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for psychotherapy & psychological counselling
Psychotherapy: costs covered by Sanitas
Get support if your mental health is suffering. Under certain conditions, basic insurance covers the cost of psychotherapy.
What is the difference between psychotherapy and psychological counselling?
Psychological counselling
Short-term psychological counselling can provide support in the event of conflicts at work, making difficult decisions or separations. The focus is on a clearly defined issue that can be discussed in a few meetings. A coach or psychologist guides the conversation. Online offers can also offer support. Neither basic insurance nor supplementary insurance from Sanitas cover the costs of coaching and counselling. Vital supplementary insurance pays a contribution to online coaching sessions from Aepsy or HelloBetter, for example as part of health promotion.
Psychotherapy
In psychotherapy, therapists treat mental suffering that affects all aspects of a patient’s life – for example anxiety, depression, compulsions, addictions or relationship problems. Psychotherapy is long-term and is carried out by trained psychotherapists. With psychotherapy, costs may be covered by health insurance.
Cost share towards psychotherapy
Basic insurance pays for psychotherapy under certain conditions.
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What costs are covered under basic insurance?
Since 1 July 2022, basic insurance has covered the costs of psychotherapeutic treatments. Requirements that must be met:
- A doctor with the appropriate qualification prescribes the psychotherapy.
- The psychotherapist is recognised under basic insurance, i.e. they are a psychologist with a psychotherapy qualification and a cantonal license to practice.
- Basic insurance covers the cost for up to 30 sessions, minus the deductible and copayment.
- A commitment to cover costs is required for further sessions. In this case, a psychiatric specialist must assess your medical history and recommend an extension of the therapy. The decision lies with the insurance company.
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Which therapists are recognised under basic insurance?
- Therapists have to be recognised by the canton. This means that they must have a federal or a recognised foreign advanced training title in psychotherapy.
- They must have at least three years of psychotherapeutic experience.
- They practise their profession independently and on their own account.
Check with your chosen therapist before your first session whether he or she is accredited. Or contact us directly and we will be happy to assist you with the clarification.
Difference between psychiatrists, psychotherapists and psychologists
- Psychiatrists have studied medicine, specialising in psychiatry. They can prescribe medication.
- Psychotherapists have studied psychology and then completed several years of training in psychotherapy or psychoanalysis. They cannot prescribe medication.
- Anyone who has completed a university degree in psychology is considered a psychologist. A psychologist has no therapeutic training and therefore does not treat illnesses.
- Psychological counsellor or coach are not protected designations.
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What costs are covered under supplementary insurance?
Our supplementary insurance plans contribute to the costs of non-medical psychotherapy.
- Vital Basic: No contribution
- Vital Smart: 80% of costs, max. CHF 1,000 per calendar year
- Vital Premium: 80% of costs, max. CHF 5,000 per calendar year.
- Jump*: No contribution
- Classic*: 80% of costs, max. CHF 1,000 per calendar year
- Family*: 80% of costs, max. CHF 1,000 per calendar year
* The Jump, Classic and Family supplementary insurance plans can no longer be taken out. Existing customers continue to enjoy the usual benefits.
Requirements that must be met: The therapist has not signed up to the KVG/HIA tariff agreement, and is therefore not allowed to bill under basic insurance. And they have a psychotherapy qualification.
Vital also supports mental balance with digital offerings from Aepsy and HelloBetter:
- Vital Basic: No contribution
- Vital Smart: choice of cost coverage of 50% of the costs, max. CHF 400 or max. CHF 600 per calendar year
- Vital Premium: 80% of costs, max. CHF 800 per calendar year
- Jump*, Classic*, Family*: no contributions for online coaching
Coaching and psychological advice for personal development are not insured.
What costs does Sanitas cover?
The Cover Check in the Sanitas Portal shows you at the click of a button which costs are covered by Sanitas.
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Frequently asked questions
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Which requirements does a doctor have to meet to be able to prescribe psychotherapy?
If a doctor wants to prescribe non-medical psychotherapy that is paid for under basic insurance, they have to have one of the following specialist qualifications:
- General internal medicine
- Psychiatry and psychotherapy
- Paediatric psychiatry and psychotherapy
- Paediatrics
Doctors specialising in psychosomatic and psychosocial medicine from the Swiss Academy for Psychosocial and Psychosomatic Medicine can also prescribe psychotherapy.
For non-medical psychotherapy that is paid under supplementary insurance, the referring medical specialist does not need a specific specialist title.
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Does health insurance contribute towards the cost of couples therapy?
Yes, basic insurance covers couples therapy, provided it is prescribed by a doctor.
The Sanitas Classic and Family supplementary insurance plans contribute to the costs of couples therapy if they are medically prescribed and the psychotherapist works on their own account.
Vital supplementary insurance (only Smart or Premium) also contributes to the cost of couples therapy with Aepsy via video call.
Vital Smart: 40% of costs, max. CHF 1,000* per person
Vital Premium: 40% of costs, max. CHF 5,000* per person
* These amounts apply for all benefits for “Additional forms of treatment”.
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What costs are covered for psychological help for children?
With children and young people, the same conditions have to be met as for adults.
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Does Sanitas contribute to online therapies?
Basic insurance does not cover the cost of online therapies or counselling by phone.
The Smart and Premium categories of the Vital supplementary insurance solution contributes to telephone psychotherapy sessions with Aepsy, provided these are prescribed by a doctor. It also pays for online courses for mental balance (one-time app purchase or one-time subscription for a maximum of 12 months or in-app purchases):
- Aepsy: coaching
- Braive: prevention modules
- Hellobetter: prevention modules
- Mementor: sleep training
Vital also supports mental balance with digital offerings from Aepsy and HelloBetter:
- Vital Basic: No contribution
- Vital Smart: choice of cost coverage of 50% of the costs, max. CHF 400 or max. CHF 600 per calendar year
- Vital Premium: 80% of costs, max. CHF 800 per calendar year
- Jump, Classic, Family: no contributions for online coaching
Sanitas also offers online programmes in cooperation with various partners such as Klenico, Aepsy, Gaia and HelloBetter. You can find these in the mental health guide in the Sanitas Portal app. The programmes are free or available at a reduced price with the Vital supplementary insurance. Customers who don’t have supplementary insurance also benefit from attractive conditions.
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Does it make a difference whether I’m treated by a psychiatrist or a psychotherapist?
Apart from the fact that psychiatrists have studied medicine with a specialisation in psychiatry and are therefore allowed to prescribe medication, and psychotherapists have studied psychology, another difference lies in the number of therapy sessions allowed: With psychotherapists, you need a commitment to cover costs from your health insurer after a total of 30 sessions, with psychiatrists after 40 sessions. This applies to cost coverage under basic insurance.