Health insurer not paying for a medication or therapy?
Your doctor prescribes a medication, a therapy or an aid, but the health insurer refuses to cover the costs? That is not the last word. With a well-reasoned objection, much can be achieved.
Reach your next steps and the matching ready-made texts in just a few minutes, free of charge:
Create an objection →Your chances of getting your money back
What you should do now
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1. Check the reason for refusal
Why was it refused (not in the benefits catalog, lack of necessity, economy)? That determines your arguments.
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2. Object on time
File an objection in writing within one month. You can submit the reasons later.
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3. Obtain a medical statement
Have your doctor justify in writing why the service is necessary and why alternatives are not sufficient.
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4. In urgent cases, an urgent application
If it concerns an urgently needed treatment, an urgent application to the social court can help quickly.
Frequently asked questions
How long do I have for the objection?
One month from notification of the decision (§ 84 SGG). If the instruction on legal remedies was missing, it is up to one year. File an objection on time and submit a medical justification.
What helps so that the insurer does pay?
A concrete medical justification of the medical necessity, including the question of why cheaper standard benefits are not sufficient in your case. For urgent treatments, an urgent application to the social court can secure the care.
Take action now
We put together the ready-made texts and the right places to contact for you.
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.