Spezialisierte ambulante Palliativversorgung für Krankenversicherte Finanzierung

Insured persons are entitled to specialized outpatient palliative care (SAPV) in the home or family setting.

As a legally insured person, you are entitled to specialised outpatient palliative care (SAPV). The service includes medical and nursing services including their coordination - especially for pain therapy and symptom control. The aim is to enable care to be provided in the familiar surroundings of the home or family. This also includes, for example, facilities providing integration assistance for people with disabilities, child and youth welfare services and nursing facilities. The special needs of children and adolescents must be taken into account.

SAPV is a team service in which different professional groups work together: Doctors, nursing staff and cooperation partners.

Included are - yes according to individual needs

• Consultation
• Coordination of care,
• supportive partial care or
• complete care

If you have been admitted to an inpatient hospice, you will receive the medical care required within the framework of SAPV as a partial benefit.

• Medical prescription

• a non-curable, progressive and far advanced disease.
• life expectancy is limited and particularly complex care is required.
• The service must be prescribed by a contract physician or a hospital physician.

There is no co-payment to be made.

If the health insurance company refuses to provide the treatment, you can lodge an objection.

• Insured persons are entitled to specialised outpatient palliative care
  • with a non-curable, progressive and far advanced disease
  • with a limited life expectancy
  • who require particularly complex care
• The service must be prescribed by a panel doctor or hospital doctor.
• Specialised outpatient palliative care comprises medical and nursing services including their coordination, in particular for pain therapy and symptom control.
• care of the insured in the familiar environment of the home or family should be made possible (e.g. facilities of integration assistance for disabled persons and child and youth welfare, nursing facilities)
• Entitlement to partial payment of the necessary medical care for insured persons in inpatient hospices
• the special needs of children are to be taken into account
• The details of the prescription, the entitlement to benefits and the cooperation of the parties involved have been determined by the Federal Joint Committee in its guideline on the prescription of specialised outpatient palliative care.
• on the basis of a framework agreement at the federal level, the health insurance funds conclude contracts with SAPV teams at the state level

The responsibility lies with the respective health insurance company.