Complementary medicine

Frequently asked questions on complementary medicine

  1. When does Helsana cover the cost of complementary medicine?
  2. How much of the cost of complementary medicine does Helsana cover and what conditions apply?
  3. Which complementory methods does Helsana pay for under basic insurance?
  4. Do I need a medical prescription?
  5. Why does Helsana not pay for preventive complementary medical treatment?
  6. Will the cost of my treatment be charged to my basic insurance excess?
  7. Why does Helsana send me a questionnaire to clarify benefits?
  8. Why does Helsana not recognise my therapist even though he/she is registered with the EMR?
  9. What is the EMR?
  10. What is a Helsana complementary medicine specialist?
  11. What does the complementary medicine advisory team do?
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When does Helsana cover the cost of complementary medicine?

We will reimburse you for the cost of complementary medicine where medical necessity has been established. Preventive treatment is not medically necessary and is therefore not reimbursed. Treatment for many mood disorders that do not urgently require treatment, such as stress, tension or tiredness, are also not considered medically necessary.

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How much of the cost of complementary medicine does Helsana cover and what conditions apply?

Outpatient treatment: You receive 75% of the costs of complementary medicines and therapies, such as osteopathy, kinesiology, acupuncture massage and Bach flower therapy, provided there is an established medical necessity.

Inpatient treatment: You receive 100% of the costs of complementary medicines and therapies, provided there is an extablished medical necessity, up to CHF 5000 per calendar year.

Conditions:

  • Your doctor, naturopath or complementary therapist is recognised by us.
  • The therapy method is recognised by us and can be found on the "Recognised special forms of treatment" (PDF, 122KB) or "Recognised therapeutic methods in complementary medicine (PDF, 30KB) " list.
  • The medicine is provided or prescribed by a doctor or naturopath recognised by us and approved by the Swiss Agency for Therapeutic Products Swissmedic for the treatment of the condition. (Medications on the list of pharmaceutical products with a special application (LPPV) are excluded).
  • The inpatient treatment is prescribed by a doctor and is performed in a medical institution or convalescent facility recognised by us.
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Which complementory methods does Helsana pay for under basic insurance?

You receive contributions towards the costs of the following types of complementary medicine:

  • Anthroposophic medicine
  • Classical homeopathy
  • Phytotherapy
  • Pharmacotherapy within traditional Chinese medicine (TCM)
  • Acupuncture

Please ensure that your doctor holds a recognised certificate of competence awarded by the Swiss Medical Association (FMH) for these methods.

The costs are refunded according to the tariff in the canton where the person lives or the tariff for his work location.

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Do I need a medical prescription?

No. However, in more complex cases, we may request information from you so that we can check the medical necessity of the treatment.

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Why does Helsana not pay for preventive complementary medical treatment?

Our effective complementary medical products are available to you at attractive prices. We want to be able to continue to offer that in the future, too. If we were to expand the range of benefits, it would lead to an increase in premiums. Helsana provides you with a range of offers to prevent illness and promote good health. You can see a selection of offers and information here.

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Will the cost of my treatment be charged to my basic insurance excess?

No, provided that the treatment is not a benefit covered by basic insurance (KVG).

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Why does Helsana send me a questionnaire to clarify benefits?

For longer-term treatments, we need to compile a report in order to assess the medical necessity. Unfortunately, the details on the invoices are not sufficient. That's why we send you a questionnaire for the therapist/doctor treating you to fill in. We do this for both adults and children.

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Why does Helsana not recognise my therapist even though he/she is registered with the EMR?

Our decision to approve a therapist is based on two basic principles: the information provided by the EMR (Erfahrungs-Medizinische Register) in Basel, and our own in-house criteria. If a therapist meets our requirements in both regards, he/she will be included in our list of approved complementary therapists. Helsana currently works with over 14,000 approved complementary therapists and supports around 70 methods.

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What is the EMR?

Based in Basel, the EMR (Erfahrungs-Medizinische Register) is an independent auditing body for alternative health practitioners and complementary therapists. The EMR checks therapists' qualifications and gives them a quality label. Helsana uses this as evidence of sound training.

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What is a Helsana complementary medicine specialist?

Our specialists in complementary medicine are trained professionals and are also sometimes naturopaths themselves, with many years of experience in treating patients. These experts examine our insured members' medical reports, medical certificates and questionnaires. They also provide therapists and doctors with information on complementary medicine and advise you as our customer.

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What does the complementary medicine advisory team do?

We give advice – the doctor, naturopath or complementary therapist provides treatment. Our experts share their knowledge with the utmost care and on the basis of current knowledge. We cultivate the exchange of expertise with doctors, naturopaths and complementary therapists. It goes without saying that we regularly attend training on conventional and complementary medicine topics. However, we can accept no liability as regards the advice being accurate, complete or up to date. In particular, we accept no liability for the services provided by therapists or doctors recommended by us.