For the complementary, they can even refuse you. Don’t play with that.
They can NOT require a health check for any reduction of deductible. Just ask for the change of deductible and do not follow up on any health check requirements. Alternatively, if you don’t want to be bothered just cancel and take the basic insurance with another provider (probably what they want you to do actually). Keep in mind that:
- You can have your basic and complementary health insurances with different providers. If you wish to cancel only the basic insurance with your provider, make it very explicit.
- Your complementary health insurer cannot kick you out because you are now sick (quite obviously they cannot reject to pay because you now need your insurance, otherwise why would anyone take an insurance in the first place?). However, a new complementary health insurance provider can reject to insure you on the basis of a health check.
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noob question: when you have a health expense in your case (different basic and supplementary insurers), how does it work? Do you have to send the request to both insurers, or do the basic coordinate with the supplementary with no hassle to you?
Your providers won’t sync, it will be on you to send the bills to both and they will check seperately what they cover.
All of that does not really matter as long as your are not (chronically) sick and start to deal with rolling medical expenses. At that point it could make sense to move your basic insurance to your supplemental provider to remove the admin burden. Keep in mind that it won’t be possible the other way because of the health checks requirements. Until then optimise your basic insurance purely on cost and suitable model.
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My SWICA basic insurance premiums went up by over 25% (Geneva, male)
SWICA told me I could change to their cheapest basic insurance with restricted choice of doctor. In the event I get a chronic illness (cancer) I could change to a more expensive coverage with free choice of doctor with 1 month notice.
This was news to me, does anyone know if this is correct? Can you also change between providers with one month notice, are the insurers obliged to accept you (?)
So if I have supplemental insurance with a different insurer, and with just the possibility to change the canton in case of hospitalization (in the basic with the other insurer I cannot change canton), is it going to work?
I changed to KPT in 2023…and forgot about migrate also that part.
I think you can only switch to same franchise, more expensive plan, same provider (but would need to double check).
Some years ago I asked to Swica and they said it was possible
Yes. Your basic insurance will cover for the cost of the equivalent treatment in your canton (in general ward, art. 41 al. 1bis KVG) and the supplemental insurance will pay any difference not covered (also in semi- or private ward if you have taken that option).
Note that if a treatment is not available in your canton, then the basic insurance has to cover you for the treatment elsewhere (still in general ward).
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According to this page from the government, it is possible to change insurer AND model only at year end by notifying your insurer by end of November. However, I do know instances of people changing models mid-year. Your insurer may also force you to switch from a restrictive to a general model if you do not respect the conditions.
Note that there is one exception from the change of insurer at year end. If you have a deductible of 300 and a general (i.e., non-retrictive) model, you can also change insurer at the end of June, with a 3 months notice period.
Thanks for the thread, it’s very helpful.
I’m looking for supplementary insurances that cover the following two things:
- treatment abroad in case of standard care (e.g. going to a physiotherapist, or visit a doctor abroad)
- choosing the doctor and hospital in case of a big medical procedure but without private or semi-private room.
Have you any of these by any chance? I found something at Sanitas, but it looks like these two requests are not common.
Did anyone already try AGRIsmart from Agrisano? It’s basically an app you are supposed to use first and uses services from medgate. For the details: AGRI-smart digitales Versicherungsmodell - Agrisano - Schweizer Bauernverband
Looks the same as Smartmed from Aquilana (also medgate). So kind of a Telmed offer where you can either request a call or chat with a doctor. First they will ask you a bunch of questions about your symptoms.
Asked Swica what what the disadvantages are if I move my basic insurance to another company and if this influences the supplementary insurance in a bad way. Their response:
Dear xerox5003
Thank you for your inquiry.
The benefits and also the premiums of the supplementary insurances would not change with a change of the basic insurance.
The only disadvantage would be that you would have an additional administrative effort if you have to send the invoices concerning the basic and supplementary insurances to both health insurances.
You will receive your adjusted policy shortly.
We thank you for your cooperation and will be happy to answer any questions you may have.
With kind regards
Switched this morning to EGK TelCare.
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Hey, just curious if you made the switch. I’m also looking at this exact model (cheapest in Geneva, next is Assura =/ ).
I love the color-coding system. Makes it easy to see what’s what.
We got two offers of the same price, one is an HMO model and the other Telmed (hotline or medgate app). Anyone can share their experiences and their preferences?
Also in Geneva currently basic insurance with Swica, 2500fr franchise. 2024 basic insurance premium is increasing to 485 CHF/m so I am looking for a new insurer
I am considering Mutuel Optimed (Family Dr model) which is ~10 CHF/m more than the Assura models you are looking at, or more likely Mutuel Primaflex ~30 CHF more than Assura
Why Mutuel vs. Assura? Mutuel model is less restrictive according to the FRC review posted by @ardius on Sep 30 . Additionally Assura is tiers garant. We had the experience when insurance rejected a Dr’s bill. Luckily we were under tiers payant so we did not have to get involved but it would have been a mess
Why pay more for Mutuel Primaflex vs. Mutuel Optimed?: Free Dr advice 24/ 7 by phone including prescriptions sent to nearest pharmacy. i.e. not having to wait to Monday morning or go to family Dr for something straightforward or a referral to a specialist and have to pay for the consultation
Anyone have experience of these?
Curious to know about this as well.
I was busy and never actually changed Providers the last couple of years but I want to do it for 2024. That will give me a whopping ~0CHF savings compared to 2023 but given the increases across the board it’s not bad news.
For my gemeinde in Canton Zurich the best provider is Concordia with HMO model (278.70 CHF) and there’s also Concordia with smartDoc model at 285.90. (There’s also Wädensil but since their website is only in German I will pass them).
We will schedule an appointment with Concordia next week (for me and my gf) and we will ask them some questions but do you folks have any thoughts on these two models and what we should look out for? In the 5 years that I have been in Switzerland I haven’t used my health insurance once, but you never know…
According to what is written in the T&C (section 23.2):
If Sanitas owes fees to a healthcare provider on the basis of contracts, Sanitas will pay benefits directly to the healthcare provider and invoice the insured person for his share of the costs.
So it means that the Compact One model is tiers-payant.
Last week I already signed for it, I will see how it goes.
@Barto, I suggest you to double-check what you read on frc.ch because, in my case, many things were incorrect 