Basic insurance vs. supplemental insurance in Switzerland: A clear comparison for psychotherapy
A comparative guide to understanding what covers what—and how to best use them for your treatment journey.
Introduction
When talking about psychotherapy in Switzerland, many people come across two terms that seem similar but have very different implications for your career and your wallet:
- Basic insurance (LAMal/KVG / AOMS)
- Supplementary insurance
The difference between these two isn’t just bureaucratic: it affects what is reimbursed, how much the therapy actually costs, how much freedom you have in choosing your provider, and even how long it takes before starting treatment.
This comparison guide will help you understand, with concrete examples and simple language:
- what does basic insurance cover;
- what can supplemental insurance add;
- when and why it is convenient to activate the complementary one;
- the risks of unexpected costs;
- how to orient yourself without confusion.
Basic health insurance (LAMal/KVG /AOMS): what it covers and how it works
1. Psychotherapy reimbursed with prescription
From 1 July 2022, psychological psychotherapy in Switzerland is covered by basic insurance if:
- you have a medical prescription (family doctor or psychiatrist);
- The therapist is a federally recognized qualified psychotherapist.
This means that:
- psychological therapy has the status of a mandatory health service;
- it is no longer an optional extra;
- Reimbursement is guaranteed, with certain financial conditions (deductible + rate).
2. Costs at your expense with the base
Psychotherapy is covered, but not completely “free”:
| Voice | What does it mean? |
|---|---|
| Deductible | Annual amount you pay before reimbursement (300–2,500 CHF) |
| Percentage rate | After the deductible, you pay 10% of the costs (maximum CHF 700/year) |
This is the standard scheme: first the deductible, then the percentage.
The base doesn’t cover the entire cost, but it drastically reduces it.
3. Who can prescribe and how
The prescription can be made by:
- family doctor;
- pediatrician (for minors);
- psychiatrist.
A clear clinical assessment of the discomfort is sufficient to obtain the prescription.
4. Typical duration covered
- 15 sessions in the initial prescription;
- another 15 possible with renewal.
After 30 sessions, a psychiatric evaluation may be required to proceed.
Supplemental insurance: what it really adds
Supplemental insurance is optional and supplemental to the basic insurance. It doesn’t cover what the basic insurance doesn’t cover by definition, but it can broaden and improve the therapeutic experience.
Here’s how:
1. Greater freedom in choosing your therapist
With basic insurance, you are linked to recognized and reimbursed psychotherapists.
With supplementary insurance, you can also get contributions for professionals not (yet) recognized in the LAMal/KVG system.
This can be helpful if you desire specific therapeutic modalities (e.g., integrative or transdisciplinary approaches) that are not covered by the foundation.
2. Higher reimbursement and more generous limits
While the basic policy covers net of deductible and tax rate, the complementary one can offer:
- higher percentage refund;
- above franchises dedicated to psychotherapy;
- higher maximums (i.e. more CHF reimbursed per year).
This means that, even if you already have the basics, the complementary one can reduce the direct costs per session even further.
3. What can the supplementary insurance cover (depending on the plan)
| Possible coverage | Explanation |
|---|---|
| Professionals not listed under the LAMal/KVG list | Contributions also for therapists not recognized under the LAMal/KVG list |
| Psychotherapy for specific approaches | e.g., complex trauma therapy, EMDR, integrative approaches |
| Certificates/attestations | Contribution for specialized documentation |
| Additional treatments | Counseling, supervision, Coaching (depending on plan) |
Coverage depends on the plan you choose. Not all supplemental plans are created equal.
4. When is it convenient to activate a complementary insurance?
The complementary can make sense:
- if you undertake a long course of psychotherapy;
- if you want greater freedom in choosing the professional;
- if your basic insurance has a high deductible;
- if you want more refunds with fewer costs for you.
Please note: the complementary verb is used to integrate, not to replace, the base.
Basic or Complementary: direct comparison
| Feature | Basic Insurance | Supplementary Insurance |
|---|---|---|
| Reimbursable psychotherapy is covered | with a prescription | Yes, as a supplement |
| Freedom of choice of therapist | limited to recognized LAMal/KVG (Health Insurance Act) | can be broad |
| Deductible | Yes | Yes, but plans with dedicated deductibles |
| Percentage rate | 10% (maximum CHF 700/year) | can reduce net costs |
| Reimbursement limits | linked to the base | often higher |
| Coaching/counseling coverage | No | possible (depending on plan) |
| Coverage for special approaches | Limited | possible |
Practical examples to understand the difference
Example A – Standard psychotherapy with only basic
Marco has:
- basic insurance with a deductible of CHF 300;
- medical prescription;
- start psychotherapy with a recognized therapist.
Pay the deductible + 10% of the costs (max 700 CHF/year).
The rest is covered by the base.
Example B – Basic + complementary psychotherapy
Giulia has:
- basic with deductible 2,500 CHF;
- complementary which covers part of the sessions even for unrecognized therapists;
- long and modular path.
The basic insurance covers you according to the LAMal/KVG (Low Mal) rules.
The supplementary insurance helps reduce “extra” costs and increases the CHF reimbursed.
Risks and limitations to be aware of
1. The complement does not replace the base
If you don’t have the basic insurance, you can’t get reimbursed for psychotherapy under the LAMal/KVG (Local Health Insurance Act). The supplementary insurance doesn’t cover what the basic insurance isn’t required to pay by law.
2. Each floor is different
The supplementary insurance varies greatly from one insurance company to another.
Always read the contractual conditions before choosing.
3. Waiting period
Some supplemental plans have waiting periods before certain benefits are reimbursed.
Q&A rapida
Is psychotherapy covered without supplementary insurance?
Yes — if you have a medical prescription and a recognized LAMal therapist.
Is supplemental insurance mandatory?
No — it’s optional and used to add coverage or increase reimbursements.
Can I choose any psychologist with the basic?
No—only LAMal/KVG-recognized therapists. Other professionals require supplementary treatment.
Is online therapy covered?
Yes — if prescribed and with a recognized therapist.
Conclusion: How to orient yourself without confusion
Basic insurance is the cornerstone of reimbursement for psychotherapy in Switzerland.
Supplemental insurance can be a useful ally, but it is not a substitute for, and does not eliminate, the need for basic insurance.
The golden rule is: first secure basic coverage, with a medical prescription, then evaluate the supplemental coverage based on your needs, costs, and freedom of choice.
If you want to gain concrete guidance on which plan is best suited to your personal situation or your therapeutic needs, a targeted consultation can make all the difference.