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Remedies covered by statutory health insurance; application

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

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Procedure details

As a person with statutory health insurance, you are entitled to medically necessary remedies. This includes physiotherapy, podiatry, voice, speech and language therapy, occupational therapy and nutritional therapy. The services are provided on medical prescription by approved service providers. Approval from your health insurance company is not required.

  • The dispensing of remedies at the expense of the statutory health insurance funds requires a doctor's prescription.
  • Remedies can only be prescribed at the expense of the health insurance funds if they are necessary to
    • cure an illness, prevent its aggravation or alleviate the symptoms of an illness,
    • to eliminate a weakening of health that would probably lead to illness in the foreseeable future,
    • to counteract a threat to the health development of a child, or
    • to avoid or reduce the need for care.
  • Remedial services may only be provided by licensed providers of remedial services such as physiotherapists, occupational therapists, speech therapists, speech therapists or nutritional therapists.

  • Required Documents

    A doctor's prescription is required.

Check with your health insurance company.

Insured persons who have reached the age of 18 must make a co-payment of 10% of the price of the medicine, but no less than 5 euros and no more than 10 euros; however, no more than the cost of the medicine and 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 for this.

If the latest start of treatment is not specified 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 the benefit, an objection can be lodged. If the objection is not upheld, you can appeal to the social court.

Status: 08.01.2025
Editorially responsible for prodecure description: Niedersächsisches Ministerium für Soziales, Gesundheit und Gleichstellung + Niedersächsisches Ministerium für Soziales, Gesundheit und Gleichstellung
Source: Federal Portal
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