Which costs are covered by health insurances for a cure?

A cure is a very important means to maintain the efficiency and thus the work performance of every human being. However, certain illnesses also qualify for a cure in order to alleviate or cure them. However, not all cures are covered by the statutory health insurance.

When a cure makes sense

Time and again, the insured ask themselves what prerequisites must be met for a cure. Many consumers have worked until retirement age and have managed without a cure. However, this can mean that they can no longer enjoy their pension due to the stress of the past few years. Frequently then still another cure is requested, which is undoubtedly meaningful, particularly if in certain cases still certain age illnesses emerge. Thus it can be avoided that older humans must be accommodated too early in a care facility.

A cure should also be considered sensible if a long illness has preceded it or if a chronic illness, such as asthma, is the reason for a loss of performance. Furthermore, the mother-child cures should be named which women can already receive in younger years if they have reached the end of their strength for various reasons.

Already here it becomes apparent that a cure is not only something for the elderly, as it was perhaps assumed twenty years ago. On the contrary, as everyday life and working life become more and more stressful, more and more young and middle-aged people are longing for a few weeks of relaxation.

The types of cures have become more and more varied and have been specially adapted to the needs of individuals and their illnesses. Cures after hospital stays are very common, but even without this reason a permission can take place. In principle, a cure should help to improve or even zero in the disease conditions, but at least a worsening should be avoided.

What should I bear in mind when applying for a cure?

It is repeatedly reported that the approval procedures for cures vary not only from health insurance fund to health insurance fund, but also from state to state. In many cases, a long road via the statutory health insurance system is necessary in order to be able to preserve one’s right to these special treatments.

The effectiveness of the cure must be proven by the treating physician.

In principle, the attending physician must approve and prove the effectiveness of a cure, which means that the application procedure may only run through him. The probability is then high that the health insurance company will approve the cure. But of course it has the right to examine the individual case in detail. Here it is a question of which planned service can really be recognised as medically necessary.

The length of the cure also determines its approval

Whereas in the past a cure of six weeks was no exception, today only three weeks are granted by default. An extension is only possible in particularly severe cases.

Problems with the assumption of accommodation and catering costs

Many health insurance companies are reluctant to pay for accommodation and meals, especially when it comes to paying for them. Because they are of the opinion that a cure does not necessarily have to be carried out on an inpatient basis, but can also be carried out on an outpatient basis.

Lawmakers encourage health insurance companies to prefer outpatient to inpatient treatment

This may be a nuisance for many consumers, but the statutory health insurance funds are obliged to adhere to the principle of “outpatient before inpatient”.

mother-child cure or father-child cure

In the case of a mother-child cure or even a father-child cure, the situation is somewhat different, because here the inpatient treatment is to be regarded as sensible. However, the doctor must prove that it is medically necessary.

Costs for preventive cures are seldom covered

With the so-called preventive cures, which are to be distinguished from the rehabilitation cures, the point is that an existing disease risk should be reduced. Only in very few cases do the health insurance funds cover the costs of meals and accommodation. For a full assumption of costs, it is again the case that in-patient admission must be medically justified.

Private supplementary health insurance can be the solution

If an in-patient cure is approved, but the patient has to pay the costs for food and accommodation out of his own pocket, then this can be an enormous cost factor, which will have a negative effect on the household budget. For this reason alone, many people do not even consider such a possibility.

Supplementary health insurance also for cures

However, almost all supplementary health insurers now offer the point of cure as a benefit factor. Here the statutorily health insured should concern itself once more exactly with it and set the respective offerers into a comparison. It is already specified in the conditions, which extent this achievement point contains.

If the health insurance company has paid in advance, the remaining costs can be claimed from the private provider. However, it should also be compared how high the cost coverage will be. In the ideal case it will amount to 100 per cent, so that the consumer has to expect no own risk.

Supplementary health insurance is usually available for a small monthly premium and has the advantage that it closes the existing gaps in health care that have arisen as a result of various health reforms. Thus the insured receives a good package, which refers to the individual needs. An insurance comparison, which can be accomplished comfortably over Internet, gives thereby information about the tariffs valid at present with the appropriate achievements.

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Christina Cherry
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