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Sophie

What is reimbursed, and what is not

Four items account for most of the unpleasant surprises. For each, the line between basic and supplementary cover is clear — you just need to know where it runs.

Glasses and orthodontics

Basic insurance contributes to children’s glasses on prescription, within a modest limit set by the ordinance, and pays nothing for an adult outside a recognised condition. Everything else falls to supplementary cover, usually with an annual or multi-year cap.

Orthodontics is the heaviest item: several thousand francs, no cover from basic insurance outside a recognised malformation, and supplementary cover that must have been taken out well before the need is visible.

Osteopathy and psychotherapy

Psychotherapy delivered by a psychologist is covered by basic insurance on medical prescription, within a defined and renewable number of sessions. Delivered outside that framework, or without a prescription, it is not.

Osteopathy is not in the basic catalogue: it falls entirely to supplementary policies, which typically reimburse a percentage per session up to an annual cap, and only with practitioners they recognise. The list of recognised practitioners matters more than the headline percentage.

What drives the price

  • Age: several benefits change regime at majority.
  • The medical prescription, often required to open the entitlement.
  • Recognition of the practitioner by the insurer.
  • The annual cap of the supplementary policy chosen.

We show no tariffs on this page. Unlike LAMal premiums, no public register publishes prices for this branch: they depend on your profile and are calculated case by case. Quoting a figure here would be an invention.

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