Alternative medicine in private health insurance: naturopathic treatments at a glance

Whether a plan reimburses alternative medicine is governed by two mechanisms. The first is the scientific recognition clause, modeled on § 4 (6) MB/KK. Under this clause, the insurer pays for methods that are generally recognized by science. Beyond that, it pays for methods that have proven just as promising in practice, or that are used because no recognized method is available. Plans can make this clause stricter or extend it in favor of the policyholder. This is exactly where plan quality differs.

The second mechanism is the Hufeland directory, a catalog of naturopathic methods. Plans that refer to the Hufeland directory reimburse the methods listed there, for example acupuncture or methods of traditional Chinese medicine, even without proof of scientific recognition in the individual case. If you need treatment regularly, a plan with an explicit reference to the Hufeland directory is the most reliable basis.

Each method has its own place in the plan. The following overview classifies the six common methods.

This classification does not replace a detailed check. Each method has its own cost ranges and clauses, which are described on the individual pages of this section. What they all share is the basic requirement of medical treatment. No plan reimburses wellness treatments without a link to an illness.

Within the module for naturopathic treatments, plans work with a reimbursement rate of usually seventy to one hundred percent and an annual maximum between €1,000 and €3,000. With an alternative practitioner, the fee schedule for alternative practitioners also limits the rates that can be reimbursed. You submit bills in the normal way. For longer courses of treatment, a written confirmation of cover in advance is advisable.

Honesty is part of this. The evidence for many methods is disputed, and we do not assess it. Our job is the plan side, which means the question of whether the treatment you want is covered in the contract and on what terms. The medical decision is made by the patient and the practitioner.

In our advice work we see a clear split. On one side are policyholders who use naturopathic treatments regularly, on the other those who never use the module. We recommend that you base your decision on the module honestly on your own behavior. If you use it regularly, a plan with a high budget and a reference to the Hufeland directory pays off. If you do not use it, the module is premium you can do without.

We also recommend that you pay attention to separate budgets when you choose a plan. A plan that pays for alternative practitioners, osteopathy and acupuncture from one shared pot looks generous on paper and is quickly used up in practice.

Depending on the plan, methods of traditional Chinese medicine such as acupuncture or herbal therapy fall under the Hufeland directory or the general module for naturopathic treatments. Acupuncture by doctors has the widest cover, and other methods depend heavily on the individual clause.

The insurer can check medical necessity in the individual case, even for listed methods. A clear diagnosis and documentation of the course of treatment are then the best arguments. In case of a dispute, you can turn to the ombudsman for private health insurance.

Yes, you must state treatment from recent years, including treatment by an alternative practitioner. What matters is the reason. The insurer assesses regular treatment for specific complaints like any other medical history. Wellness appointments without a diagnosis are usually not critical.