When someone goes on a “wellness retreat,” it means they’re spending anywhere from a few nights to a few weeks at a spa, resort, or other type of off-the-grid haven where they can recharge under strict supervision.
These restorative experiences have become an increasingly popular pillar of the increasingly profitable “wellness tourism” industry, projected to grow 50 percent faster than recreational tourism overall. And, per a study published last month by Australian researchers, wellness retreats do in fact have lasting, measurable health benefits. The study was actually a review of 23 prior studies, published between 1995 and 2017. And it found that psychological and physiological health improvements consistently emerged in retreat attendees, but were most pronounced for people in less-than-stellar states of health.
Those generally aren’t the people, though, who are booking wellness retreats — at least not in the US. Here in the land of opportunity, anyone can attend a retreat, so long as they don’t have to work and can foot the bill themselves. Retreats rarely cost less than $1,000 for a three-night stay, and buzzy, top-rated ones can cost that much or more per day. As a result, they’re filled with health-conscious high-earners.
But that’s not the case everywhere. A number of European countries make an effort to subsidize wellness-retreat experiences, specifically multi-week visits to spas, for people who really need to hit pause for the sake of their health.
That doesn’t mean anyone can put a week of thermal baths, lymphatic massage, and circadian-rhythm recalibration on the government’s tab, or that healthy, wealthy Europeans don’t check into spas on their own dime. In a lot of cases, the same health spas serve both wellness tourists and those with an Rx for state-funded spa time.
Across the pond, spa-therapy coverage policies vary considerably and change all the time. But here’s an overview of seven (of at least 10) European countries where wellness retreats aren’t only for celebrities, rich people, and reporters at publications for rich people.
On the state: Germany boasts 300 officially recognized spas and health resorts, known as “Kur” destinations, where health professionals furnish services including exercise and diet programs, thermal bathing, massage therapy, and chronic-illness treatment. In some cases, Kur visits are subsidized by Germany’s statutory (government-run) healthcare system. Until 1997, doctors (general practitioners or specialists) could prescribe up to four weeks of inpatient (residential) Kur treatment every three years, entirely free of charge. The number of Kur prescriptions, however, has fallen in recent years, as restrictions on the practice have grown. Today, insured Kur visits max out at three weeks, every four years, and come with a co-pay of €10 per day. Some statutory insurance organizations also permit Germans to obtain spa therapy outside the country (a trend across EU nations).
The inclusion of Kur visits in German healthcare reflects a rather un-American investment in holistic health. The underlying idea is that it’s cheaper and more effective to pay for Kur visits now than hospitalization later. Additionally, Kur visits may be a wise expenditure for employers: As one 2008 study found, German workers who visited a Kur subsequently spent fewer days in the hospital and missed fewer days of work the following year.
Out of pocket: Germany makes more money from wellness tourism — $60 billion in 2015 — than any other European country. And about 80 percent of Kur guests, many of whom are foreign tourists, now pay for their visits themselves.
On the state: Statutory healthcare subsidizes the cost of treatment at “holistic health clinics.” At one such clinic, the 60-year-old NLFÍ Rehabilitation and Health Clinic in Hveragerði, visitors receive individually tailored versions of treatment and recovery programs designed for conditions including chronic pain, obesity, stress, arthritis, heart disease, and age-related decline. Services at NLFÍ include aquatic aerobics, yoga, mindfulness lectures, massage therapy, and mud baths.
Out of pocket: Holistic health clinics increasingly cater to foreign tourists, particularly from the US. These clients, per the NLFÍ website, are “people who want to change their lifestyle, are around 40 years of age and have money.”
On the state: Every year, more than 300,00 Polish residents with medical referrals undergo 2- to 3-week spa treatments that are covered by government-funded healthcare organizations.
Out of pocket: One-hundred-thousand additional overnight spa visitors, including both Polish residents and foreign tourists, pay their own way.
On the state: French residents, all of whom are covered by statutory health insurance, may be reimbursed for up to 70 percent of the cost of inpatient spa therapy, but not without effort. In addition to writing prescriptions for spa therapy, medical specialists (not GPs) have to obtain prior authorization from insurers.
Out of pocket: France, which consistently ranks among the top three European wellness tourism destinations, is a hub for (and the birthplace of) a popular, pricey saltwater treatment known as thalassotherapy. Statutory healthcare plans no longer cover any portion of the cost of thalassotherapy retreats.
On the state: Perhaps more so than in other European countries, Slovakian spas have historically catered to the sick. Balneotherapy, a regional practice combining inpatient spa visits with medical treatment, remains a staple of Slovakian statutory healthcare. All Slovak spas specialize in addressing a particular health issue, such as respiratory diseases, cancer, or anemia.
While spa-therapy coverage is far-reaching, it isn’t uniform. Spa stays of one to three weeks, at one of the country’s 24 approved facilities, are nearly free for people diagnosed with “Category A” diseases, including post-operative heart conditions, stage-3 Rheumatoid Arthritis, Crohn’s Disease, and chronic atopic dermatitis. (There’s been a daily €1.99 surcharge on all insured spa visits since 2003). Those with “Category B” diagnoses, including occupational radiation exposure, some psychiatric conditions, and eczema, can obtain coverage for spa medical treatments, but have to pay for their own room and board.
Out of pocket: Slovakian spa culture is changing; today, half of the 50,000 annual visitors to Slovakia’s largest spa town, Piestany, are wellness tourists. But while the rise of wellness tourism has prompted some spas to undergo renovations, many still project a more clinical vibe than Americans are accustomed to, with waiting rooms full of prescription-wielding locals. Only a small percentage of paying customers, on whom spas have increasingly relied to stay afloat, are Slovaks.
On the state: Everyone in the Netherlands is required to have basic health insurance. But spa-therapy coverage is only available to people who pay extra for supplementary care (and only under some plans). One insurance provider, for instance, offers supplementary plans — which cost €20 and €32 per month, respectively — that cover up to 75 percent of up to three weeks of overnight spa treatment a year. But coverage requires having one of a few, rare medical conditions, the most common being a specific type of Rheumatoid Arthritis that afflicts less than .1 percent of the Dutch population. “Spa treatments” include soaking in thermal baths, undergoing active remedial therapy, and “relaxation.”
Out of pocket: The Netherlands is becoming a hub for eco-friendly wellness retreats, frequented by baby boomers with large travel budgets.
On the state: Swiss citizens may be able to get a discount on spa therapy. Compulsory health insurance, guaranteed to everyone, will chip in 10 Swiss Francs (CHF) per day, for up to 21 days a year, for medically prescribed spa stays carried out at registered medical-spa centers. The cost of medication, medical tests, and recognized therapies (which include some but not all herbal and homeopathic practices) administered during spa treatment may also be covered, but are reimbursed separately.
Out of pocket: Some of the world’s fanciest and most exclusive medi-spas are nestled in the Swiss alps. But, according to the Swiss tourism bureau, the country is working to capture a greater share of the wellness tourism market, which accounts for less than 10 percent of the 70 million Swiss vacations taken each year. They’re targeting non-Europeans from countries such as the UAE.