Speech therapy

What is speech therapy?

Speech therapy (in Swiss German Logopädie) is the treatment of communication and swallowing disorders. The speech therapist assesses, advises and treats people who have difficulty understanding or forming language, pronouncing sounds correctly, using their voice, speaking fluently or swallowing safely. It concerns children as well as adults, for example after a disease of the nervous system, after an operation in the throat or mouth area, or in old age.

For health insurance, what matters is where the disorder comes from. Basic health insurance does not pay for every kind of speech therapy, only for treatment whose cause is named in the Health Care Benefits Ordinance (KLV):

• Neurological conditions with an infectious, traumatic, surgical-postoperative, toxic, tumour-related, vascular, hypoxic or degenerative cause.
• Phoniatric conditions, in particular partial or complete malformations of the lips, tongue, palate, jaw or larynx, and disorders of the oral and facial muscles or of laryngeal function.

If there is no such cause, for example with delayed language development without a medical finding, basic health insurance is generally not responsible. For school-age children, the canton’s school system is then usually responsible; the cantons provide special needs education for disabled children and young people up to their 20th birthday. If the disorder is due to a recognised congenital disorder, invalidity insurance can pay for medical measures up to the age of 20.

How it works

For speech therapy paid for by basic health insurance, these steps apply:

1. Doctor’s prescription. A doctor prescribes the therapy and justifies it with the cause of the disorder.
2. Authorised professional. The speech therapist must be authorised to practise under cantonal law, have completed a recognised three-year training course and two years of clinical practice, work independently and meet the quality requirements. Authorised speech therapy organisations can also bill.
3. Start within eight weeks. The first treatment must take place within eight weeks of the prescription.
4. Twelve sessions per prescription. For further sessions the doctor issues a new prescription.
5. Report after 60 sessions. If the therapy is to continue after 60 one-hour sessions within one year, the doctor sends the insurer’s medical adviser a report with a reasoned proposal. The doctor also reports at least once a year on progress and further indication.

Reports to the medical adviser may only contain the information needed to assess whether the insurer must pay. The invoices count towards your deductible; after that you pay a 10% retention fee up to the annual maximum.

Legal basis

Under Art. 25 para. 2 let. a no. 3 of the Federal Health Insurance Act (KVG), basic health insurance covers services provided on a doctor’s prescription. For speech therapy, these provisions apply:

• Art. 10 KLV: Authorised speech therapists treat, on a doctor’s prescription, disorders of language, speech, voice, fluency and swallowing that are due to neurological (let. a) or phoniatric conditions (let. b).
• Art. 11 paras. 1 and 2 KLV: At most twelve sessions per prescription, first treatment within eight weeks; a new prescription for further sessions.
• Art. 11 paras. 3 to 5 KLV: After 60 one-hour sessions within one year, a report and proposal to the medical adviser; a progress report at least once a year; reports only with the necessary information.
• Art. 50 KVV: Requirements for the authorisation of speech therapists.
• Art. 64 KVG and Art. 103 KVV: Deductible and 10% retention fee; for children no deductible and a retention fee of at most CHF 350 per year, for adults at most CHF 700.
• Art. 14 para. 3 IVG: Invalidity insurance does not cover the costs of speech therapy measures, not even for congenital disorders. Basic health insurance then pays as in the case of illness (Art. 27 KVG).
• Art. 62 para. 3 Federal Constitution: The cantons ensure adequate special needs education for all disabled children and young people up to their 20th birthday at the latest.

Example: same therapy, adult and child

We compare two people who each have 24 sessions of speech therapy paid for by basic health insurance, i.e. two prescriptions. For the example we assume CHF 100 per session; the actual amount depends on the tariff and the length of the session. There are no other healthcare costs in the year. The calculation uses the statutory values for the deductible and retention fee.

What this means for you

For adults, speech therapy usually starts after a hospital stay or an operation. Make sure the prescription is in place before the therapy begins and that a new one is issued after twelve sessions. For longer therapies it is worth checking your deductible: if you expect high costs, a low deductible is often cheaper. The premium calculator shows the comparison for all insurers; you must request a lower deductible by 30 November, see deadlines.

For children, the first question is who is responsible:

1. Medical cause? If a doctor confirms a neurological or phoniatric condition, basic health insurance pays.
2. Congenital disorder? Invalidity insurance does not pay for speech therapy (Art. 14 para. 3 IVG). Basic health insurance covers it as in the case of illness if the requirements of the KLV are met (Art. 27 KVG).
3. Language development without a medical finding? Then the school or the canton is usually the place to turn to.

For children, the deductible is also worth considering. A child premium with a CHF 0 deductible is more expensive than one with CHF 600, but you pay less yourself if therapy is needed. In the municipality of Zurich (region 1), the median monthly premium in 2026 for a child with accident cover was CHF 146.80 with a CHF 0 deductible and CHF 114.90 with a CHF 600 deductible (source: FOPH). The difference of CHF 31.90 a month adds up to CHF 382.80 a year; in the example above, the CHF 0 deductible saves Mia CHF 540 in co-payment. Related therapies such as occupational therapy have similar but not identical rules. What individual insurers offer in supplementary insurance is shown in the profiles of the health insurers.

Common mistakes

• Submitting every speech therapy to the insurer. Without a neurological or phoniatric cause, basic health insurance does not pay.
• Starting without a prescription. Sessions before the doctor’s prescription are not covered.
• Exceeding the twelve sessions. From the 13th session onwards a new prescription is needed.
• Waiting for invalidity insurance. Invalidity insurance does not pay for speech therapy, not even for congenital disorders; submit the invoices directly to your health insurer.
• Overlooking the retention fee for children. Children pay no deductible, but a 10% retention fee up to CHF 350 per year.

We explain how we calculate our examples under How we calculate.