Anthroposophic medicine in private health insurance: reimbursement and status

Among complementary methods, anthroposophic medicine has a special position. It is mostly practiced by licensed doctors with an additional qualification, and conventional medicine remains the basis of treatment. Doctors bill under the fee schedule for doctors, so the treatment goes through the outpatient part of the plan and does not necessarily need a naturopathy module. The Gesellschaft Anthroposophischer Ärzte in Deutschland (GAÄD), the association of anthroposophic doctors in Germany, brings the qualifications together.

It gets more complex with the accompanying therapies. Eurythmy therapy, rhythmical massage and art therapies are provided by their own therapists and are not classic therapeutic remedies. Some plans reimburse them with a doctor's prescription, others assign them to the naturopathy budget, and still others exclude them. As with homeopathy, the clause decides in each individual case.

Medical services follow the usual ranges of the fee schedule. Anthroposophic medicines such as mistletoe products are usually in the two-digit range per prescription. Sessions of the accompanying therapies typically cost between €40 and €80, depending on the therapist and the length. Over a series of several weeks, this adds up to a relevant amount. Herbal medicines go through phytotherapy and its own prescription route. All figures are guide values. The plan is what counts.

The scientific assessment of anthroposophic methods is disputed, and we do not assess them. Mistletoe therapy as part of accompanying cancer treatment is well known. Whether it makes sense in an individual case is for a conversation between the patient and the treating doctors. For the plan, the clause counts, not the worldview.

In our advice work we see that families with an anthroposophic orientation usually plan their care for the long term, from the pediatrician to the choice of clinic. We recommend that this group looks closely at three clauses in the plan comparison. The first is the reimbursement of medicines that do not require a prescription. The second is the treatment of accompanying therapies, and the third is the plan's scientific recognition clause.

For inpatient stays in anthroposophic clinics, the usual procedure applies. They are regular hospitals, and the treatment goes through the normal inpatient plan benefits. For hospitals with a mixed character, a confirmation of cover before admission is advisable.

With a doctor's prescription and depending on the plan's medicines clause, often yes, especially as part of accompanying cancer treatment. Before longer therapies, a written confirmation of cover gives you certainty. The medical assessment belongs with the treatment team.

An anthroposophic movement therapy, carried out on a doctor's prescription by specially trained therapists. Reimbursement depends on the plan, sometimes through the prescription, sometimes through the naturopathy budget, sometimes not at all. An enquiry to the insurer before the series is worth it.

Yes, and then the usual rules for alternative practitioners apply. Billing is based on the fee schedule for alternative practitioners, and reimbursement goes through the module for naturopathic treatment, including its annual limits. The route through a doctor remains the one with the strongest reimbursement.

It improves your position in the argument. A therapeutic approach recognized in social law is harder to dismiss as scientifically untenable. What counts remains the terms of the plan and the medical reason in the individual case. In a conflict, the Ombudsman for Private Health Insurance can help.