Remedies and medical aids: terms and reimbursement in private health insurance

Medical aids are items that help sick people or people in need of long-term care in everyday life, for example hearing aids, visual aids, wheelchairs, prostheses or orthopedic insoles. They compensate for a physical limitation. Remedies are external treatments such as physiotherapy, occupational therapy, speech therapy, nutritional therapy or podiatry. Medical aids are supplied by medical supply stores, opticians or orthopedic technicians, while remedies are provided by trained therapists.

Which medical aids are reimbursed is set by the National Association of Statutory Health Insurance Funds in its directory of medical aids. For remedies, the Federal Joint Committee defines a catalog of remedies. Both directories list the products and treatments and their maximum rates. Special rules apply to visual and hearing aids. In both statutory and private health insurance, reimbursement requires a doctor's prescription and medical necessity.

In private health insurance, reimbursement depends on the plan you chose. Many insurers use an open catalog of medical aids that also includes new methods. Others work with a closed list that sets out a fixed range of reimbursable aids. The maximum rates are usually higher than those of the statutory health insurance fund.

Many plans reimburse remedies according to the federal regulation on healthcare allowance for civil servants (BBhV). So look for reimbursement that covers at least 120% of the maximum amounts in this regulation. Get advice at the medical supply store before you buy a medical aid, and clarify reimbursement with your insurer in advance. This way you avoid unnecessary costs of your own.