Does Swiss health insurance pay for physiotherapy?

What basic health insurance pays

Physiotherapy is one of the benefits of basic health insurance that professionals provide on a physician’s prescription (Art. 25 para. 2 let. a no. 3 of the Federal Health Insurance Act, KVG). Art. 5 of the Health Care Benefits Ordinance (KLV) lists exhaustively what is covered. The condition is that a disease of the musculoskeletal or neurological system or of the internal organs and vessels is being treated and that it is amenable to physiotherapy.

Quantities: Per medical prescription, the insurer pays at most nine sessions, and the first treatment must take place within five weeks of the prescription (Art. 5 para. 2 KLV). Further sessions require a new prescription (para. 3). If therapy is to continue after 36 sessions, the treating physician sends the insurer’s medical adviser a report with a reasoned proposal. The medical adviser recommends whether, to what extent and for how long the insurer continues to pay (para. 4).

Training therapy and groups: Medical training therapy begins with an introduction to the equipment and ends at the latest three months later; before that, an individual physiotherapy treatment is required (Art. 5 para. 1ter KLV). Movement therapy, physiotherapy to reduce muscle tone, respiratory physiotherapy, training therapy, movement therapy in water and cardiovascular physiotherapy may also take place in groups (Art. 5 para. 1bis KLV).

Accident: After an accident, the accident insurance pays first. It covers outpatient treatment by a paramedical professional on a physician’s prescription (Art. 10 para. 1 let. a UVG), without the health insurer’s deductible and retention fee. Employees who work at least 8 hours per week for the same employer are also insured during their free time (Art. 13 UVV). In the event of an accident, basic health insurance only pays insofar as no accident insurance covers it (Art. 1a para. 2 let. b KVG).

Children with congenital disorders: Up to the age of 20, disability insurance also pays for prescribed physiotherapy for recognised congenital disorders (Art. 13 and 14 IVG). If therapy continues after that, basic health insurance applies the same review as after 36 sessions (Art. 5 para. 5 KLV).

What supplementary insurance pays

You do not need supplementary insurance for physiotherapy prescribed by a physician; it is covered by basic health insurance. Supplementary outpatient insurance can help where basic health insurance stops. Whether it pays and how much is set by each insurer in its general terms and conditions, for example for:

• sessions without a medical prescription,
• methods not listed in Art. 5 KLV, such as osteopathy or complementary medicine therapies with recognised therapists,
• massages outside prescribed physiotherapy,
• contributions to fitness or prevention.

Supplementary insurance may not cover the deductible and retention fee of basic health insurance (Art. 64 para. 8 KVG). We are building a benefits comparison of supplementary products under Supplementary insurance. What always counts is the general terms and conditions and the information from your insurer.

Conditions

• Medical prescription: Without a prescription from a physician, basic health insurance does not pay for physiotherapy (Art. 5 para. 1 KLV). The prescription is valid for at most nine sessions.
• Five-week deadline: The first session must take place within five weeks of the prescription. If you wait longer, you need a new prescription.
• Admitted therapist: Only physiotherapists with a cantonal licence to practise, two years of practical experience and who meet the quality requirements (Art. 47 KVV), as well as admitted physiotherapy organisations (Art. 52 KVV), may bill basic health insurance. If in doubt, ask before the first session.
• Review after 36 sessions: To continue, a report to the medical adviser is required. Until the medical adviser decides, it is not certain whether the insurer will pay for further sessions.
• Deductible and retention fee: Physiotherapy counts towards your deductible (Franchise); after that, you pay a 10 % retention fee up to CHF 700 per year, CHF 350 for children (Art. 64 KVG, Art. 103 KVV). There is more on co-payment in the glossary.
• Aids and appliances separately: Bandages, orthoses or walking aids are not part of physiotherapy. Basic health insurance only reimburses such aids and appliances if a physician prescribes them and they are on the Aids and Appliances List (MiGeL) (Art. 20 KLV).
• Other insurance first: In the event of an accident, the accident insurance pays; for congenital disorders up to the age of 20, disability insurance pays.

Sample calculation

Example with fictitious people and an assumed price per session. Sandra is 47 and has the standard deductible of CHF 300. Her physician prescribes physiotherapy in February 2026 and issues a second prescription in April: 18 sessions in total. One session costs an assumed CHF 60.00. Sandra has no other medical bills during the year. The deductible and retention fee are the statutory values from Art. 64 KVG and Art. 103 KVV.

Because the deductible has now been used up, Sandra only pays the retention fee for further medical and therapy bills in the same year, until she reaches the maximum of CHF 700; CHF 78 of this has already been reached.

Whether the low or the high deductible is cheaper depends on how much you spend per year on doctors, therapy and medicines. You can work out the break-even point in the deductible calculator and compare premiums in the premium calculator. The article Deductible of 300 or 2,500? explains how to choose your deductible.

How to proceed

1. Get a prescription: Have your physician prescribe physiotherapy before you book the first appointment.
2. Start within five weeks: Schedule the first session so that it takes place within five weeks of the prescription.
3. Count the sessions: After nine sessions, you need a new prescription. After 36 sessions, the report to the medical adviser is required; raise this with your physician in good time.
4. Report an accident: If an accident is the cause, report it to your employer if you are employed, otherwise to your health insurer. If you are insured through your employer, the health insurer’s accident cover can be excluded; you can check this with Exclude accident cover.
5. Check the invoice: Check on the statement of benefits whether the number and dates of the sessions are correct. The health insurer profiles show how insurers organise contact channels and billing.

Common mistakes

• Starting without a prescription. Basic health insurance does not pay for sessions before the medical prescription.
• Letting the five weeks pass. If therapy starts later, the prescription is no longer valid for basic health insurance.
• Simply continuing after the ninth session. Without a new prescription, the insurer does not pay for the tenth session.
• Confusing wellness with therapy. A relaxation massage without a prescription is not physiotherapy under Art. 5 KLV.
• Bypassing the accident insurance. If you bill your health insurer after an accident, you may pay a deductible and retention fee that the accident insurance would not have charged.

The page Osteopathy explains when health insurance pays for osteopathy, and the page Massage sets out the rules for massages. You will find all other benefits in the overview What does health insurance cover?.