Nutritional advice: what does health insurance cover?
Nutritional advice is covered by health insurance – under certain conditions. Comparis explains what these are.
04.11.2024
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1. Nutritional advice: costs in Switzerland
A consultation costs about 120–180 francs per hour. However, an appointment does not typically take a whole hour. Initial consultations are usually longer than follow-up consultations.
The exact price for nutritional advice depends on the services as well as the qualifications of the consultant. Under certain conditions, your health insurance covers the costs.
2. What happens at a nutritional consultation?
When you attend a nutritional consultation, you discuss your eating habits. You also receive tips on how to improve your diet.
If necessary, the specialist will draw up a nutritional plan adapted to your needs. If you have a medical condition, you will learn how to best control it with the right diet.
Good to know: at a nutritional consultation, you don't just create a diet plan. For example, you will also learn about your body.
3. When is nutritional advice approved by health insurers?
Health insurance only covers costs with a referral from your family doctor. This is also the case for children. The consultation can take place in person, online or over the phone.
In addition, the treating specialist or organisation must be approved for nutritional consultations (Art. 9b HIBO).
Nutritional advice is recognised by basic insurance in the following cases (Art. 9b HIBO):
Obesity: severely overweight patients from a BMI of 30.
Overweight patients from a BMI of 25 with a related disease. Losing weight must have a positive effect on the related illness.
Food allergies or severe intolerances.
Cardiovascular diseases.
Metabolic diseases such as diabetes or Hashimoto’s disease.
Diseases affecting the kidneys or digestive tract, such as renal insufficiency or irritable bowel.
Malnutrition
A different BMI criterion applies to children. This is because BMI depends on your age and gender. In the case of children, health insurance pays if:
the BMI is above the 97th percentile.
the BMI is between the 90th and 97th percentile and a related disease is present. The prognosis for the related disease must be exacerbated by obesity.
The 97th percentile means that the child is heavier than 97% of the children in their age group. Only up to 3% of children are heavier.
4. How many nutritional consultations does health insurance cover?
Basic insurance pays for nutritional advice minus out-of-pocket expenses for as long as medically necessary.
To begin with, health insurance covers the first six sessions. For a further six sessions, you will need a new medical referral.
Do you need more sessions? Then the health insurer will need a medical report. The report must contain a proposal for further treatment (Art. 9 HIBO).
Good to know: for diabetic patients, the health insurer initially pays for ten nutritional consultations. The second referral also includes ten sessions.
5. What can I do if my health insurer doesn’t pay for nutritional advice?
Without a medical referral, you don’t necessarily have to pay for the treatment yourself. Some supplemental insurance policies include nutritional advice. However, the scope of coverage varies with each health insurer.
Some contribute to the costs. Others offer telephone advice or support with nutritional programmes and health apps. Before taking out supplemental insurance, check which benefits are important to you. How to find the right supplemental insurance for you.
This article was first published on 27.06.2024
