Therapy Insurance Coverage in Switzerland in 2023
Find Out If Your Insurance Covers Therapy Services In Switzerland
If you are looking to work with me and want to know if your insurance will pay for psychotherapy services, this guide will provide you with the necessary information.
Key Details for Insurance Inquiries
For a smoother process when contacting your insurance provider to confirm your policy's coverage, it's essential to mention the following key details:
Therapist's Name: Please note that you are seeking services from Franziska Teo-Hunkemöller.
Licensure Status: Verify that your therapist is a Federally Licensed Psychotherapist. In the case of my practice, the answer is yes, as I am recognized as an "eidgenössisch anerkannte Psychotherapeutin", with a "Praxisbewilligung" and very important "no ZSR-Number".
Requirement of Referral: Find out if your insurance plan requires a doctor’s note or referral before you can commence therapy sessions and ask if the doctor needs to hold a specific titel.
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Understanding the Reimbursement Process
Please bear in mind that in Switzerland, it is your responsibility to initially cover the cost of your therapy sessions, after which you can seek reimbursement from your supplementary insurance provider. Here's a step-by-step breakdown of what to expect in the reimbursement process when you choose to work with me:
Verify that your supplementary insurance policy covers the therapy services I provide.
Get your doctors note or referral if necessary
We then proceed with regular therapy sessions.
At the end of each month, I will send you a cumulative invoice that includes all the sessions conducted during that month.
If needed, I'm here to provide any additional documentation or support that may be required for the reimbursement process.
You will need to pay the cumulative invoice upfront, covering it out-of-pocket.
Following this, you submit the invoice to your insurance provider for reimbursement.
Based on the terms of your policy, your insurance provider approves and reimburses the therapy costs.
Basic and Supplemental Insurance
Additional Insurance: Many clients are unsure whether their health insurance will cover the costs of psychotherapy. Since the new Psychotherapy Act was introduced in July 2022, there have been significant changes. That's why this article provides a list of major Swiss insurance providers that cover therapy sessions with me. The list also includes details about the insurance's contribution amount and any additional requirements that need to be met (such as whether a doctor's prescription is needed for reimbursement, etc.). To make things easier, I've included direct links to sources of information and also found out how you can get in touch with your insurance provider. This allows you to quickly check how your insurance covers the therapy costs.
Basic Insurance: Unfortunately, basic insurance does not cover the costs of therapy with me. Following the introduction of the new Therapy Act in July 2022, all psychotherapists must decide whether they will work within the Basic Insurance or Supplementary Insurance model. However, at the moment, insurance companies do not allow billing under both systems. Therefore, I am currently only able to provide therapy services through supplementary insurance. My colleagues and I are hopeful that in the future, insurance companies will be more flexible, making access to psychotherapy simpler for everyone.
Supplemental Health Insurance In Switzerland In 2023
The cost of therapy sessions can be a concern for many individuals in Switzerland as our mandatory base insurance (i.e. Grundversicherung) does not cover all licensed therapists offering psychotherapy. Some people take up a supplementary health insurance policy that extends the coverage provided by the "Grundversicherung" to cover a wider range of services.
It is important to note that the different Swiss supplementary insurance providers offer coverage for therapy, either fully or partially. In general, the policies will have some of the following terms of coverage per calendar year:
Total cost covered per calendar year (e.g. the policy pays up to CHF 3000 per year of therapy costs)
Partial coverage (%) of therapy costs (e.g. the policy will reimburse 80% of your CHF1000 therapy costs which will be CHF800)
Amount reimbursed per session (e.g. the policy will only reimburse a maximum of CHF 50 per session)
Maximum number of sessions (e.g. the policy will reimburse a maximum of 20 sessions of therapy per year)
Important: Coverage under supplementary insurance is currently changing rapidly. There might be details or conditions that are not published on the internet. Therefore, it is advisable and your responsibility to directly contact your insurance provider to verify the coverage of costs.
Swiss Insurance Providers Paying For Therapy In 2023
Here's an alphabetically sorted list of Swiss supplementary insurance providers along with their coverage details for therapy services (accurate as of July 2023, please confirm all information with your insurance provider)
Agrisano
AGRI-spezial: CHF 50 per session, up to 20 sessions per year
Doctor's note required for reimbursement
Contact info:
Phone: +41 56 461 78 78
Email: beratungen@agrisano.ch
Assura
Complementa EXTRA: Up to CHF 1,500 per year
Complementa PLUS: Up to CHF 1,500 per year (no longer available)
Complementa Maxi: No coverage (no longer available)
Doctor's note required for reimbursement
Contact info:
Phone: 0800 277 872
Form: online form
Atupri
Basic: No coverage
Mivita Reala: 60% of therapy costs, up to CHF 1,000
Mivita Extensa: 60% of therapy costs, up to CHF 1,500
Diversa: 50% of therapy costs, up to CHF 1,000 (no longer available)
Doctor's note required for reimbursement
Contact info:
Phone: +41 800 200 888
Email: info@atupri.ch
CSS
CSS-Standard: CHF 40 per session, up to 20 sessions per year
ECONOMY - not covered
BALANCE - 75% of therapy costs up to CHF 1,000 per year
PREMIUM - 75% of therapy costs up to CHF 3,000 per year
Other policies from CSS:
Intras UNO+: not covered (no longer available)
Intras DUE+: 90% of therapy costs, up to CHF 1,000 (no longer available)
Sanagate OPTIMA+: not covered (no longer available) (no longer available)
No doctor's note required for reimbursement
Contact info:
Phone: 0844 277 277
Form: online form
EGK
EGK SUN: 80% of therapy costs up to CHF1,080 per year
EGK SUN 2020: 80% of therapy costs, up to CHF 1,000 (no longer available)
Doctor's note required for reimbursement
Contact info:
Phone: +41 (0)61 765 51 11
Form: online form
Helsana
SANA: no coverage
TOP: 75% of therapy costs, up to CHF 3,000
COMPLETA: 75% of therapy costs, up to CHF 4,500
PRIMEO: no coverage
No doctor's note required for reimbursement
Contact info:
Phone: 0844 80 81 82
Form: online form
Rhenusana
SILBER: 75% of therapy costs, up to CHF 1,500
GOLD: 75% of therapy costs, up to CHF 3,000
PLATIN: 75% of therapy costs, up to CHF 5,000
No doctor's note required for reimbursement
Contact info:
Phone: +41 (0)71 727 88 00
Email: info@rhenusana.ch
Sanitas
Jump: No coverage
Classic: 80% of therapy costs, up to CHF 1,000 per year
Family: 80% of therapy costs, up to CHF 1,000 per year
Diversa: 75% of therapy costs, up to CHF 3,000 per year
Doctor's note required for reimbursement
Contact info:
Phone: 0844 150 150
Form: online form
Sympany
Plus: 50% of therapy costs, up to CHF 1,000 per year
Premium: 50% of therapy costs, up to CHF 2,000 per year
No doctor's note required for reimbursement
Contact info:
Phone: +41 58 262 42 00
Customer portal: mySympany Login
Visana
Ambulant III: 80% of therapy costs, up to CHF 5,000
No doctor's note required for reimbursement
Contact info:
Phone: 0848 848 899
Form: online form
Vita Surselva
Surselva Completta: 50% of therapy costs, max. CHF 60 per session, up to 25 sessions
Allgemeiner Zusatz: 50% of therapy costs, max. CHF 60 per session, up to 25 sessions
No doctor's note required for reimbursement
Contact info:
Phone: +41 81 925 61 60
Form: online form
Remember, the above therapy coverage by Swiss insurance providers is accurate as of July 2023, so please get in contact with your insurance provider directly to confirm the current coverage of psychotherapy services
Couldn't you find your insurance provider in the list? I strongly recommend contacting your insurance directly, as an increasing number of supplementary insurance providers are still covering the costs under certain conditions. I'm also happy to assist with any necessary forms or confirmations you might need.