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Heilmittel für Krankenversicherte finanzieren

Rheinland-Pfalz 99134011174000, 99134011174000 Typ 2/3

Inhalt

Leistungsschlüssel

99134011174000, 99134011174000

Leistungsbezeichnung

Financing remedies for people with health insurance

Leistungsbezeichnung II

nicht vorhanden

Leistungstypisierung

Typ 2/3

Begriffe im Kontext

nicht vorhanden

Leistungstyp

Leistungsobjekt mit Verrichtung

Leistungsgruppierung

Krankenversicherung (134)

Verrichtungskennung

Finanzierung (174)

SDG Informationsbereiche

  • Medizinische Versorgung
  • Medizinische Behandlung in einem anderen Mitgliedstaat

Lagen Portalverbund

  • Krankheit (1130200)

Einheitlicher Ansprechpartner

Nein

Fachlich freigegeben am

12.01.2021

Fachlich freigegeben durch

Lower Saxony Ministry of Social Affairs, Health and Equality

Teaser

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

Volltext

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 provision. Approval by your health insurance company is not required.

Erforderliche Unterlagen

A doctor's prescription is required.

Voraussetzungen

  • The supply 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 companies if they are necessary to:
    • to cure a disease, prevent its exacerbation or alleviate symptoms of illness,
    • to eliminate a weakening of health that would probably lead to a disease in the foreseeable future,
    • to counteract a threat to the health development of a child, or
    • To avoid or reduce the need for care.
  • Therapeutic services may only be provided by approved providers of therapeutic products such as physiotherapists, occupational therapists, speech therapists or speech therapists or nutritional therapists.

Kosten

Insured persons who have reached the age of 18 must pay 10% of the selling price for remedies, but at least 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 regulation.

If you have little or no income, you can be exempted from the additional payment on request. Please contact your health insurance company.

Verfahrensablauf

Check with your health insurance company.

Bearbeitungsdauer

nicht vorhanden

Frist

If no information on the latest start of treatment has been provided on the prescription, the treatment should be started within 28 calendar days. An urgent start of treatment must be hereby en en tribuned on the prescription. If the treatment of therapeutic products cannot be included during the period mentioned, the regulation loses its validity.

Weiterführende Informationen

nicht vorhanden

Hinweise

nicht vorhanden

Rechtsbehelf

If the health insurance company rejects the benefit, an objection can be lodged against it. If the objection is not remedied, you can appeal against it before the Social Court.

Kurztext

  • Insured persons are entitled to a supply of therapeutic products
  • The details are regulated in the Therapeutic Products Directive of the Federal Joint Committee.
  • The remedies include measures of the
    • Physical therapy
    • Podiatric therapy
    • Voice, speech and speech therapy
    • occupational therapy
    • dietetic treatment
  • The remedy must be medically necessary, e.B. 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 for remedies, but at least 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 regulation.

Ansprechpunkt

nicht vorhanden

Zuständige Stelle

nicht vorhanden

Formulare

nicht vorhanden