adds CHF2500 of cost minimally. Maybe it's better to outsource specialist in Germany since traveling costs might not be that much (CHF50 two-way from Zurich, with halb tax abbo)
Traveling cost, no, but youd need to pay the full medical treatment yourself and that wont be cheap in Germany either
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Old 07.01.2018, 21:40
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Re: Mental Health Coverage

Swiss health insurance provides the EHIC card which only covers you for emergency treatment outside of Switzerland. So as roegner says, any non-emergency treatment in an EU country you'd have to pay for in full.

Nor would free choice of doctor necessarily mean you get a choice in your specialist. The doctor will refer you to whoever he thinks is suitable. That may not be who you'd choose. But again this is something to discuss with your doctor when you finally have one.
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Old 07.01.2018, 22:01
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Re: Mental Health Coverage

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Swiss health insurance provides the EHIC card which only covers you for emergency treatment outside of Switzerland. So as roegner says, any non-emergency treatment in an EU country you'd have to pay for in full.
I'm fully aware of that. What I had in mind was that paying out of pocket for a specialist in Germany would be still decently cheaper (travelling costs included), in comparison to standard health insurance scheme in Switzerland. I am guessing this based on the fact that a lot of people living in CH outsource their dentists/orthodontists in Germany, so maybe the same could be done for mental health professionals as well.

[/QUOTE]
Nor would free choice of doctor necessarily mean you get a choice in your specialist. The doctor will refer you to whoever he thinks is suitable. That may not be who you'd choose. But again this is something to discuss with your doctor when you finally have one.
[QUOTE]

What's the point of "free choice of doctor" model then? Yet another "conditions apply" thingy, right?
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Old 07.01.2018, 22:22
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Re: Mental Health Coverage

There's not really any point. You're still paying the Swiss health insurance as well as any German medical costs. People outsource their dentistry because Swiss health insurance cover for that isn't particularly good and it's a supplemental that people add to their basic cover. As you've been told your specialists would be covered by the basic health insurance cover.

As said, this is something you need to discuss with your doctor. They may recommend a specialist, but if you would like to see someone else they may be able to refer you to them. Bear in mind that many specialists will only see people referred by their doctors or if someone goes direct it may take much longer to get an appointment than if you were referred.
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Old 08.01.2018, 14:42
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Re: Mental Health Coverage

When I lived in Swizterland I had basic health insurance with a CHF300 deductible. I had the model where there were no limits on who I saw, and where I could go directly to a specialist if I wanted to.

I registered with a GP and told them that I had a pre-existing mental health condition, and that I wanted to see a psychiatrist. They gave me the contact details of the outpatient department of my local psychiatric hospital. It took me several weeks to get through on that number, as I was working and the consultant whose number I had only took external calls twice a week in two two-hour windows... I later found out that I could have just contacted a psychiatrist directly, or indeed walked into the outpatient clinic in my town (the psychiatric hospital had two satellite clinics).

When I did get through, I explained my issues and I was referred to a junior psychiatrist and psychotherapist who spoke English. I saw her in the outpatient clinic for several years. She then moved to work in the hospital, but I was able to carry on seeing her as an outpatient there. She then moved to the other outpatient clinic, and again I carried on seeing her. She then moved to a large private practice, and asked me if I wanted to see her in that setting, and I did. (As you will gather I was very happy with her). At no point did my health insurance query this. However she then moved to another canton to get some experience in geriatric psychiatry. I couldn't follow her there, so she discussed my case with her colleagues and I ended up being treated by a psychiatrist who spoke English and a psychologist who spoke French.

I don't have the same kind of issues you do, but what I would say is that perhaps you should look for a large private psychiatric clinic where there are a number of psychiatrists and psychologists working together. I found that the benefit of this is that if your allocated clinician needs advice about your case, they have on hand a wide range of experience. You are also more likely to be allocated a psychiatrist who specialises in adult ADHD in a larger setting. Also, if your psychiatrist moves on (which in my experience they do tend to do), it seems to me a larger setting is more able to find another clinician who is a good fit for your needs.

Just to present the other side of the coin, the advantage of being seen in an outpatient clinic of a psychiatric hospital is that if you are ever hospitalised in my experience the transition to and from hospital to outpatient care is smoother if you are being treated as in an outpatient clinic of the same hospital, because it is the same global organisation. But from my limited understanding of ADHD I don't think hospitalisations are that likely.

From a cost point of view, for most of the time I was insured with Assura. I had no issues with my coverage. I was even able to arrange for something called a Cession de Creance (I don't know the German, sorry), which enabled the last clinic I was treated at to bill Assura directly, as opposed to billing me and then me submitting the bill to Assura for reimbursement.

As you may know, once you have paid the deductible you are liable to pay 10% of any additional treatment costs, up to a total of CHF 700. So if you have a CHF 300 deductible the most you will pay in any one year is CHF 1,000, plus the premiums. I found that I tended to reach that limit by the late summer, however that was often with hospitalisations as well as weekly sessions with my psychiatrist / psychologist.

Looking back, on average my sessions with my psychiatrist came to around CHF 200 - 400 or more per bill, but I don't have the paperwork so I can't be sure how many sessions that was... but judging by the frequency of the bills, two or three sessions tops, maybe less.

I hope that helps.
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Old 08.01.2018, 16:27
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Re: Mental Health Coverage

Look for a specialist in adult ADD. For example, the University of Zurich has such a clinic in the psychiatry depatment. Your GP may have to refer you even if you have free choice of specialists. Some clinics operate that way. Unless you are prepared to pay for therapy and treatment in Germany out of pocket, you are better off sticking to Swiss treatment.

Although Ive been really happy with the care received here, Swiss health care is a little weird with adult ADD. Were you officially diagnosed? I was tested in the US, and that was ok. But you may be required to have some testing. Not sure how much of that is paid by insurance. Also, while your psychiatrist visits should be covered under insurance, some medication is not covered in adults. I take a small dose of ritalin. My insurer told me that they would not cover ritalin for adults, only kids. They would cover concerta in some cases. So I pay out of pocket, its only chf 120 each year.
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Old 08.01.2018, 21:26
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Re: Mental Health Coverage

Quote:
Look for a specialist in adult ADD. For example, the University of Zurich has such a clinic in the psychiatry depatment.
That's the institution that I want to visit. Looked for specialists many published scientific papers, and most of them are from there.


Quote:
Your GP may have to refer you even if you have free choice of specialists.
Yeah that's the policy of many specialists. It still doesn't mean that I can exclude the "free choice of doctors" model, as anything else could limit my choice to the internal list of doctors and specialists dictated by insurance company?

[QUOTE]
Some clinics operate that way. Unless you are prepared to pay for therapy and treatment in Germany out of pocket, you are better off sticking to Swiss treatment.
[/QOUTE]

Well, above has been said that only dental treatment is justified to be outsourced. So if swiss treatment is equally expensive or even marginally more expensive, I would go with swiss due to saved time (1.5h in one way to reach Konstanz)

Quote:
Although Ive been really happy with the care received here, Swiss health care is a little weird with adult ADD. Were you officially diagnosed? I was tested in the US, and that was ok. But you may be required to have some testing. Not sure how much of that is paid by insurance.
Haven't been tested yet, but on informative visit at psychologist in my domicile country, she told me, that all symptoms point on a textbook ADD case. She also suggested that it's at least 50% of chance that with ADD come also other disorders, in my case that would be bipolar disorder.

Quote:
Also, while your psychiatrist visits should be covered under insurance, some medication is not covered in adults. I take a small dose of ritalin. My insurer told me that they would not cover ritalin for adults, only kids. They would cover concerta in some cases. So I pay out of pocket, its only chf 120 each year.
If 200CHF per year is total cost for medication, then this would be the last concern. I should be concerned about the cost of visits, as psychiatrist told me, that for psychotherapy, one visit per week is not unusual and therapy can last at least for a year. If bipolar is indicated, it can last even longer and more often.

That being said, I have to choose a health insurance wisely, which would cover me all this expensive stuff, and also enable me access to specialists in the psychiatry hospital ZH.
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Old 09.01.2018, 09:12
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Re: Mental Health Coverage

So basically, choose a low franchise, and free choice of doctors.

Weve had visana and Swica and were/are happy with both, in terms of service for the most part. I like the telmed ( you notify them of appointments, but do not have to follow their advice), but not everyone finds it easy to deal with.

Coverage is pretty much the same between insurers since it is all mandated by law for basic insurance, so people choose on price, service, and for many people, English speaking.

I imagine if youre diagnosed with bipolar, treatment and therapy should be generally well covered. ADD less so, for adults. Not saying I agree with that. Ive not had therapy here though....mine (generalized anxiety) was treated with therapy in the US and the meds for that work well.
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