Complementary medicine: Questions and answers about the costs covered
As a general rule, the following applies: Supplementary outpatient insurance covers the costs of recognised alternative medicine methods with recognised therapists. Requirements: The treatment must be medically necessary, effective, appropriate and cost-effective. Sympany regularly checks whether these requirements are met.
Why is it necessary to check cost coverage?
Complementary medical therapy must be used to treat an illness or condition. This will usually improve, or even be cured, as the treatment progresses. We regularly check whether the treatment plan complies with our terms and conditions of insurance.
Checking process
- Complete the power of attorney form you have received and forward the questionnaire for alternative medical treatments to the therapists who are treating you.
- You (or your therapist) must submit the completed questionnaire, including the power of attorney you issued, to Sympany within 30 days.
- Our trusted complementary medicine therapist will use the information in the questionnaire to assess whether the treatment plan described complies with our terms and conditions of insurance – and whether it is effective, appropriate and cost-effective.
- You will receive written notification of the cost coverage decision.
Frequently asked questions about covering costs for complementary medicine
If you would like Sympany to contribute to the costs, you must have the questionnaire completed by your complementary medicine therapists (General terms and conditions of insurance, obligation to cooperate). Without this information, it will not be possible to conclusively assess the obligation to pay benefits and therefore further cost coverage cannot be guaranteed.
In order for costs to be covered, the treatment must be medically necessary and used to treat an illness or condition. Preventive treatments, for example for supporting general good health, stabilisation, maintaining the ability to work or preventing relapses, are not covered by supplementary insurance.
Yes. Benefits provided while we are conducting our checks will still be remunerated. Any restriction or rejection of benefits will only take place from the date of the decision communicated in writing.
No. The approval of coverage applies for all complementary medicine treatments and is not restricted to a specific specialist or method, provided that the treatment is carried out within the approved number of sessions or frequency.
If an application for cost coverage is rejected, this rejection always relates to the specific submitted treatment plan, which may include several complementary medical methods.
If you use complementary medical treatments again at a later date, the obligation to pay benefits may be reassessed. In this case, please resubmit the questionnaire completed by all complementary medicine specialists involved. This should include a detailed treatment plan that comprehensibly states the diagnosis or symptoms, the method used, the planned frequency and duration of treatment, and the intended treatment goal.
In accordance with the terms and conditions of insurance, the insurance provider determines the number of therapy hours that will be reimbursed in accordance with the principle of medical need. Alternative medicine benefits are subject to the following restrictions:
- Contribution amount per hour of therapy – the insurance provider defines a maximum amount that will be reimbursed per hour.
- Number of hours of therapy – an upper limit is set for the hours that can be reimbursed.
- Recognised treatment methods – only those methods that are included in the insurance provider's list of recognised alternative treatment methods will be reimbursed.
- Recognised therapists – services are only covered if they are provided by specialists on the insurance provider's relevant recognition list.
- Time limit per calendar year – the reimbursement is also limited by an annual benefit period.
The therapists and methods on the list are reviewed annually and may be adjusted accordingly. To the list of methods and therapists ›
No. As the treatment has already been completed, no further checks are required. Please let us know briefly that the treatment has been completed. However, if you need complementary medical treatment again in future, you must submit the completed questionnaire in advance so that the cost coverage can be assessed.
Complementary medicine follows a holistic treatment approach in which symptoms are treated using the body’s self-healing powers. With that in mind, multiple treatments are not advisable from a complementary medicine perspective. As a result, parallel treatments are not covered by supplementary insurance.
