Massage on prescription: what German health insurance pays

The question usually comes up in two places: at the doctor's surgery when your back has been hurting for weeks, and at the till in a massage studio. This article explains what a prescription is, how the route to treatment works and what limits apply. Whether a massage chair is possible on prescription is covered in a separate article: Massage chair on prescription.

Which massages health insurance pays for

In German statutory health insurance, massages are among the physiotherapy remedies. Which ones exist and what they may be prescribed for is laid down in the remedies guideline. They include:

• Classic massage therapy: Stroking, kneading and friction on the muscles. How a session works is described in Classic massage: procedure and strokes.
• Connective tissue massage: Pulling on the subcutaneous tissue in defined zones. More in Connective tissue massage.
• Underwater jet massage: Massage with a jet of water in a tub.
• Manual lymphatic drainage: Gentle pumping strokes for swelling, for example after operations. The procedure is described in Manual lymphatic drainage: how a session works.

What health insurance does not pay for: Thai massage, hot stone, aromatherapy massage, wellness treatments in hotels and any massage you book without a prescription. A doctor's recommendation on a note is not enough either. The official form for remedies is required.

The route to massage on prescription

1. Doctor's appointment: The GP, orthopaedic specialist or another specialist makes a diagnosis and decides whether a remedy makes sense. You have no entitlement to a particular massage. Physiotherapy exercises are often prescribed first, because medical guidelines put active exercise first for many back conditions.
2. Prescription: The form states the diagnosis, the remedy and the number of sessions. How many appointments fit on one prescription depends on the diagnosis group.
3. Finding a practice: You choose a licensed physiotherapy or massage practice. Call early, as many practices have waiting times.
4. Starting in time: Treatment generally has to start within 28 days of issue. If there is an urgent need, which the doctor notes on the prescription, it is 14 days. If the deadline passes, the prescription expires.
5. Co-payment: The practice bills the insurer and only charges you the statutory co-payment.

How high the co-payment is

For remedies, adults pay ten euros per prescription plus one tenth of the cost of the sessions. For a prescription of six massages, that means the flat fee plus one tenth of the amount the practice bills to the insurer. The practice will tell you the exact figure in advance.

Children and young people up to their 18th birthday are exempt from the co-payment. For everyone else there is an annual limit on payments, which depends on income and is lower for the chronically ill. Once you reach it, you can ask your insurer to exempt you for the rest of the year. Keep all receipts for this.

Private insurance, state allowance, supplementary insurance

With private health insurance, everything depends on the tariff. Many refund prescribed remedies up to certain maximum amounts, and some require prior approval of costs. Read the terms or ask in writing beforehand. For civil servants, the rules of the relevant state allowance scheme apply.

For people with statutory insurance, an outpatient supplementary policy can cover co-payments or alternative practitioner services. Wellness massages without a medical reason are almost never included there either.

Massage without a prescription: what remains

For a relaxing massage in between, you pay yourself. What a massage without a prescription costs, sorted by type and duration, is covered in What does a massage cost?

One route that is often overlooked runs through your employer. Many companies offer membership of fitness and wellness networks. The NAIPO Relax Lounge in Hamburg is a partner of Wellpass, Urban Sports Club, Hansefit and Classpass. With an existing company membership, you can book a room with a massage chair there without an additional subscription. It does not replace a treatment prescribed by a doctor, but it is an option for a regular break.

For use at home, massagers for the neck, back or feet are an option. Health insurance generally does not pay for them. An overview is available under Massagers.

If back pain comes with numbness, paralysis, fever or problems passing urine, see a doctor or go to an emergency department immediately. That is not a case for a massage.

Frequently asked questions

How often does health insurance pay for a massage?

As often as it is prescribed. For each diagnosis group, the remedies guideline sets how many sessions fit on one prescription and how many apply overall as a guide. The doctor then decides whether a further prescription is needed. There is no fixed number per year.

Massage or physiotherapy: which is more expensive?

With a prescription, you only pay the co-payment in both cases, which is based on the insurer's rate. Without a prescription, the price depends on the practice, the duration and the region. For people paying themselves, physiotherapy and classic massage are often in a similar range per appointment. Ask about the price beforehand.

Can the masseur give a different massage from the one prescribed?

No. The practice may only bill the remedy stated on the prescription. If the therapist thinks something else would make more sense, the doctor has to change the prescription.

This article gives a general overview and does not replace medical advice or information from your health insurer.