Physiotherapy, occupational therapy or speech therapy: remedies from the insurer

Remedies such as physiotherapy, occupational therapy, speech therapy or podiatry are prescribed by a doctor and covered by the health insurer. For a lasting need you can have a long-term remedy need approved. Disputes sometimes arise over the quantity or the approval, and you can take action against that.

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Your chances of getting your money back

You are entitled to medically necessary remedies that are prescribed by a doctor (§ 32 SGB V). For chronic or long-term conditions a long-term remedy need can be approved, which makes recurring prescriptions easier.

For those with statutory insurance a statutory co-payment applies (10% plus 10 euros per prescription), from which you can be exempted once you reach the burden limit. If an approval is refused, you can object.

What you should do now

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1. Secure the prescription
Have the remedy prescribed by a doctor and the diagnosis/necessity documented.
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2. Check the long-term need
For a lasting need, apply for a long-term remedy need: this saves repeated approvals.
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3. Co-payment/exemption
Note the statutory co-payment and have yourself exempted once you reach the burden limit.
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4. Lodge an objection
If an approval or extension is refused, lodge an objection within one month and prove the necessity.

How to spot the scam

A necessary follow-up prescription is refused without medical justification.
You keep paying co-payments even though you have reached the burden limit.
For a chronic need, no long-term remedy need is examined.

Frequently asked questions

Does the health insurer pay for physiotherapy?

Yes, medically necessary remedies such as physiotherapy, occupational therapy or speech therapy are covered by the insurer on a medical prescription (§ 32 SGB V). For those with statutory insurance a statutory co-payment applies.

What is a long-term remedy need?

For chronic or lasting conditions the insurer can approve a long-term remedy need. Recurring prescriptions are then easier, without every prescription having to be examined anew.

What if the insurer refuses an approval?

You can lodge an objection within one month and prove the medical necessity with medical findings. For a lasting need, an application for a long-term remedy need is worthwhile.

Take action now

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General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.