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Old 05.07.2010, 14:28
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No longer have to pay the 10% for health insurance?

Hi,

I'm hoping some kind person on here will be able to explain what happened to me in the pharmacy today.

I have my health insurance with Assura, I have a CHF 300 franchise (which I passed in my second month here), and I have had a LOT of medical bills since being here - I spent 3 months in hospital, for starters (I will have been here a year at the end of the month).

I am currently receiving Revenue d'Insertion and I am on a 100% medical certificate. I also have my health insurance premiums paid for by the OCC.

Because I have a low income and am on a lot of expensive medication, Assura and my local pharmacy agreed that I could have a 'cession de créance' (I think that's how you spell it), which meant that I only paid the 10% and the bills got sent straight to Assura.

So I went in today, handed over my prescription and when the pharmacist said 'Do you have to pay for this?', I politely replied that no, I had a cession de créance and I only paid 10%. Whereupon she went out to the back, was there for ages, and then returned with the boss. Who told me that I didn't have to pay the 10% any more, that in fact the pharmacy owed me money and could they please have my bank details? Which she took, and then they gave me my medication and I left!

Obviously I am rather pleased at not having to pay 10% of my medication any more, but I am rather perplexed as to why this is. She seemed to be saying that I had passed a certain limit - but I didn't catch what that limit was? And I don't understand if this just applies to my medication or if I now don't have to pay the 10% for anything...

So if anyone can shed any light on all that...

Also, will this all 'reset' when my insurance comes up for renewal (which I assume will be at the end of this month)? Will I have to go through all the hassle of getting my cession de créance set up again?

Thanks for any info!

Victoria
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Old 05.07.2010, 14:35
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Re: No longer have to pay the 10% for health insurance?

Yes in french it's called "quote-part". You pay 10% of the amount that is above your franchise until you reach 700 CHF. So you quote-part can't exceed 700CHF.
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Old 05.07.2010, 14:40
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Re: No longer have to pay the 10% for health insurance?

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Yes in french it's called "quote-part". You pay 10% of the amount that is above your franchise until you reach 700 CHF. So you quote-part can't exceed 700CHF.
Thanks,

I'm a little surprised it's taken me nearly a year to get to that figure, but they didn't seem to bill me the 10% on all of my hospital bills...

It's so confusing!
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Old 05.07.2010, 14:47
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Re: No longer have to pay the 10% for health insurance?

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Thanks,

I'm a little surprised it's taken me nearly a year to get to that figure, but they didn't seem to bill me the 10% on all of my hospital bills...

It's so confusing!
if the total treatment (medics, hospital, medical consultation) reached 7000CHF, your quote-part would be 700CHF. Everything above this amount will be paid 100% by insurance. Check your bills...but you shouldn't worry as they are paying you some money back. I wish you a swift recovery.
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Old 05.07.2010, 14:54
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Re: No longer have to pay the 10% for health insurance?

I got today my assura card i am new for such situation , i wish will not pay any too ;(
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