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Sociotherapy for people with health insurance Financing


Are you seriously mentally ill and unable to make use of medical or medically prescribed services independently? If you have statutory health insurance, you are entitled to sociotherapy.

Sociotherapy includes practical life instructions that enable you to make use of outpatient medical and psychotherapeutic services. The aim is to strengthen your personal responsibility in such a way that you can manage without sociotherapeutic care in the long term.   

Sociotherapy may be prescribed if it avoids or shortens hospital treatment, or if it is necessary but not feasible.

For each case of illness, you are entitled to 120 hours of sociotherapy within three years. The health insurance companies conclude contracts with suitable persons or institutions for the provision of sociotherapy.

Competent authority

The responsibility lies with the respective health insurance company

Requirements

  • You are legally insured
  • Due to severe mental illness, you are unable to make use of medical or medically prescribed services independently.
  • The service must be approved by the health insurance company

Which documents are required?

  • Doctor's prescription

What are the fees?

  • If you are at least 18 years old and are not exempt from statutory co-payments, you pay a co-payment of ten percent for each calendar day.
  • However, the co-payment amounts to a minimum of five and a maximum of ten euros per day of treatment

Fee: 5,00 - 10,00 EUR
Payment in advance: No

Appeal

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

Technically approved by

Lower Saxony Ministry of Social Affairs, Health and Gender Equality

Professionally released on

27.11.2020

Author

The text was automatically translated based on the German content.

Source: Serviceportal Niedersachsen (Portalverbund des Bundes und der Länder)