Thursday, 15 December 2011

Why Swiss Health Insurance Doesn't always work (and why I now Love the NHS)

WARNING: If you get bored easily, you probably won't want to read this! Contains detailed workings of Swiss Health Insurance (yawn)

I had a fairly successful appointment with my Psychiatrist yesterday and one of the things we discussed was my health insurance.
I may have explained it before (and can't remember which blog post it was in) but it's like paying car insurance - you pay a premium and have an excess.  The smaller the excess, the higher the premium. When you have resided in Switzerland for more than three months you are obliged to have health insurance.
This is all well and good, when you pay your premiums.  When you see a doctor or other specialist or have a blood test, anything, the bill is sent to you and you then send a copy to the insurer who then refund you the amount of the bill less 10%.  You then pay the bill.  Sounds simple huh?
My problem was about two years ago I got into arrears with my premiums.  I tried making a payment plan with my health insurer, A. They refused and kept demanding the amount I owed which was 3 months worth of premiums for myself and my boyfriend at the time (he paid the rent).
As a result of the arrears, they then stopped paying my medical bills.  So as a result, any money I had had to pay the medical bills and not against the arrears.  I asked for a payment plan again.  They refused.
Well, I thought, I will change insurers so that the new insurer will pay my medical bills, close off my old insurance and make part payments until the arrears are paid off.
You can only "leave" an insurer twice a year, by the end of June or by the end of December.  To cancel the contract, the insurer has to receive your cancellation a month before the end of June/December and this has to be sent recorded delivery.  They are Swiss - don't follow thse rules and your request is ignored.
I duly sent the letter, correctly and within the timescale.  Insurer A replied with a letter confirming the cancellation.  I then signed up with a new insurer, O,  who sent me the contract which I signed and returned. I started paying the new insurer from the January.
Insurer A kept sending me bills.  I telephoned them and said they had accepted my "resignation" and I was no longer insured with them.  They said it was not possible to change insurer because I had arrears on my account.  I asked for a copyof the letter and they sent me the original "acceptance of resignation" PLUS another piece of paper attached (which they had not attached before) which stated that you cannot change insurance when you have arrears on your account.  News to me. I wrote to them explaining their mistake and they didn't accept it.  Meanwhile, the debt kept mounting up, but at least the new insurer was paying my medical bills.
So, to insurer 2, O. I explained to them that I was not allowed to change insurers because of the arrears and the new insurer said because I had now signed a contract with them, I had to continue to pay them insurance premiums. Problem: I was now expected to pay 2 insurance companies.
Of course, this put me in complete panic and being in a pretty poor mental state these days with coping with stuff like this I decided to refer to Social Services.  Initially I saw the SW as part of the Psychiatric service and she investigated, telephoned people, contacted Ombudsmen etc etc on my behalf and what she discoverd was interesting:

1. The Old insurer is meant to write to the proposed new insurer to "allow" me to leave them.  Insurer A DID NOT DO THIS.
2. You are not allowed to be insured by 2 companies.  Both insisted that I pay them premiums.
3. Basically, what these insurers were doing is illegal.

Anyway, to cut a long  and boring story short (thankfully, you say!), My medical bills and health insurance are now paid for by the state, the debt has mounted up and I have been placed on an official Swiss debt register.
I was discussing this with my Psychiatrist yesterday as he has been trying to get hold of my SW with no luck, so he is going to talk to the Psychiatric service SW to review this whole situation again.  If I have to have any seriously expesive treatment then there is some State "governer" type for health insurance who will approve the treatment.
This has been going on for 2 years now and neither insurer will accept any responsibility and I feel the pressure of it all.  Luckily my doctor will keep treating me, I can still see my Psych (although I have reduced the number of appointments) and my pharmacist will keep supplying me with medication as they all agree I need continued support and treatment.  This is where it is handy to have a more personal relationship with professionals (which somes with living in a small village) and they have been great.
But I don't half miss the NHS.  I will never complain about them again.  Well, until I am back into the system when I return to the UK.

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