No therapy spot? The insurer may have to pay
Anyone who urgently needs psychotherapy often waits months for an insurance-covered spot. You do not simply have to accept that: if the health insurer does not provide a spot within a reasonable time, it can be obliged to pay for treatment with a private therapist.
Reach your next steps and the matching ready-made texts in just a few minutes, free of charge:
Demand cost reimbursement →Your chances of getting your money back
What you should do now
- 1
1. Diagnosis / indication
Have the need for treatment established (for example in a psychotherapeutic consultation).
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2. Document the search
Contact several covered therapists and note rejections and waiting times; use the appointment service center (116117).
- 3
3. Application to the insurer
Apply for cost reimbursement (§ 13 para. 3 SGB V) and enclose the documented unsuccessful search.
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4. Object if refused
If the insurer refuses, you can lodge an objection within one month (§ 84 SGG).
Frequently asked questions
Must the insurer pay for private psychotherapy?
Possibly yes: if you cannot find a therapy spot with a covered therapist within a reasonable time, the health insurer can be obliged to reimburse the costs of self-procured treatment (§ 13 para. 3 SGB V). The prerequisite is the proven need for treatment and a documented, unsuccessful search.
What do I have to do beforehand?
Have the need established (psychotherapeutic consultation), search provably for a covered spot (contact several therapists, use the appointment service center 116117), and apply for cost reimbursement from your insurer, ideally before you start the private treatment. If refused, you can lodge an objection.
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.