Can you negotiate down large medical bills (ambulance rides)?

So did you have to pay the full or was part of it covered by basic health insurance?

You might want to consider getting a supplementary insurance to cover this. It is really quite cheap.

So I don’t know yet if the insurance will pay any of it. They’re still thinking about it.

It’s either:

  • an accident => 100% of the bill paid, no deductible and no copay
  • medically necessary => some of it paid, typically 50% up to 500.- unless you have supplementary insurance
  • medically unnecessary => they pay none of it

My problem is that:

  • I’m not a doctor, I have no idea if it’s medically necessary (short of the very obvious, like a bruise or a very minor every day injury)
  • The definition for “accident” is very complicated and it can take a lot of arguing to decide whether something is an accident (“sudden and external” is the definition… good luck with that)
  • Having to try and decide all this in the heat of the moment while injured is really not something anyone should be expected to do, yet here we are
  • The price in some cantons is fixed (some in Romandie, the result is that a ride costs more like 200–500.- and yet everything works fine) and unregulated in others (where you get 1000.- or 1500.- for a short ride)
  • Insurance in general is extremely opaque: it’s hard to tell if (and how much) many things are going to cost you and whether they’ll be reimbursed or not.
  • Switzerland is expensive, yes but why is it so hard to obtain generic medicines that cost 5x or sometimes even 10x less than their branded version for instance?
  • Or why are medicine (any medicine) so much cheaper anywhere outside of Switzerland? These things aren’t made here, they’re imported and thus don’t cost 3x or 5x as much to make, yet we pay through the nose for them compared to the rest of the EU.
  • Some doctors (mostly psychiatrists) flat out refuse to take insurance even if insurance would otherwise cover it because it’s way too much hassle dealing with the paperwork, the billing codes, the issues… How is that efficient and effective at all?
  • It feels like the insurance system here mostly benefits insurance companies rather than the general population.

I personally think all this is the result of making health insurance mandatory (which is a good thing) but leaving up to private insurers to influence the laws and charge whatever they want.

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If you were bleeding - it’s obviously at least point 2 from your list.

Did you speak to the insurance re. any coverage from their end?
(You said you spoke to the hospital re. payment)

I wish it was so simple. We’ll see what they say, for now they refuse to say anything. It shouldn’t be like that, ambulances are medical expenses and the insurers should be mandated to cover the costs without exception. Maybe that’d also help the cost of ambulance transport go back down to reasonable amounts.

If the dispatcher thinks an ambulance is necessary then that should be it. But nope, it has to be a gamble anyway.

So you want even higher health insurance premiums? How many times in your lifetime do you think you need an ambulance? Ambulance should only be called in severe cases in my opinion and there I agree with you that the costs should be covered in full but not if calling the ambulance was unreasonable (without knowing what your case has exactly been).

I think you are overreacting a little bit here.

When I was a young adult I also had to pay about 1000.- for a seven minute ambulance ride. Whatever as long as you are healthy and you learned how high the costs are I think you just have to bite the bullet.

I wonder what effect these high costs of ambulance have an on the amount of people who fail to call the ambulance when actually needed because they fear the bill. Such phenomenon, if existing, must affect more poor/FIRE people compared to the average person.


Well in the US you have the phenomenon of people calling Uber instead of an ambulance…

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Yes, completely agree. Nobody should turn away from medical help because of the costs.

I think the problem is that with normal medical help you know your fixed costs based on premiums+franchise+10% part up until 700.-.

In the case of the ambulance or rescue missions for example the cost can almost be unlimited which can be a problem.


You gotta think about the bigger picture here.
People who reached the maximum of the Franchise or definitely after reaching the maximum of the Selbstbehalt will call the ambulance for other reasons than emergencies.
I think you will agree that this wouldn‘t be feasible?

I don’t think this is true.

There are many countries (I’d say all of the EU) where ambulance rides are “free” in the sense that the patient doesn’t get the bill for them.

Last I checked, taxis were still in business. It’s not like people call ambulances because they’re free instead of taxis… why would it be any different here?

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15 posts were split to a new topic: Health insurance policy

According to a belgian show I watch, some people call the ambulance for nothing, and the dispatchers refuse to send them


Which is also a very reasonable solution to a real problem. Much better than charging through the nose.

Whataboutism? 20 chars

I recall an ad campaign in the UK a few years back, where they tried to raise awareness for the societal impact frivolous call outs for ambulance had. From a newspaper article: “People have dialled 999 because of a split condom, a nose bleed, a finger trapped in a door, a sore throat and toothache”…

I would agree that 1’500 CHF seems high and might make somebody hesitate getting help, when it may well turn out to have been urgent. On the other hand, making it completely free / always fully insured would leave it too open for abuse. Leaves us with the question of what the fair cost should be?

Also, you call them out on corporate greed and excessive profits, but I’m not sure I would want to start an ambulance business. What would it take as minimum to serve your 10 minute drive?

  • Assuming the 10 minutes drive was 1-way, total use time was probably close to 30 minutes (get in, get there, load passenger, get back, get out). Add 15 minutes for staff to disinfect & restock any items used. Total down time = 45 minutes.
  • If we want to cater to the more trivial end, we probably need at least a second ambulance ready to go if a more urgent call comes in during those 45 minutes. To allow for repairs, upgrading equipment, etc. maybe consider a third ambulance to ensure there are always two ready to go.
  • Per ambulance a team of two people, driver & paramedic. 24 hours standby @ 2 ambulance @ 3 shifts = 12 people. Possibly needs 4 shifts to ensure sufficient rest time and need to cover weekends as well, let’s make the total 18 people. Also need to train people, cover for vacation, sick leave, maternity leave… New total maybe 22 people? Add some admin & cleaning & car/equipment maintenance… New total 24 people?

I don’t know… Maybe 1’500 CHF is on the high end, but I don’t think I’m going to invest any time soon.

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FFS, you don’t even know how much you will have to pay yet. You are just getting your knickers in twist because they are not responding fast enough for you. Get off your high horse and go sign up for the supplementary insurance. Don’t blame others and the system for not having done your research.

In the same way that a police force might be expensive to run, or a fire department, or… an army (in a country that’s never at war)

Why do ambulances need to be for profit? The main goal is to save lives, why can’t it also be a public service? It would not be free to run but surely wouldn’t cost 1500.- per trip. Even if the insurance pays, it’s still passed down to us one way or another because insurers are also in it for a profit.

The fact that it can be abused isn’t a reason for punishing the vast majority who use it as intended. We’re all worse off because of a few offenders? That doesn’t make any sense. And it’s not like Uber where you get an ambulance sent by clicking a button. You have to talk to a dispatcher first who assesses the situation and can decide whether an ambulance is really needed or not. Yes people can lie but this is universally true and not limited to ambulances. Even then, it’s easy to see that the person wasn’t having a heart attack but got their finger in the door once the ambulance arrives: it was a lie → they get charged.

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Huh ? you asked if there is an effect to high cost and in a country where the costs are also pretty high it has actually been measured. So not sure where the Whataboutism is coming from…

Well actually if you take the total costs you would properly pay more. Problem is those cars are pretty expensive and have incredibly low runtime (since you have to have at least one for about maximum 10 min driving time). Basically, you are not only paying for the driving time, but for the infrastructure behind it (being close enough, having doctors available on call, having enough in case of multiple need at tge same time, the dispatch etc.)

Question is now : how much of this infrastructure is taken over by the community (through taxes) and how much is billed through the 10 min drive. And this differs from canton to canton (and can be seen through the respective tax rates).

And to the extend of my knowledge, the normal ambulances are state owned and are not making profit on the long run, they are allowed to only cover their long term costs (incl. provisions for renewal etc.).

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Sorry if that came out too rough. I was wondering what effect the current system and its cost could have in Switzerland and I didn’t see what the situation in other countries have to do with such question.

Just got this in a mail from Comparis, and suits this topic.

Of course Comparis is basically a sales site for insurance these days, so the recommendations will be biased.