Heilmittel für Krankenversicherte Finanzierung

Insured persons of the statutory health insurance are entitled to medically necessary remedies.

As a legally insured person, you are entitled to medically necessary remedies. These are services of physiotherapy, podiatry, voice, speech and speech therapy, occupational therapy and nutritional therapy. The services are provided on medical prescription by approved service providers. Approval by your health insurance company 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 to:
  • to cure a disease, to prevent its aggravation or to alleviate symptoms of illness,
  • to eliminate a weakening of health which is likely to lead to disease in the foreseeable future,
  • to counteract a threat to the health development of a child, or
  • to avoid or reduce the need for long-term care.
• Therapeutic products may only be provided by licensed providers of therapeutic products such as physiotherapists, occupational therapists, speech therapists or speech therapists.
   

Insured persons who have reached the age of 18 must pay 10% of the selling price as a co-payment for therapeutic products, but not less than 5 euros and a maximum of 10 euros; however, in each case not more than the cost of the remedy and an additional 10 euros per prescription.

If you have a low or no income, you can be exempted from the co-payment upon request. Please contact your health insurance company.

Check with your health insurance company.

If the prescription does not specify the latest start of treatment, treatment should be started within 28 calendar days. An urgent start of treatment must be indicated on the prescription. If the treatment of the therapeutic product cannot be commenced during this period, the prescription ceases to be valid.

If the health insurance fund rejects the benefit, an objection can be lodged. If the objection is not remedied, you can appeal against it to the social court.

• Insured persons are entitled to the supply of therapeutic products
• Details are regulated in the Therapeutic Products Directive of the Federal Joint Committee.
• Remedies include measures taken by
  • Physical therapy
  • Podiatry therapy
  • Voice, speech and language therapy
  • Occupational therapy
  • Dietetic treatment
• The remedy must be medically necessary, e.g. to cure or alleviate a disease.
• It must be prescribed by a doctor.
• It can only be provided by approved service providers.
• Approval by the health insurance company is not required.
• Insured persons who have reached the age of 18 must pay 10% of the selling price as a co-payment for therapeutic products, but not less than 5 euros and a maximum of 10 euros; however, in each case not more than the cost of the remedy and an additional 10 euros per prescription.
• Please contact your treating panel doctor and your health insurance fund.

Please contact your treating panel doctor and your health insurance fund.