According to Swiss health insurance laws, all residents of Switzerland should benefit from the exact same compulsory health insurance coverage while premiums remain flexible. But in practice, differences between insurance providers run deeper than higher or lower premiums.
Customer service discrepancies between health insurance providers
In order to determine health insurance service levels, moneyland.ch obtained information from insurance providers which outlines their claim settlement methods and reimbursement periods. Additionally, moneyland.ch commissioned a representative survey (conducted by market research institute GfK Switzerland) to determine the levels of customer satisfaction with Swiss health insurance providers.
The result: Differences between individual insurance providers reach far beyond varying insurance premiums. The differences in customer service exist and directly affect health insurer’s claim settlement processes, among other things. These differences are reflected in widely differing levels of customer satisfaction.
Differences in claim settlement methods
The two claim settlement methods most commonly used in Swiss obligatory health insurance are indirect settlement (known as tiers garant) and direct settlement (known as tiers payant). When the indirect settlement system is used, the healthcare provider (a doctor or pharmacy, for example) bills the patient for services rendered.
After paying the medical bill, the patient then forwards the receipt to the insurance provider, which settles the claim by reimbursing eligible healthcare expenses. Direct settlement, on the other hand, is more customer friendly because the healthcare provider bills the health insurance company directly.
The majority of Swiss health insurance providers estimate that approximately two-thirds of all bills are now paid using the tiers payant system (direct settlement), but the actual portion of claims handled by each settlement method varies between insurance providers. Direct settlement is normally used to settle claims for purchases at pharmacies, but some insurers – like Supra – primarily use indirect settlement for pharmacy claims.
Claim settlement periods compared
Following up on a survey conducted by the Federal Office of Public Health in 2014, moneyland.ch obtained up-to-date information regarding healthcare bill reimbursement time frames from Swiss health insurance providers. Specifically, moneyland.ch asked insurers how many days a policyholder can expect to wait before being reimbursed for a claim through indirect settlement. The majority of insurance providers settle reimbursement claims within 10 days.
However, settlement periods employed by a number of providers are noticeably longer. For example, Groupe Mutuel has an average claim settlement period of 15 days, Supra takes 17 days to reimburse healthcare costs and Assura takes up to 37 days to settle claims.
Considering the high costs of healthcare services, a long settlement period can put a strain on a policyholder’s finances. The claim settlement periods employed by each insurance provider are clearly shown in the moneyland.ch health insurance comparison.
More on this topic:
Health insurance comparison
Claim settlement methods used by Swiss health insurance providers
Health insurance customer satisfaction comparison
Best Swiss health insurance policies compared
Health insurance claim settlement periods compared
