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Our Swiss Holiday...in the Luzerner Kantonspittal (An update on insurance)

The Plan:

We are two couples, best of friends for 30+ years, off to Switzerland for a hiking holiday in the Lauterbrunnen Valley. Left Labor Day weekend from ATL to Zurich, then direct to Lucerne by train. Two nights in Lucerne for Mt Pilatus and the city sights, then to Murren for a week at their most special two bedroom suite with a view at the Hotel Eiger. (We were celebrating 101 anniversary years in August between the four or us, and this was to be a higher-end luxury kind of trip than our usual!) Guys were heading home after this week and my friend and I were staying on another week in Lausanne, Zermatt, and Bern.

The Reality:

Direct flight on Delta. (Allow extra time to buy the rail passes in Zurich; super busy rail office.) Postcard blue skies for train ride to Lucerne. Checked in to The Bed and Breakfast - charming, easy city bus ride direct to the center, would stay here again. Fun lunch on Lucerne’s riverfront at Rathaus Brauerei. (We’ve been in Luzern about 2 hrs.) Crossed over the river, planning to turn left and walk through the flower-bedecked Kapellbrücke. But there’s a lovely double-domed church to our right, the Jesuit Church. The church has a small step up to the center aisle, and my husband did not see it. New Hokas with super tread for hiking stuck one foot to the marble floor while the rest of him went airborne. Kaboom. Left knee will not lift.

A city of Lucerne tour guide was leading a group in the church and called an ambulance to take him to the large teaching hospital in Lucerne. Diagnosis: Complete tear of quadriceps tendon from kneecap.

Surgery required. Do we stay or do we try to get home? We’ve been in the ER for hours. I was a trauma nurse in my past life, but am now at the hour 40 mark with about two hours sleep. We’re staying on the second floor of a hotel with a curving wooden staircase and no lift; our flight home is from another city, and it’s only direct to ATL three days a week.

I generally like teaching hospitals because of the layers of oversight, and we’ve been treated with kindness and general competence (if not with a great sense of urgency) but in a foreign system it’s difficult to discern rank. I know I’ve not dealt with any Attendings, but have been assured by various residents that an Attending will definitely supervise the surgery. Weighing the chance of a further injury if he should fall again, nearing midnight, running on fumes, we make the decision to stay in Switzerland for the surgery, which they hope to schedule tomorrow.

The Hospital:

The Luzerner Kantonspittal was extremely clean, well-staffed, not air-conditioned, and had only one available bed - on the cardiac post-op floor. Virtually all the doctors and nurses spoke competent English; technicians and support staff less so. At 5 PM, two hours after arrival, I was directed to the business office to make a 2000 CHF payment to cover expenses so far. We have our usual AMEX travel insurance underwritten by AMEX Assurance Company, but the hospital only reimburses.

Surgery the next day, Tuesday, was pronounced successful. Pain was well-controlled and PT started him on a perpetual motion device and got him walking on crutches.

Grateful our friends were here for the two worst first days, and to move me to another hotel after my reservation ran out and there was no more room at that inn! They’ll send us pictures from the mountains, and we’ll plan another trip.

Posted by
995 posts

The Red Tape:

There are hoops to be jumped through, and this hospital was exceptionally helpful for negotiating these. They sent both a patient rep and a medical staff person to help us, several times, gave me documentation for the Swiss rail office to get refunds for my Berner Oberland passes and Half-fare cards, and arranged the medical transport to get us back to the Zurich airport.

The critical document we needed was the Release to Fly. AMEX would talk with me only guardedly until I provided this. No commitments; no plane reservations until they had it. Because Bob was in a full-leg locked position brace, he had to fly in a seat where his leg could be extended straight out, i.e., Delta One. Delta only flew direct to ATL on Saturday, Monday, and Thursday that week. Monday looked sold out, and we sure didn’t want to stay until the next Thursday, or go through JFK!, so getting on that Saturday flight was critical once the orthopedist thought it was doable from a medical standpoint. (We were told Delta is one of the easier airlines to deal with on Release to Fly issues.) AMEX would not budge because they didn’t have the paperwork yet, and Saturday was closing in.

To be sure we got on that flight, we booked the tickets ourselves, rather than waiting any longer on AMEX. The irony, because of his Delta status, Bob gets automatic upgrades, so AMEX is actually only being charged for Delta Premium Plus seats, saving them several thousand dollars on the Delta One fare.

The Bill:

Before we left the hospital on Saturday, I paid them an additional 12,000 CHF, and got 250 CHF in cash to pay the medical transport driver. Unbelievably, that means that in a top hospital in Switzerland we paid approximately $16,000 for ER care, five nights in the hospital, surgery, anesthesia, an MRI, a CT, PT, a leg brace, and his first post-op meal of a charcuterie board!

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995 posts

The Cautionary Tale:

We have Medicare, which of course does not pay out of the US. We also have a Humana PPO, which, surprisingly, does cover some emergency medical care outside the US. I have submitted pages of required documentation to AMEX, which they say they will respond to in the next 30 days. Until they know what Humana will pay, I think AMEX has an excuse to stall. I do believe they will eventually pay the complete bill minus the Humana contribution. We always buy their top level of coverage for $100K in medical expenses and $100K in transportation, and it’s still a bargain at about $65/trip - IF IT ACTUALLY WORKS! (I don’t do trip cancellation or interruption.) It is annoying that they won’t separate the airline tickets from the medical charges - something Humana obviously has no responsibility for.

We’re also at an age and stage in life when we can put it on a credit card and pay it all off. But we started traveling to Europe in our thirties and who knows if we even had any medical coverage! I do know a $16K bill would have wrecked us then, and am certain we had no credit card in our backpack that would let us charge anything near that! I’m smarter now, but I was lucky then!

The Rest of the Story…not great:

Flew back to ATL on Saturday; saw top Atlanta Braves orthopedist on Monday. Because the surgical notes they sent are all in German, he needed an MRI to know what they actually did.

ALL their sutures have come UNTIED! The surgery must be REDONE! Either their knots failed, or possibly they stressed them too much, too soon using the perpetual motion device.

Second surgery was three weeks ago, adding a donor tendon for strengthening. Went well. Three more weeks in a locked brace, walking like a pirate, until they can consider gentle PT “until the cows come home” in the words of his orthopedist. I’ve unfortunately lost my longest traveling companion for months, probably til mid spring. But we will be back on the road at some point!

Meanwhile he’s coping “adequately” with cabin fever, and I’ve just returned from a mental health break in London, but that’s a TR for another night.

Posted by
4097 posts

Oh Ruth this was a hard report to write but it will help put perspective for many of us on dealing with real time emergencies. I wish your husband patience and healing in the coming months. Thanks for sharing your experience.

Posted by
11773 posts

The stuff of nightmares! So sorry this happened to you but love the attitude of knowing you’ll be back! You and Bob handled this with grace many would not have had. Amazing the prices in European medical systems! I suspect the US cost for the second surgery far exceeded the Swiss one!

Good wishes for continued recovery!

Posted by
207 posts

So sorry this happened, and thank you for taking time to share. This information is helpful for all of us planning overseas travel. Best wishes to your husband for a speedy recovery.

Posted by
8963 posts

Ruth, thank you for this report and I hope you follow up with what happens regarding the insurance and reimbursement.

Posted by
1583 posts

Wow, Ruth, what a nightmare. I'm glad you two are home and recovering. Your post is quite timely and informative. Incidentally, I also got an unsolicited flyer in the mail from Travel Guard. Thank you for sharing your experience. Best wishes for a full and speedy recovery.

Posted by
27 posts

Ruth,
Travel nightmares! I am so sorry that your celebration was spent in this manner. I am hoping that he is healing well and a new journey is in store for the two of you.
I am curious about the Bed and Breakfast you stayed at. I always think providing positive feedback helps promote more business for small businesses that are competing with larger hotels.
I was happy to hear that the surgery went well and that your friends where able to travel onward.
We are also celebrating an anniversary as we travel to Germany and Switzerland. Though we are still in the plan making stage, it is always interesting to see what plans others have made.
Wishing you more journeys ahead!
d

Posted by
10186 posts

Oh Ruth, I am so sorry! Thank goodness for excellent assistance to get through this and financial resources too. What a nasty-sounding injury! Thank goodness for your experience as a trauma nurse. I hope the insurance companies work in an expeditious fashion and that your husband heals quickly and completely. And I am sorry that you didn't get to have your trip.

And this is separate but — what an excellent writer you are. Although it was a rough situation, you made this so interesting to read about.

Posted by
995 posts

Two weeks ago Humana sent us a check for $8000 for their part. I was somewhat amazed at this because we had no itemized bill to submit. So far, AMEX Assurance has paid nothing. They have also not been timely at returning phone calls. Their first response to covering the air fare home was to say they were only responsible for the $200 change fee. When it was pointed out that they approved the upgraded fare, their response was basically, "Oh."

So we are in wait-and-see mode. I'm optimistic enough to think they will eventually pay the claim. Considering that we bought 200K in coverage and are asking for about a $12,000 payout, this seems like a small ask.

Posted by
627 posts

Always gripped by your trip reports. I’m so sorry for what you two went through! I’m also doing PT till the cows come home for a bad knee so am in complete sympathy. Looking forward to hearing if/when Am Ex comes through.

Posted by
3558 posts

I just read this and now, going to purchase better travel insurance. Ugh, how awful. I hope it works out and your husband can get back to travel.