Sociotherapy for people with health insurance Financing
Are you seriously mentally ill and unable to make use of medical or medically prescribed services on your own? Then, as a person with statutory health insurance, you are entitled to sociotherapy.
Sociotherapy includes practical life guidance that enables 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 get by 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, they are not able 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 will pay a co-payment of ten percent for each calendar day.
- However, the co-payment is at least five and a maximum of ten euros per day of treatment
Fee: 5,00 - 10,00 EURPayment in advance: No
Legal basis
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 Equality
Professionally released on
27.11.2020
Author
The text was automatically translated based on the German content.
