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HEALTH INSURANCE

Going under the knife in Germany: ‘it was all over almost before it began’

Hospital visits aren’t pleasant to begin with - even more so when you’re in a foreign place where you don’t yet feel you belong. But writer Cindy Tong was impressed by how easy it all was at her hospital near Heidelberg.

Going under the knife in Germany: ‘it was all over almost before it began’
Photo: DPA

I wouldn’t call myself a total noob in Germany; we made the move here from Singapore more than a year ago. But two months ago, we relocated 300 kilometres north of where we’d been, and in between the unpacking and getting acquainted with our new neighbourhood, we hadn’t had time yet to see to the nitty-gritty administrative details of life – such as locating a Hausartz.

For that reason, I’d stupidly ignored a strange bubble-like swelling under my skin, hoping it would subside with warm compresses and soothing balms. It didn’t, and soon, I was hobbling like an old lady and wincing in pain each time a breeze so much as tickled me across the affected area.

It was a Friday night, and I didn’t fancy the idea of starting the weekend with a trip to the emergency room. But my husband, concerned about the growing cyst, bundled me into the car and drove me straight to the nearest Krankenhaus.

In the emergency room

Sinsheim, with a population of 36,000, isn’t a big city to begin with. But given its proximity to Heidelberg and considering that it was a Friday night, I was expecting the hospital to be overrun with hordes of the sick and injured. The reality, however, was different. In actual fact, there were no more than three patients ahead of me in line.

Registration was swift, and after a 45 minute-wait, I was ushered in to see the emergency doctor on duty. My German is still nowhere as good as I would like it to be, and it was certainly in no condition to handle complicated medical talk. So I was relieved when my doctor easily made the switch to English and put me at ease.

“Can’t you just lance it now and drain it?” I asked, hopeful that my weekend could be salvaged. Unfortunately, my doctor was still in-training, and because it was after office hours, there was no one who around who was qualified to perform the procedure. Even then, because the cyst was located in a sensitive area, it was likely that I would need more than just a simple slice and cut.

She sent me home with some antiseptic salve, and advised that I should return on Monday morning for another consultation.

D-Day Monday

I spent the weekend howling in pain and behaving like a sick puppy, and come Monday morning, I obediently made my way again to the emergency room. I wasn’t optimistic. Considering that the cyst wasn’t life-threatening, I wasn’t sure the hospital would schedule a same-day surgical procedure.

The wait turned out to be a little longer that morning – a build-up of patients from over the weekend, I was told. Still, I found myself in the consultation room within no more than an hour. This time, the doctor was an elderly man, clearly more senior and experienced. Hard luck for me, though. He didn’t speak English, and I was forced to describe the problem using my limited German.

Sensing my discomfort, he whipped out a notepad and began sketching a series of diagrams to explain the recommended surgical procedure. “Sofort?” I asked, confused, expecting to be sent home and given an appointment later in the week.

“Heute,” he confirmed. With that, a nurse bustled into the room and proceeded to draw blood and place a catheter in my arm.

Going under

I was given a surgical procedure questionnaire to fill out and a stack of consent forms to sign, but how was I to make any sense of all that German medical gobbledygook! Not to worry. I was provided translated copies, and for the one form without an English version, a kindly staff nurse patiently explained its contents to me in simple, baby German.

After a consultation with the anaesthesiologist, I was shown to the day ward and to my bed, and given a hospital gown. Now, this was where it got uncomfortable. There were six beds in the room, three of which were already occupied. Yet there was no private changing area and I had little choice but to strip into hospital garb before a room of strangers.

After the initial awkwardness, however, I settled into bed and a short while later, found myself being wheeled into the surgical room.

This would be my first surgery, my first experience going under general anaesthesia. If I was nervous, it showed, and I watched the surgical prep nurse with an eagle eye. “Schlafe ich jetzt?” I asked each time she made a movement. Slowly, I felt myself growing heavier and heavier, and then…

Recovery

“Frau Tong? Frau Tong?” I woke to the anaesthetist whispering urgently in my ear.

I stared at the lights above me. “Sind wir noch in Deutschland?” I asked, confused. The medical team watching over me chuckled, reassuring me that yes, I was still in Germany and that the surgical procedure had gone well. They wheeled me into the recovery area, and after I’d finally shaken off my grogginess, I was taken back to the day ward.

In true German fashion, my recovery meal was a pair of würstchen, a brötchen and lots of mustard. “Schmerz?” asked the ward nurse. “Kein schmerz,” I said. In fact, apart from a little soreness, I was feeling just fine. The ward doctor came to visit a few minutes later, and after a quick exam, prescribed some painkillers and pronounced me good to go.

It had just been seven hours since initial registration in the morning to my discharge from day surgery. In addition, the cost had been fully paid for with my public insurance plan. If my experience is an accurate reflection of the healthcare system in Germany, I’ve got to say, it’s pretty darn good!

For members

HEALTH INSURANCE

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

If you pay for supplementary health insurance in Switzerland you can benefit from access to complementary therapies. We look at what's available and how the system works.

Acupuncture to rolfing: What your Swiss health insurance gets you (if you pay more)

Like numerous countries in Europe, health insurance in Switzerland is a compulsory coverage that all people must have.

Most Swiss insurance providers offer several options for their customers, which are separated into two categories: basic and supplementary.

Basic health insurance (KVG / LaMal) must be purchased, because it is compulsory. Supplementary insurance comes with extra benefits for healthcare but also of course an extra fee.

The franchise (or deductible) will need to be met, but thereafter, even basic insurance has you covered. It pays for medical care, prescriptions, and specialist care like eye doctors, sometimes even without  referrals from your primary care physician. Supplementary health coverage, however, gives you access to complementary therapies that can differ substantially from what basic coverage allows. 

CLICK HERE for more on health insurance in Switzerland

You have to fill out a form the insurance carrier provides and sometimes might have to undergo a health check and discuss preexisting conditions in order to see how much insurance coverage can be offered — if any at all. 

Unlike the KVG / LaMal, which must be provided to all residents regardless of their health status, insurers can deny supplementary coverage if they deem you too much of a risk.

This can happen if you have chronic illnesses or pre-existing health problems, in which case you could be either turned down or offered a policy with wavers for your specific conditions.

Each insurance company decides what coverage they will offer and what percentage they pay, depending on both your overall health at the time of enrolment, and which plan you choose. You’ll be able to read what’s included in your plan in the paperwork you receive from your health insurance and, as always, the fine print is important to read. 

People who only have basic KVG / LaMal insurance still have thorough coverage for many things, from standard doctor visits to in-patient care and hospital stays.

READ ALSO: What is not covered by compulsory basic health insurance in Switzerland?

What complementary treatments are available?

In Switzerland, homeopathy is included in all health insurance plans, as healthcare isn’t merely approached with classical treatments; instead, a holistic approach is applied to healthcare throughout the country. The complementary therapies available through the supplementary insurance give individuals the opportunity to play an important part in their own wellness. 

Having a supplementary insurance not only increases the financial coverage you’ll have for some of your standard medical needs, but it also brings expanded access to numerous forms of wellness therapies. The Swiss are very focused on health and wellness and it is clear through the various types of insurance available, that a primary focus is getting the population healthy and keeping it that way. This additional insurance creates a way for people to access treatments and care for their well-being which, in turn, creates a healthier population. 

Complementary therapies can include various styles of massage including, classic, manual lymph drainage, therapeutic, connective tissue, acupressure, and medical massage, among others.

There are additional treatments and therapies such as foot reflexology, osteopathy, and Rolfing (massage/treatment of connective tissues) that are included in the coverage, plus there is also access to traditional Chinese medicine including cupping (suction cups applied to your body), acupuncture, and herbal medicine. Some practitioners also offer consultations in naturopathic health, including detoxification (guided cleansing of your digestion and body), nutrition, and hydrotherapy (using the element of water as therapy).

READ ALSO: How people in Switzerland can save money on healthcare

Your insurance provider will be able to better detail what is covered for you.

Another thing to take into consideration is that some insurance plans will even reimburse a portion of the costs of other health-related things, such as a part of the annual cost of a gym membership. Some plans will refund about 800 Francs per year for a gym membership that costs about 1,400 Francs. Granted, you will pay more each month for some of these extra options, but having access to them– and utilising them– can make the pricier monthly cost worth it. 

How do you go about getting complementary therapy?

Once you’ve signed up for supplementary insurance, you’re able to view a list of complementary therapies on the website of your insurance provider. Getting connected with a masseuse, osteopath, or other care provider is as simple as calling them up and scheduling an appointment. Once you have the supplementary insurance, there is no need to go to your primary physician and get a referral. 

In Switzerland, the reimbursement process for these therapies is also a little different. While some practitioners will still have you pay direct and out of pocket for the treatment (with a reimbursement coming later, after you’ve submitted the receipt to your insurance company), others will send you a bill in the mail. This creates a unique way that you can receive the receipt from the treatment, file it with the insurance, and often times have the reimbursement from the insurance deposited directly into your bank account before you even pay for the initial treatment. This makes it so that people who also don’t have a lot of access to cash can still receive quality care.

READ ALSO: Which Swiss cantons see the biggest hikes in health insurance premiums?

Be aware though you can’t just go for as much cupping, acupuncture or “rolfing” as you’d like because most insurers will put a limit on how much treatment you can get in a certain period. Some insurers might not cover the full cost meaning the patient might have to pay 10 to 20 percent of the fee.

This focus on providing access to things that augment an individual’s overall wellness makes Swiss healthcare among some of the best in the world. If you can see beyond the price tag (and let’s admit, it is expensive: sometimes 400-500 Francs or more each month), there are myriad ways to source treatments and therapies that will benefit your overall health and well-being, making for a healthier and ultimately happier person. 

When you first move to Switzerland, you can either select an insurance on your own, or sit down with an insurance consultant who will not only go over what each insurance offers, but can help you find the best coverage for you, your family, and your situation. When you need to make a change with your health insurance, you can get in touch with the consultant and they will procure the papers needed to make the changes. Although there is a cost associated with this sort of service, it can make selecting and signing up for health insurance in Switzerland an easy and smooth process. 

To find out more and compare rates for health insurance in Switzerland, information can be found here: https://en.comparis.ch/krankenkassen/default

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