Heilmittel für Krankenversicherte Finanzierung

People insured under the statutory health insurance scheme are entitled to medically necessary remedies.

As a statutory insured person, you are entitled to medically necessary remedies. These are services of physiotherapy, podiatry, voice, speech and language therapy, ergotherapy and nutrition therapy. The services are provided by approved service providers on the basis of a doctor's prescription. Approval by your health insurance fund is not required.

A doctor's prescription is required.

• The dispensing of remedies at the expense of the statutory health insurance funds requires a medical prescription.
• Remedies can only be prescribed at the expense of the health insurance funds if they are necessary in order to
  • to cure an illness, to prevent its aggravation or to alleviate symptoms of illness,
  • to eliminate a weakening of health which would probably lead to illness in the foreseeable future,
  • to counteract a risk to the health development of a child, or
  • to prevent or reduce the need for care.
• Therapeutic services may only be provided by approved providers of therapeutic services such as physiotherapists, occupational therapists, speech therapists or speech and language therapists or nutrition therapists.
  
  

Insured persons who have reached the age of 18 must pay a co-payment of 10 % of the price of the remedy, with a minimum of 5 euros and a maximum of 10 euros, but no more than the cost of the remedy plus an additional 10 euros per prescription.

If you have little or no income, you can apply for exemption from the co-payment. Please contact your health insurance company.

Check with your health insurance provider.

If no indication of the latest start of treatment is given on the prescription, treatment should be started within 28 calendar days. An urgent start of treatment must be indicated on the prescription. If the treatment cannot be started within the specified period, the prescription will lose its validity.

If the health insurance company refuses to pay the benefit, you can lodge an objection. If the objection is not upheld, you can take legal action against it before the social court.

• Insured persons are entitled to the provision of remedies
• The details are regulated in the Therapeutic Products Guideline of the Federal Joint Committee.
• The remedies include measures of
  • Physical therapy
  • Podological therapy
  • Voice, speech and language therapy
  • Ergotherapy
  • Nutrition therapy
• The treatment must be medically necessary, e.g. to cure or alleviate an illness.
• It must be prescribed by a doctor.
• It can only be provided by approved service providers.
• Approval by the health insurance fund is not required.
• Insured persons who have reached the age of 18 have to pay 10% of the price of the remedy, but at least 5 Euros and at most 10 Euros; however, not more than the cost of the remedy and an additional 10 Euros per prescription.

Statutory health insurance funds

The responsibility lies with your health insurance company.