Osteopathy in private health insurance: reimbursement, costs, requirements

In Germany, osteopath is not a protected professional title with its own license. Doctors and alternative practitioners may treat patients on their own. Physiotherapists with further training in osteopathy need a license as an alternative practitioner to treat on their own responsibility. For private health insurance, this results in two billing routes. The doctor, often with a qualification from the DGOM, for example, bills under the fee schedule for doctors, and the treatment goes through the normal outpatient plan. The alternative practitioner bills based on the fee schedule for alternative practitioners, and the treatment falls under the naturopathy module.

The most common rejection concerns the third case. Without a doctor's prescription, many plans do not reimburse treatment by therapists who are licensed neither as a doctor nor as an alternative practitioner, even if the plan has a naturopathy module. A quick look at the qualification before you book the appointment saves the discussion afterwards.

At €50 to €100 per session and usual series of three to six appointments, osteopathic treatment stays manageable. Over a year, it can still add up to several hundred euros. Plans with a module for naturopathic treatment usually reimburse seventy to one hundred percent within the annual maximum amount. Plans without the module reimburse osteopathy by a doctor through the outpatient part, but not treatment by an alternative practitioner.

The following also belongs to the full picture. The scientific assessment of osteopathy is disputed, and only the plan governs reimbursement. We do not recommend for or against the method. Medical questions are for a conversation with your doctor or practitioner. All amounts are guide values.

From our contract work we know the typical pattern. The treatment runs for months, the bills pile up, and at the end of the year the shared budget for naturopathic treatment has been used up without anyone noticing. For policyholders who regularly need osteopathy, we recommend a plan that has separate maximum amounts per method or that reimburses osteopathy by a doctor without limit through the outpatient part.

If you are about to join private health insurance and use osteopathy, state ongoing treatment in the health questions. Regular treatment for back problems can lead to follow-up questions. Clear documentation of the reason for treatment helps the insurer assess it.

For reimbursement through the module for alternative practitioner services, usually not. For treatment by physiotherapists, on the other hand, often yes. Some plans require the prescription in general. The clause in your own plan gives the answer.

Yes, if the children's plan includes a naturopathy module, under the same rules as for adults. Because children in private health insurance have their own contracts, the scope can differ from the parents' plan.

No, the two are kept separate. Physiotherapy is a prescribed therapeutic remedy, while osteopathy is a naturopathic treatment with its own area in the plan. Even if the same therapist offers both, the bills belong to different budgets of the plan.