Costs & Health Insurance

A cannabis therapy almost always raises the same question: what does health insurance pay for – and what will I have to cover myself? Here we break the costs down so that you can plan realistically. One important point up front: whether a therapy with cannabis-based medicines is an option for you is something we clarify individually and medically; there is no entitlement to a particular preparation.

The essentials at a glance

• Consultations run like a GP appointment through your basic mandatory health insurance (Grundversicherung) (tiers payant – billed directly with your insurer).
• Cannabis-based medicines are generally not covered by health insurance.
• A cost-coverage request (Kostengutsprache) can be submitted – it is not guaranteed and takes time.
• In most cases there is a self-funded trial of therapy at the start.

CHF 300–600Guideline figure for the medicines per month – depending on preparation & dosage

What health insurance covers: the consultations

The appointment covers the same tariff services as a GP consultation. We bill it through your basic mandatory health insurance (Grundversicherung) and invoice your insurer directly (tiers payant) – so you do not have to pay for the consultations up front.

As with any medical service, your usual terms under the basic insurance apply, namely your deductible (Franchise) and co-payment (Selbstbehalt). Depending on your insurance model (e.g. the family-doctor or Telmed model), a prior referral or authorisation may also be required – it is best to check this briefly with your insurer. You will find more on this in our Treatment process.

What health insurance usually does not cover: the medicines

Cannabis-based medicines are currently, as a rule, not automatically funded by either the basic or the supplementary insurance. This can mean a noticeable financial burden and should be planned for from the outset.

The monthly costs depend heavily on the prescribed preparation, the form it takes and the dosage that is effective for you individually. As a guide: usually around CHF 300–600 per month – in individual cases below or above this. You will receive a firm assessment only after the medical evaluation during the appointment.

The cost-coverage request

So that your insurer might nonetheless contribute to the cost of the medicines, we can submit a cost-coverage request (Kostengutsprache) to your insurer. The aim is at least a partial reimbursement. Important to know:

• A cost-coverage approval is not guaranteed – the insurer decides on a case-by-case basis.
• The most important argument is evidence of treatment success in your individual case – that is, that the treatment is working sufficiently well for you.
• Processing usually takes several weeks to months, and in individual cases longer.

We are in close contact with the health insurers and prepare the requests to be as promising as possible. We will support you throughout.

A realistic course: a trial of therapy first

As a rule, a self-funded trial of therapy beforehand is advisable (usually around two months). This makes it possible to demonstrate whether and how well the therapy works for you – and it is precisely this evidence that forms the basis for a promising cost-coverage request.

In practical terms this means: plan to cover the cost of the medicines yourself at first, while the consultations run through your basic mandatory health insurance.

Further answers

We answer questions about insurance models, referrals and the process in our frequently asked questions as well as on the Process page. Whether a cannabis therapy is an option for you can be read under Indications.

A personal assessment

Every situation is different. How your therapy might look and what costs are realistically likely to come your way are best discussed together during the appointment.