Key points at a glance
- Osteopathy is not a compulsory benefit of basic health insurance, not even with a doctor’s prescription.
- Since the Health Professions Act, osteopathy has been a federally regulated health profession; it requires a Master of Science in Osteopathy from a university of applied sciences (Art. 12 GesBG).
- Anyone practising the profession on their own professional responsibility needs a licence from the canton (Art. 11 GesBG).
- Supplementary insurance pays for osteopathy under its own terms, sometimes only for therapists on a recognised list.
- Chiropractic, by contrast, is a benefit of basic health insurance (Art. 35 para. 2 let. c KVG).
What is osteopathy?
Osteopathy is a manual method: the osteopath examines and treats with the hands, without equipment or medicines. They work on muscles, joints, connective tissue and organs and aim to release restrictions of movement. Typical reasons for treatment are back and neck pain, muscle tension or complaints after overuse. Experts differ in their assessment of whether and how well the method works for a particular condition; this page only explains how osteopathy is treated in Swiss health insurance.
In Switzerland, osteopathy is a recognised health profession. The Federal Act on the Health Professions (GesBG) lists osteopaths as a health profession alongside nurses, physiotherapists and occupational therapists, midwives, nutritionists and optometrists. Anyone practising the profession on their own professional responsibility needs a licence from the canton and a Master of Science in Osteopathy from a university of applied sciences or an equivalent qualification.
The distinction from health insurance is important: a recognised profession is not automatically a service provider under basic health insurance. Which professions may bill basic health insurance is set out exhaustively in the Health Insurance Act (KVG). Osteopathy is not listed there. In health insurance it is therefore one of the benefits that only supplementary insurance under the Insurance Contract Act (ICA) can pay for. There it is often listed under complementary medicine or alternative medicine.
Osteopathy should not be confused with two benefits that basic health insurance does pay for: chiropractic by licensed chiropractors and physiotherapy prescribed by a doctor. Some physiotherapists also have additional training in osteopathic techniques. If they bill basic health insurance, this only covers physiotherapy prescribed by a doctor, at the tariff rate.
How it works
In basic health insurance
Basic health insurance does not pay for osteopathy. This applies regardless of insurer, model and deductible, and even if your doctor recommends the treatment. You cannot submit an osteopath’s bill to basic health insurance; it does not count towards your deductible either.
In supplementary insurance
Many supplementary outpatient insurance policies include a module for complementary or alternative medicine. Each insurer decides for itself whether osteopathy is included. Check these points in the general and special terms and conditions:
- Recognised therapists: insurers can limit reimbursement to therapists who are on their list or registered with a register such as ASCA or EMR. Before the first session, ask whether your therapist is recognised.
- Share and maximum amount: the insurance covers a percentage of the bill up to a maximum amount per session or per year.
- Number of sessions: some products limit the number of sessions per year.
- Prescription: some products require a doctor’s prescription.
Supplementary insurance is a contract under private law. Before concluding the contract, the insurer may ask about your health and turn you down or add reservations. It is therefore best to take out such insurance while you are healthy and before any treatment is due.
Bill
The osteopath sends the bill directly to you. You pay it and submit it to your supplementary insurance, if you have one. Make sure the bill shows the therapist’s name and, if required, their register number.
Legal basis
For basic health insurance, Art. 35 para. 2 KVG is decisive. It lists the service providers exhaustively; osteopaths are not among them. Chiropractors, on the other hand, are (let. c). Under Art. 34 para. 1 KVG, insurers in basic health insurance may not cover any costs other than those for the statutory benefits. The complementary medicine benefits that basic health insurance pays for are also regulated exhaustively: Art. 4b KLV names acupuncture, anthroposophic medicine, drug therapy of traditional Chinese medicine, classical homeopathy and phytotherapy, and only when provided by doctors with the relevant further training. Osteopathy is not on this list.
The profession is governed by the Health Professions Act: Art. 2 para. 1 let. g GesBG names osteopaths as a health profession, Art. 11 GesBG requires a cantonal licence to practise on one’s own professional responsibility, and Art. 12 para. 2 let. g GesBG requires a Master of Science in Osteopathy from a university of applied sciences for this. Under Art. 34 para. 3 GesBG, the Federal Council can declare intercantonal diplomas in osteopathy issued by the Conference of Cantonal Health Directors up to 2023 at the latest to be equivalent.
Supplementary insurance is governed by the Insurance Contract Act (ICA). Art. 4 ICA obliges you to answer the health questions truthfully when concluding the contract. Which benefits are insured is determined by the contract.
Example: five sessions of osteopathy
Nina is 41 and has five sessions with an osteopath because of neck tension. She compares what she pays herself with and without supplementary insurance. The price per session and the terms of the supplementary insurance are assumptions for this worked example and not the terms of any particular insurer.
| Assumption | Without supplementary insurance | With supplementary insurance (75%, at most CHF 500 per year) |
|---|---|---|
| 5 sessions at CHF 140 | CHF 700 | CHF 700 |
| Basic health insurance pays | CHF 0 | CHF 0 |
| Supplementary insurance pays | CHF 0 | CHF 500 (75% would be CHF 525, capped at CHF 500) |
| Nina pays | CHF 700 | CHF 200 |
What this means for you
- Clarify your cover. Before the first session, check your policy and the terms of your supplementary insurance: is osteopathy included? How much per session, per year?
- Check the therapist. Ask whether they have a cantonal licence and whether they are recognised by your insurer or in the required register.
- Know the alternatives. If you need manual treatment of the musculoskeletal system, basic health insurance pays directly for chiropractic and for physiotherapy with a doctor’s prescription. Both count towards the deductible and retention fee.
- Compare supplementary insurance while you are healthy. The insurer may ask health questions and add reservations. You will find a comparison of supplementary insurance under compare supplementary insurance.
You can switch basic health insurance independently of supplementary insurance; your current insurer may not force you to cancel your supplementary insurance as well when you switch basic health insurance (Art. 7 para. 7 KVG). The premium calculator shows the basic health insurance premiums for your municipality, and you will find the key data for all insurers under health insurers.
Common mistakes
- Submitting osteopathy bills to basic health insurance. They will be rejected and do not count towards the deductible.
- Believing that a doctor’s prescription makes osteopathy a covered benefit. In basic health insurance it changes nothing; only some supplementary insurance policies require one.
- Not checking whether the therapist is recognised. Without recognition, depending on the terms, the supplementary insurance will not pay either.
- Taking out supplementary insurance only once complaints have appeared. Known complaints can be excluded from the contract.
- Confusing osteopathy with chiropractic. Basic health insurance pays for chiropractic, but not for osteopathy.
How we build our examples is explained under How we calculate.
Frequently asked questions
Does basic health insurance pay for osteopathy?
No. Osteopaths are not service providers under Art. 35 KVG, and in basic health insurance insurers may not pay for any benefits other than those provided for by law. A doctor’s prescription does not change this either.
Which insurance pays for osteopathy?
A supplementary outpatient insurance that includes complementary or alternative medicine. How much it pays, for how many sessions and for which therapists is set out in the contract terms of the insurer concerned.
Do I need a prescription for osteopathy?
Not for the treatment itself. Some supplementary insurance policies, however, require a doctor’s prescription before they reimburse costs. Check this in your terms before the first session.
What is the difference between osteopathy and chiropractic?
Both work manually on the musculoskeletal system. Chiropractors, however, are service providers under basic health insurance and may bill the health insurer directly. Osteopathy is only paid for by supplementary insurance.
Related terms
- Complementary medicineComplementary medicine covers treatment methods used alongside conventional medicine, such as acupuncture, homeopathy or phytotherapy. Since 2017, basic health insurance has paid for five methods, but only if a physician with a specialist title and recognised additional training provides the treatment. Treatment by non-medical therapists, such as naturopaths or osteopaths, is only covered by supplementary insurance.
- ASCAASCA is the Swiss Foundation for Complementary Medicine. It checks the training of non-medical therapists and keeps a register of around 18,000 people and more than 150 methods. Many health insurers require ASCA recognition before a supplementary insurance helps pay for treatments such as massage or shiatsu. Basic health insurance does not pay for such therapies.
- EMRThe EMR (Erfahrungsmedizinisches Register, register of empirical medicine) is a private directory of therapists in alternative and complementary medicine. Since 1999 it has checked training and continuing education and awarded a quality label. Many supplementary insurance policies only pay for non-medical therapies if the therapist is recognised, for example by the EMR. Basic health insurance does not pay for such therapies.
- Recognised therapistsRecognised therapists are therapists whose services a health insurer pays for. In basic health insurance, these are professionals authorised under the KVV who work on a doctor’s prescription, for example in physiotherapy with up to 9 sessions per prescription. For naturopathy and massage, your supplementary insurance decides with its own list.
- PhysiotherapyPhysiotherapy is the treatment of complaints of the musculoskeletal system, the nervous system and the internal organs with movement, manual techniques and physical measures. Basic health insurance pays for it when prescribed by a doctor, at most nine sessions per prescription; after 36 sessions, continuing requires a review by the insurer’s medical adviser.
- ChiropracticChiropractic is the examination and treatment of disorders of the musculoskeletal system, especially the spine, by hand. In Switzerland, chiropractors are independent service providers: basic health insurance pays for their treatment in the standard model without a doctor’s referral. As with a visit to the doctor, you pay the deductible and a 10% retention fee.
Sources
- Federal Health Insurance Act (KVG), Art. 35Art. 35 KVGfedlex.admin.ch
- Federal Act on the Health Professions (GesBG), Art. 2, 11 and 12Art. 12 GesBGfedlex.admin.ch
- Federal Health Insurance Act (KVG), Art. 25 and 34Art. 34 KVGfedlex.admin.ch
- Federal Health Insurance Act (KVG), Art. 7Art. 7 KVGfedlex.admin.ch
- Health Care Benefits Ordinance (KLV), Art. 4bArt. 4b KLVfedlex.admin.ch
- Insurance Contract Act (ICA), Art. 4Art. 4 ICAfedlex.admin.ch