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Source: BUS Sachsen-Anhalt (Linie6PLus)

Apply for medical rehabilitation benefits

Description

Rehabilitation can help you avoid the permanent onset of a disability or need for care or to cope better with the consequences.

In order for your health insurance company to bear the costs of a rehabilitation measure, you must have statutory health insurance. Your health insurance company first checks whether another service provider is primarily responsible.

In the case of workers, for example, pension insurance finances necessary rehabilitation benefits. Rehabilitation benefits for pensioners, mothers or fathers with children as well as for those in need of care are usually the responsibility of the statutory health insurance.

Rehabilitation services must be requested from you. In most cases, the application is made after acute treatment in the hospital by the social service together with you (connection rehabilitation).

Your treating physicians can also encourage medical rehabilitation and issue a medical prescription for the application.

Rehabilitation can help you avoid the permanent onset of a disability or need for care or to cope better with the consequences.

Contact your health insurance company.

  • Need for rehabilitation: Your performance is impaired and cannot be restored with individual measures, such as physiotherapy and occupational therapy.
  • Rehabilitation capacity: They are capable of rehabilitation, i.e. They are resilient to the point where necessary treatments can be carried out.
  • Positive rehabilitation prognosis: You can probably achieve individual rehabilitation goals according to medical assessment.
  • You must submit an informal application to your health insurance company.
  • Your health insurance company checks whether the conditions for medical rehabilitation are met
  • Insured persons who have reached the age of 18 pay an additional payment: 10 euros per day of treatment in outpatient rehab and 10 euros in inpatient rehab per calendar day.
  • The additional payment is calculated for a no more than 42 calendar days per year. It is paid directly to the rehabilitation facility.
  • In the case of follow-up rehabilitation immediately after hospital treatment, you must pay for a longer 28 days. Additional payments that you have already made within a calendar year for another rehabilitation or inpatient hospital treatment will be credited
  • If you have little or no income, you can be exempted from the co-payment upon request. Please contact your health insurance company.

In principle, you are only entitled to medical rehabilitation after 4 years. Exception: Rehabilitation may be granted within the four-year period if it is urgently needed for medical reasons.

The health insurance fund must decide on applications for rehabilitation benefits within 2 months.

You can appeal against the decision of the health insurance company. If the objection is not remedied, you can appeal to the competent social court.

The text was automatically translated based on the German content.

Lower Saxony Ministry of Social Affairs, Health and Gender Equality

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