Complementary and alternative medicine: what’s covered by health insurance?
Alternative and complementary medicine do not fall under the umbrella of conventional medicine. Comparis describes how they differ and explains when health insurance will cover the cost of alternative and complementary medical practices.
05.07.2022
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1. What is complementary and alternative medicine (CAM)?
Alternative medicine refers to all treatments and therapies that are not classified as conventional medicine. When used in support of conventional treatment, these therapies are also described as complementary medicine. They may be administered by doctors, naturopaths and recognized therapists.
2. Differences between conventional and complementary/alternative medicine
In the approach to treatment
Conventional medicine focuses on treating symptoms and changes to or in the body.
CAM takes an holistic approach to treating those symptoms. It aims to achieve a balance between body, mind and environment.
In the effect
In conventional medicine, the body is healed by means of external intervention, such as medicine or surgery.
CAM aims to support the body's ability to heal itself. It relies on patients playing a more active part in becoming well than they do with conventional medicine.
In the science
Conventional medicine concentrates heavily on achieving measurable results using scientific methods.
CAM practices are based to some extent on positive personal experience, hence the terms empirical medicine and holistic medicine.
Which should I choose?
Conventional and CAM practices can work well in combination with each other. You do not necessarily have to decide between one or the other.
3. What practices are classified as complementary and alternative medicine (CAM)?
CAM covers a whole range of practices, and you may encounter the same one in different forms. They can be combined with each other and with conventional medicine treatments. Here is a selection of the best-known therapies:
Acupuncture (e.g. laser, electroacupuncture and ear acupuncture)
Ayurveda (e.g. massage, diet and herbal remedies)
Bach flower remedies
Bioresonance therapy
Craniosacral therapy
Electrotherapy
Homeopathy
Kinesiology
Magnetic field therapy
Osteopathy
TCM / Traditional Chinese Medicine (e.g. acupuncture, qi gong, cupping, Chinese medicines, diet)
Phytotherapy
Further practices (in German, French and Italian only)
What is homeopathy?
Homeopathy is a remedy-based therapy that was developed by the German doctor Samuel Hahnemann at the beginning of the 19th century. It is mainly characterised by the fact that remedies are chosen according to the similarity principle, which is based on the individual symptoms and the patient's personal characteristics.
4. CAM therapies covered by health insurance
Five alternative treatments are covered by law under basic insurance. Just like conventional medicine, they are charged for using the TARMED tariff system.
Acupuncture
Anthroposophic medicine
Traditional Chinese Medicine
Homeopathy
Phytotherapy
Health insurance providers also offer supplemental insurance products for CAM. Supplemental insurance will also pay for treatment provided by naturopaths and therapists. Therapists' hourly rates differ, as does how much supplemental insurance policies will pay. They will often contribute a fixed amount per hour, and there will be a cost ceiling or out-of-pocket expenses to pay. It is certainly worth comparing supplemental insurance products, and checking exactly what they pay before you start treatment.
5. Recognized CAM service providers
Basic insurance only covers only alternative and complementary medicine therapies if they are administered by a doctor who is trained in conventional medicine and holds the appropriate additional qualifications.
In the case of supplemental insurance, health insurance providers decide for themselves what criteria care providers must satisfy for their treatments to be covered. If you are treated by a certified provider, such as a naturopath, masseur or other therapist, supplemental insurance will cover the cost. Common criteria and qualifications include:
EMR: the Empirical Medicine Register awards the EMR quality label to providers who hold certain diplomas.
ASCA: therapists who hold certain diplomas in alternative/complementary medicine can have their qualifications recognized by ASCA, the Swiss complementary medicine foundation.
Qualified physicians: trained physicians can have their qualifications in specific CAM practices recognized by the Swiss Medical Association (FMH). They are then awarded the relevant proficiency certificates. If they hold five such certificates, they are entitled to charge under basic insurance for those therapies.
6. CAM products
In addition, selected medicines from the field of complementary and alternative medicine are covered by health insurance in Switzerland. Basic health insurance covers the expenses for such products less out-of-pocket expenses if they are on the List of Pharmaceutical Specialties. This list also contains products used in phytotherapy, anthroposophy and homeopathy.
Outpatient supplemental insurance often pays for products not covered by basic health insurance. Enquire directly with your insurer to find out which products are allowed.
