Soziotherapie für Krankenversicherte finanzieren

Insured persons who are severely mentally ill and are unable to take advantage of medical or medically prescribed services independently are entitled to sociotherapy.

Are you seriously mentally ill and unable to take advantage of medical or medically prescribed services independently? Then, as a person with statutory health insurance, you are entitled to sociotherapy.

Sociotherapy includes practical instructions that enable you to take advantage of outpatient medical and psychotherapeutic services. The aim is to strengthen your personal responsibility in such a way that you can manage without sociotherapeutic care in the long term.

Sociotherapy can be prescribed if it avoids or shortens hospital treatment or if it is necessary but not feasible.

For each case of illness, you are entitled to 120 hours of sociotherapy within three years. The health insurance companies conclude contracts with suitable persons or institutions for the supply of sociotherapy.

• medical prescription

• You are legally insured
• Due to serious mental illness, they are not in a position to make use of medical or medically prescribed services independently.
• The benefit must be approved by the health insurance company

• If you are at least 18 years old and are not exempt from the statutory co-payments, you pay a co-payment of ten percent for each calendar day.
• However, the own contribution is at least five and a maximum of ten euros per day of treatment

• Insured persons are entitled to sociotherapy
• preconditions:
  • Insured persons are not in a position to claim medical or medically prescribed benefits independently due to severe mental illness
  • sociotherapy avoids or shortens hospital treatment or hospital treatment is required but not feasible
• Sociotherapy includes in individual cases necessary coordination of the prescribed services as well as guidance and motivation for their use.
• Entitlement exists for a maximum of 120 hours within three years per case of illness
• Sociotherapy is to be prescribed by a doctor
• Insured persons who have reached the age of 18 have to make additional payments
• the details of the conditions, type and extent of care have been determined by the Federal Joint Committee in its guideline on the implementation of sociotherapy in contract medical care
• The health insurance funds conclude supply contracts with suitable persons or institutions