Apply for an outpatient preventive measure such as a cure for people with statutory health insurance
Source: BUS Rheinland-Pfalz
The principle of outpatient care before inpatient care applies to preventive medical services.
Outpatient preventive services
On application and subject to certain conditions, your statutory health insurance fund will cover the costs of medical services for outpatient preventive care. Accommodation and meals are paid for by you as the insured person.
Outpatient preventive medical services are medical and therapeutic treatments, for example therapeutic baths or physiotherapy, which are provided by therapy centers in state-approved health resorts. You can choose the spa and therapy center together with your doctor. You organize your accommodation and meals yourself.
Medical necessity
Your health insurance company can only approve outpatient preventive care if you have previously exhausted all treatment options at your place of residence. Your doctor must justify the necessity of the preventive care service to your health insurance company in the application.
A cure can be considered medically necessary if
- it can prevent an impending illness or avoid its worsening or
- the need for care is avoided or
- a threat to the health development of a child can be counteracted.
An outpatient cure should last a maximum of 3 weeks. An extension can only be considered if this is urgently required for medical reasons in order to achieve the preventive goal.