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Old 27.07.2010, 23:07
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Retrospective Charges

Some quick simple advice needed on some basic health insurance.

I have taken out a basic insurance plan with Atupri (182CHF/per Month).

I moved to Switzerland to work/live mid-March.

I applied for the health plan mid-June.

The first bill I have received is charging me for cover from the 1st of March to the 31st of August (1096CHF). I was surprised that I am being charged for the months prior to my application for insurance.

Is this normal? Are there any route to pushing this to reduce the costs?

Any opinions or experiences would be greatly appreciated.

Regards all,

Tim
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Old 27.07.2010, 23:14
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Re: Retrospective Charges

Completely normal, cover is always backdated to the start of the month you arrive. Which is annoying if you weren't sick in that time. But of course fantastic if you got appendicitis one week after moving over.

Nothing to be done but pay, I'm afraid. Although you may be able to get the company to spread the bill out a bit if it's a struggle to pay it all at once.

kodokan
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Old 27.07.2010, 23:18
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Re: Retrospective Charges

Aren't you allowed 3 months to get cover and that any backdating should only go that far back ?
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Old 28.07.2010, 00:06
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Re: Retrospective Charges

Minimum health insurance coverage is mandatory by law. Every person in Switzerland is insured. Every new person arriving in Switzerland must have health insurance from day one.

It was voted years ago so that every person has a equal access to medical care.
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Old 28.07.2010, 18:17
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Re: Retrospective Charges

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Minimum health insurance coverage is mandatory by law. Every person in Switzerland is insured. Every new person arriving in Switzerland must have health insurance from day one.

It was voted years ago so that every person has a equal access to medical care.
This creates an interesting issue for those who can plausibly claim exemption, typically because they receive substantially equivalent health insurance as a pension right, usually as former diplomat or employee of an international organisation in Switzerland. http://www.eda.admin.ch/eda/fr/home/...ns/inshea.html

Application is submitted on, say, Form GLAS (for Vaud) to certify equivalence, and then one waits. http://www.vd.ch/fr/themes/sante-soc...rance-maladie/

The problem is that double coverage can be worse than underinsurance since you pay both premiums but the benefits, if any, may be, and probably are, prorated between the two policies so you don't get the highest reimbursement but approximately the mid-point between the two.

And generally the retiree who cancels his or her foreign policy can never reinstate it.

The (new) US law on mandatory health cover does make exception for those entitled in principle to foreign earned income exclusion whether or not they exercise that right. But that still leaves out many, such as Canadian border crossers or even Swiss transatlantic commuters, who many have to pay twice. (The Medicare Part B penalty for late inscription fits here too: 10% per year of delay. www.medicare.gov/publications/pubs/pdf/10050.pdf .)

For those who come to Switzerland for non-economic reasons and then change their minds and their status, I can envisage arguments with the authorities and/or the insurer on the matter of retroactive premiums. And can we assume that retroactive premiums mean retroactive cover? Normally you can't buy insurance after the fact (the crystallisation of a loss or of a particular risk beyond that specifically undertaken by the insurer), and premiums uselessly paid are lost.
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Old 28.07.2010, 18:36
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Re: Retrospective Charges

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Aren't you allowed 3 months to get cover and that any backdating should only go that far back ?
I thought so too, but when I think about it, i think the words are, "you got 3 months to sort it out". But I applied for insurance from 1st day after 3 months, which they confirmed (november 2008), and they did not bill me until January 2009

Doc.
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Old 28.07.2010, 20:31
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Re: Retrospective Charges

depressing responses..

perhaps I can at least move my cover date to start from mid March when I arrived. Or does it always have to start on the 1st of each month.

Who am I kidding this is Switzerland, ignore that last question.

Damn they love taking money from you here.
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Old 28.07.2010, 23:27
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Re: Retrospective Charges

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The problem is that double coverage can be worse than underinsurance since you pay both premiums but the benefits, if any, may be, and probably are, prorated between the two policies so you don't get the highest reimbursement but approximately the mid-point between the two.


For those who come to Switzerland for non-economic reasons and then change their minds and their status, I can envisage arguments with the authorities and/or the insurer on the matter of retroactive premiums. And can we assume that retroactive premiums mean retroactive cover? Normally you can't buy insurance after the fact (the crystallisation of a loss or of a particular risk beyond that specifically undertaken by the insurer), and premiums uselessly paid are lost.
Benefits will not be prorated between the two policies, as the swiss insurer will pay the actual cost it is supposed to cover, not more, not less.

If you came to Switzerland for non-economic reasons, you will get a specific permit. If you want to take up a job or a business, this permit has to be replaced. If afterwards you fall under the category of those who cannot be exempted, the starting date for the health insurance will be the moment you got the new permit.

Retroactive payment means retroactive cover, one of the huge differences between mandatory health insurance and other types of insurance contracts.
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Old 28.07.2010, 23:53
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Re: Retrospective Charges

So if I move to CH with my US coverage still intact for a few weeks I should probably just make the arrival date identical with the start of the coverage date for the new CH health insurance plan? I absolutely do not want to pay 2x, it's expensive enough as it is.
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Old 29.07.2010, 07:31
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Re: Retrospective Charges

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Benefits will not be prorated between the two policies, as the swiss insurer will pay the actual cost it is supposed to cover, not more, not less.

If you came to Switzerland for non-economic reasons, you will get a specific permit. If you want to take up a job or a business, this permit has to be replaced. If afterwards you fall under the category of those who cannot be exempted, the starting date for the health insurance will be the moment you got the new permit.

Retroactive payment means retroactive cover, one of the huge differences between mandatory health insurance and other types of insurance contracts.
I don't claim to be an insurance attorney, but I did take courses in 2 different universities on US and European insurance law. One of the basics of insurance is this: you cannot be paid twice for the same cover. (Slight simplification because there are stated value policies, and there are also situations where two parties each with an insurable interest get paid in full by their own insurer. But this is not relevant to health insurance.) One policy may be primary and the other secondary; a travel insurance policy for example will be secondary to any valid and collectible health insurance you may have. Ditto for, say, "free" credit card (Amex, for example) cover.

But if you have two policies that are intended to be primary -- and that would include, say, a Swiss medical payments policy and a US policy such as one written under FEHBA (Federal Employees' Health Benefits Act) -- you will be asked to state, when claiming benefits, whether you have any other coverage. This might be workers' compensation, Medicare, a foreign or domestic policy in your name or that of your spouse or parent, and so on.

If and only if there is double coverage, the two insurers work out between them (or decide independently in the absence of cooperation) how much each will pay. The general rule (that's legal theory, and it can be displaced by statute or company policy; or by an insured lying on his claim form and just perhaps getting away with the fraud) is that each deals with a proportion (presumptively half) of the loss -- within the terms and limits of the coverage underwritten.

So if my annual out-of-pocket ("franchise") is $300 with one policy and CHF 400 with the other, I won't get any payment from either insurer until that insurer's out-of-pocket amount has been met. Then there is the co-payment amount. If it's 10% on one policy and 20% on the other, I am obviously worse off than if the 10% policy underwriter were paying everything. Plus, I (and my ex-employer if the insurance is a retirement benefit) have been paying double premiums without any perceptible benefit for that double payment.

Some kinds of insurance aren't health insurance at all: "cancer insurance" is more like life cover (and Americans including AIG were big and profitable operator in that sector. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1304745/ -- it is popular in Japan where there is an extraordinary fear of casncer (I am told), and shame as well so not all eligible policyholders and surviving families ever claim). Some hospital cover, especially that sold in the UK is also independent of any actual cost outlay.

Hope that helps. Read your policy, and also the law behind it. "New-for-old" and "stated value" cover are anomalies and (except for the cancer and hospital niche policies I just mentioned) I can't think of anything comparable in the health insurance field, where as in any casualty and non-life indemnity cover you are not supposed to get back more than you lost and you can't collect in full from two different policies even if you paid full premiums for both. (Distinguishing, of course, where an owner and a lessee of a building each have fire insurance on that building, and each collects in full when it burns down as each as an insurable interest in it.)

For the rest: the exemption I wrote about has limited scope and is not connected with present immigration status but prior employment with an eligible international employer. I would not try to address the issue of retroactive cover except to say that it is open to fraud since obviously if one contracts or discovers a loathesome or chronic or expensive disease one will obviously opt for the best retroactive cover available.

Last edited by andy02; 29.07.2010 at 08:24.
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