Astronomy and Coffee

Fine after surgery

So! First information is that Fernanda's surgery went fine, she's recovering fine and will be back home tomorrow.

Getting to it was a nightmare, so I decided to write some stuff here that may help other foreign researchers that are coming or will come to Germany. I hope that can help them on health insurance. BTW, some keywords so it shows up when someone google it.

Health insurance for foreigns in Germany, health insurance for researchers in Germany.

So, the story so far. We needed a health insurance for transition, between Fernanda's insurance in the Max Planck in Goettingen and the new one in the TUM in Munich, first one was private and the second one was "public" (gesetzliche). So we've got one called Mawista-Science.

It has worked well while we were in Goettingen, since Mawista hires insurance from someone else and for northern Germany is hired on Wurzburger and it worked fine (no big requests). In the south is hired on Mondial Assistance and those guys failed us twice.

First failure was the lack of respect for the human being that pays for it. They tried to find technicalities not to pay for the surgery and took them 4 work days to decide to pay for it. That means they called the doctor with the authorization less than half an hour before the scheduled time for the surgery. That's a huge lack of respect in my opinion. We were ready (doesn't mean we could do it, but someone that has good friends doesn't die alone) to pay privately for the surgery.

Second failure is related to a market "war" between two parts of this "industry" (namely physicians and insurance). Here in Germany, I don't really understand how that goes, but it seems that medical services and material have a fixed price that can be multiplied by a factor.

First time I saw this as a problem was on a dental treatment, where my dentist was charging a 3.5 factor and the insurance top was a 2.7 factor (or something like that).

Turns out Mondial/Mawista approved surgery but with a 1.8 top factor and the doctor would charge 3.5, i.e. they would pay for about half the prince. According to the doctor, 1.8 is about the price this surgery costed in the 1970's ... and even though they put in their webpage, on the coverage part "SURGERY - 100%" ... not really true ...

The main problem in this war is that it's not a fair market. If you're not happy with the price of milk, or beer, you just don't buy it. When a doctor tells you, "we need to operate you or you'll die", you're not really in a position to discuss prices ...

At the end we were very lucky because the card from AOK, Fernanda's public insurance, arrived the day before and they quickly agreed to pay for the surgery without restrictions.

In a nutshell, we were betrayed by our private health insurance.

Summarizing insurances in Germany:

- Public health insurance (gesetzliche krankenversicherung)

+ Pay the things they have to pay without complaining

+ Charge a "handling fee" (10 Euro each time in go to a doctor in a trimester, unless you're being transfered from another doctor - like, you go to a general doctor because your leg hurts and he sends you to an orthopedist, you just pay the first one)

+ If your work gives you that, the law obliges you to have it

+ They don't pay several things or limit kinds of treatments (like dental, fillings must be made with amalgam, abandoned in most of the occidental world many years ago)

+ They don't cover medicines

- Private health insurance

+ Pay medicine

+ No handling fee

+ Pay several treatments (like resin fillings)

+ Sometimes come out with a disagreement in "price factors"

Hints:

- Specifically ask about payment factors for doctors and get it written, before contracting the insurance.

- Ask about the timescale for authorizations for large procedures.

- Get clear the procedure, if you're reimbursed or if they pay the medical bill directly and what are the limits. You don't want to have to pay a 1K Euro bill and then be reimbursed.

Basically that. If something else occurs to me I'll complement this text.

Science the last few days ... not much. A lot of reading on the subway on the way to the hospital and back.

My neck and my back are much better also!

Labels: health insurance, life

posted by Cris Da Rocha @ 11:59 PM