Rehab, wellness and detox: what does health insurance pay?
If you’ve had surgery or a serious illness, a stay in at a wellness resort or rehab can help you recover. Comparis explains who covers the costs.
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Wellness resorts and rehab have similar goals, though the costs are covered in different ways. You need to be aware of this so that your insurer will cover the costs.
If you’ve had surgery or a serious illness, treatment at a wellness resort or an inpatient rehabilitation stay can help you recover. Depending on the treatment, basic insurance may not be enough to cover the costs.
1. Will basic insurance cover the cost of rehab?
Basic insurance covers inpatient rehabilitation stays if the stay is medically required and has been prescribed by a doctor. You must be undergoing rehabilitation to relieve the symptoms of an illness or recover from an operation. Additionally, the clinic must be properly recognized and led by doctors.
Other conditions that must be met:
The stay must immediately follow outpatient treatment or a hospital stay. Rehab can help to restore lost functionality with medical interventions or assist people with disabilities. A rehab stay is therefore meant to improve a patient’s quality of life.
The stay must be prescribed by your doctor. They then report your rehabilitation to an acknowledged rehab clinic. In addition, the doctor treating you or the hospital social services must request from your health insurer a commitment to provide cover.
If the rehabilitation clinic is listed on the respective canton’s hospital list, basic insurance will cover the costs of medical services and an inpatient stay.
2. Will my health insurer pay for a stay at a wellness resort?
Supplemental insurance is usually required for a wellness resort stay. They are intended to promote recovery: sick people receive time and support to regain their physical and mental strength. There is, however, no particular need for treatment. The treatments offered can range from medical and therapeutic care to light nursing support. Wellness resort treatment can (but it doesn’t have to) take place straight after a hospital stay.
The costs for a preventive stay might not be covered by health insurers. However, if the stay at the resort is medically necessary, basic insurance will cover the medical as well as therapeutic treatments. For this, the resort stay must be prescribed by your doctor and approved in advance by your health insurance company. In addition, for wellness resort stays of no more than 21 days per year, basic insurance also pays a contribution towards expenses of ten francs per day, on top of medical and therapy costs.
Supplemental insurance is required to cover part of the accommodation costs. As a rule, there is a limit on the cost per day and the number of days per year. Benefits and premiums vary considerably, so it’s worth comparing – some insurers in border cantons even support treatments in Germany.
3. Will my health insurer pay for fasting cures or detoxing?
As with wellness resorts, basic insurance doesn’t cover costs for fasting cures or detoxing. If fasting or detox is medically required and prescribed by a doctor, basic insurance will cover part of the costs. Supplemental insurance (such as that for alternative medicine) may be worthwhile as this will often cover part of the costs.
4. Summary
Rehab or wellness resort: clarify early who specifically pays which costs for which services. Be sure to submit your prescription to your health insurance company before your rehab or wellness resort stay begins and request a commitment to provide cover if your doctor hasn’t already done so.
