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Medical bill outside insurance... what to do?

Hello,


I'm posting here hoping some local people can shed some light on what happened to me.


I'm an Italian student in Lausanne for the semester. I'm covered by LaMal insurance thanks to my European insurance card. I had to go to a doctor's some weeks ago. I received a huge bill (around 500 chf) for some checks he prescribed to me.


I asked him during the visit whether the analysis were covered by my insurance and his answer was: "yes of course, you'll just need to pay the bill and then send it to your insurance which will reimburse you". Turns out the treatment wasn't included in my health insurance.


Now I have a 500 chf bill which won't be refunded by my insurance. Shall I pay it? What should I do? Thank you in advance, hope you can help me.

The text you are quoting:

Hello,


I'm posting here hoping some local people can shed some light on what happened to me.


I'm an Italian student in Lausanne for the semester. I'm covered by LaMal insurance thanks to my European insurance card. I had to go to a doctor's some weeks ago. I received a huge bill (around 500 chf) for some checks he prescribed to me.


I asked him during the visit whether the analysis were covered by my insurance and his answer was: "yes of course, you'll just need to pay the bill and then send it to your insurance which will reimburse you". Turns out the treatment wasn't included in my health insurance.


Now I have a 500 chf bill which won't be refunded by my insurance. Shall I pay it? What should I do? Thank you in advance, hope you can help me.


Marco FNov 7, 2017 @ 22:28
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Re: Medical bill outside insurance... what to do?
Post 1

I guess the procedure you had is considered non essential, or some kind of alternative treatment, if the insurance company says that to them it is out of scope.


If you dont pay they will send their bill to the "office des poursuites" and it'll just be more complications for you from there on. The best i think is to appeal to the administration for some kind of arbitration on this, such as described here https://www.om-kv.ch/fr/taches


 

The text you are quoting:

I guess the procedure you had is considered non essential, or some kind of alternative treatment, if the insurance company says that to them it is out of scope.


If you dont pay they will send their bill to the "office des poursuites" and it'll just be more complications for you from there on. The best i think is to appeal to the administration for some kind of arbitration on this, such as described here https://www.om-kv.ch/fr/taches


 


Francois F, Nov 10, 2017 @ 11:38
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Re: Medical bill outside insurance... what to do?
Post 2

As stated above, you will have to pay it to avoid worse things, a poursuite can be a bit of a nightmare  and you would end up paying fines on top of the bill. 


Do you pay tax here? if so, you sould be able to claim against it.


I am not familiar with European Heath Insurance,  maybe as you are only here tmporarily, if not posible here, you could claim in Italy aginst your taxes in some way?

The text you are quoting:

As stated above, you will have to pay it to avoid worse things, a poursuite can be a bit of a nightmare  and you would end up paying fines on top of the bill. 


Do you pay tax here? if so, you sould be able to claim against it.


I am not familiar with European Heath Insurance,  maybe as you are only here tmporarily, if not posible here, you could claim in Italy aginst your taxes in some way?


TogJay, Nov 10, 2017 @ 13:10
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Re: Medical bill outside insurance... what to do?
Post 3

Sorry for typos above .. writing in a hurry.. hope it's clear..

The text you are quoting:

Sorry for typos above .. writing in a hurry.. hope it's clear..


TogJay, Nov 10, 2017 @ 13:12
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Re: Medical bill outside insurance... what to do?
Post 4

Yes Marco - you definitely have to pay it.   The LaMal has a very tenuous link to your European Insurance, but it's more of a legal necessity than actual insurance.  It's also more or less worthless for small invoices and has different stipulations as you're here temporarily and as a student. 


So when the doc said "yes" he would have meant that you have to pay it, then claim it back under your European Insurance when you're back in Italy, not your temporary LaMal.


Just make sure you keep all the receipts and paperwork and good luck!


 

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Yes Marco - you definitely have to pay it.   The LaMal has a very tenuous link to your European Insurance, but it's more of a legal necessity than actual insurance.  It's also more or less worthless for small invoices and has different stipulations as you're here temporarily and as a student. 


So when the doc said "yes" he would have meant that you have to pay it, then claim it back under your European Insurance when you're back in Italy, not your temporary LaMal.


Just make sure you keep all the receipts and paperwork and good luck!


 


Carolyn C, Nov 10, 2017 @ 13:24
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Re: Medical bill outside insurance... what to do?
Post 5

Hy Marco, is it possible that you have chosen a high deductible (franchise) on your mandatory health insurance? I suppose when you have seen a regular doctor, that the bill is established with the legal tarif position what means paid by your insurance. But as you have (as everyone else) an annual deductible (you can choose between CHF 300.- to CHF 2500.- every year), the first medical costs till you reached this amount are taken into deduction from this amount. Once reached your franchise, the health insurance pays the 90 % of the medical bills. Hope you see a bit clearer now. You find here a great document which explains the swiss health system quite well https://www.bag.admin.ch/dam/bag/en/dokumente/kuv-aufsicht/krankenversicherung/sie-fragen-wir-antworten-oblig-kv.pdf.download.pdf/broschuere-sie-fragen-wir-antworten-e.pdf 


Cheers Daniela

The text you are quoting:

Hy Marco, is it possible that you have chosen a high deductible (franchise) on your mandatory health insurance? I suppose when you have seen a regular doctor, that the bill is established with the legal tarif position what means paid by your insurance. But as you have (as everyone else) an annual deductible (you can choose between CHF 300.- to CHF 2500.- every year), the first medical costs till you reached this amount are taken into deduction from this amount. Once reached your franchise, the health insurance pays the 90 % of the medical bills. Hope you see a bit clearer now. You find here a great document which explains the swiss health system quite well https://www.bag.admin.ch/dam/bag/en/dokumente/kuv-aufsicht/krankenversicherung/sie-fragen-wir-antworten-oblig-kv.pdf.download.pdf/broschuere-sie-fragen-wir-antworten-e.pdf 


Cheers Daniela


Daniela Z, Nov 11, 2017 @ 09:58
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Re: Medical bill outside insurance... what to do?
Post 6

You are in a situation where you need to take action without further delay.


First of all, ask the insurance company why your coverage is insufficient or non-existent for the treatment concerned.


Then, if you do have to pay the bill, ask for an arrangement to pay by instalment.  Most insurance companies are cooperative in this respect.


 


What you must not do is dally.  The longer you delay taking action, the greater the risk of your bill being forwarded to the debt collection authority and that will involve payment plus a fine and a blot on your payment record.


 


So get weaving – and all the best,


R.

The text you are quoting:

You are in a situation where you need to take action without further delay.


First of all, ask the insurance company why your coverage is insufficient or non-existent for the treatment concerned.


Then, if you do have to pay the bill, ask for an arrangement to pay by instalment.  Most insurance companies are cooperative in this respect.


 


What you must not do is dally.  The longer you delay taking action, the greater the risk of your bill being forwarded to the debt collection authority and that will involve payment plus a fine and a blot on your payment record.


 


So get weaving – and all the best,


R.


Ritchie, Nov 11, 2017 @ 11:23
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Re: Medical bill outside insurance... what to do?
Post 7

The best option is to pay it and ask questions later. If it is too much you can make a payment arrangement and pay them monthly. As long as you are paying this should be fine. The problem comes in when you do not pay.

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The best option is to pay it and ask questions later. If it is too much you can make a payment arrangement and pay them monthly. As long as you are paying this should be fine. The problem comes in when you do not pay.


Marcy S, Nov 27, 2017 @ 11:10
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Re: Medical bill outside insurance... what to do?
Post 8

Hello, can someone please let me know what kind of App I should have on my phone to pay doctor fees in Geneva? Thank you in advance 

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Hello, can someone please let me know what kind of App I should have on my phone to pay doctor fees in Geneva? Thank you in advance 


Lisa Chrabieh, Mar 20, 2021 @ 11:57
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Re: Medical bill outside insurance... what to do?
Post 9

Hi Lisa, to my knowledge there are no Apps to pay doctor fees...You should pay them with the orange slip or in an electronic way (e-bill). Maybe your health insurance has an App where you can download the details of the bill for reimbursment or taking into consideration of your deductible. Kind regards Daniela

The text you are quoting:

Hi Lisa, to my knowledge there are no Apps to pay doctor fees...You should pay them with the orange slip or in an electronic way (e-bill). Maybe your health insurance has an App where you can download the details of the bill for reimbursment or taking into consideration of your deductible. Kind regards Daniela


Daniela Z, Mar 23, 2021 @ 23:32
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Re: Medical bill outside insurance... what to do?
Post 10

Hi Daniela and thank you so much for your reply. By the way, I have checked around and I was told if we have a bank account in Geneva, the bank usually should have this app. 


In any case, I was able to pay it at La Poste with no extra charges. 


Thanks again, 


Cheers, Lisa. 

The text you are quoting:

Hi Daniela and thank you so much for your reply. By the way, I have checked around and I was told if we have a bank account in Geneva, the bank usually should have this app. 


In any case, I was able to pay it at La Poste with no extra charges. 


Thanks again, 


Cheers, Lisa. 


Lisa Chrabieh, Mar 24, 2021 @ 06:47
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