Phytotherapy in private health insurance: reimbursement of herbal medicines

Herbal medicinal products are approved medicines with plant-based active ingredients, from St John's wort products to standardized extracts. For reimbursement in private health insurance, a chain of three links counts. You need a practitioner who prescribes, a product with the status of a medicine and a plan clause that covers it. Pure dietary supplements and teas drop out of this chain. They are not medicines, and you pay for them yourself in every plan.

The most common stumbling block is the prescription requirement. Because almost all herbal medicines are available without a prescription, plans that only reimburse prescription-only medicines have no effect here. Plans with strong benefits reimburse medicines prescribed by a doctor regardless of whether they legally require a prescription, and exactly this wording makes the difference in phytotherapy.

Single herbal medicines usually cost a two-digit amount. If you take them for months, a noticeable sum still builds up. You submit them like any other medicine. The prescription and the pharmacy receipt go to the insurer. If an alternative practitioner leads the therapy, the limits of the naturopathy module and its annual maximum amount also apply.

The scientific assessment differs by product and area of use, and assessing effectiveness is not our role. Whether a herbal medicine makes medical sense is for a conversation with your doctor or pharmacist. We answer the plan question. All figures are guide values.

From our plan work we see that the medicines clause is one of the underestimated plan features. When taking out a contract, everyone looks at dentures and the chief physician, but hardly anyone reads the wording on medicines that do not require a prescription. In everyday life, however, it decides on every pharmacy receipt.

For policyholders who take herbal medication regularly, we recommend that you check your own clause once in a targeted way and always have future prescriptions issued by your doctor. We also recommend that you bundle long-term prescriptions. A prescription for a whole quarter creates fewer receipts and fewer discussions than twelve single purchases.

No, products sold freely without a prescription are paid by you. The same remedy as a pharmacy-only medicine prescribed by a doctor, on the other hand, can be reimbursable. The route decides, not the active ingredient.

Both happen. If a doctor prescribes an approved herbal medicine, it counts as a medicine. If an alternative practitioner provides phytotherapeutic treatment, it counts toward the module for naturopathic treatment. Many plans cover both routes side by side.

Individual herbal mixtures are a difficult case for plans, because they often lack the status of a medicine. Some comfort plans reimburse them through the naturopathy module. Before expensive long-term mixtures, a written enquiry to the insurer is worth it.

Yes, like any regular medication, because it points to the condition being treated. What matters for the risk assessment is the diagnosis behind it, not the fact that the remedy is herbal.