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Sociotherapy: support for severe mental illness

Some people with severe mental illness are unable, due to their illness, to use medical or therapeutic assistance on their own. Sociotherapy supports them in this and can help avoid hospital stays.

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Insured persons with certain severe mental illnesses are entitled to sociotherapy if it enables them to make use of medical or medically prescribed services or if a hospital stay is avoided (§ 37a SGB V).
Sociotherapy helps to coordinate assistance and reduce inhibitions. It is medically prescribed and approved by the health insurer.

What you should do now

  1. 1

    1. Discuss the need

    Talk with the treating doctor about the need for sociotherapy.

  2. 2

    2. Obtain a prescription

    Have the sociotherapy medically prescribed.

  3. 3

    3. Wait for approval

    Submit the prescription to the fund and wait for approval.

  4. 4

    4. Act on refusal

    You can file an objection against a refusal.

How to spot the scam

  • The entitlement to sociotherapy is unknown.
  • Assistance is not used due to the illness, without requesting support.
  • A refusal is accepted without an objection.

Frequently asked questions

What is sociotherapy?

A benefit of health insurance for people with certain severe mental illnesses, intended to enable them to actually make use of medical and therapeutic assistance. It coordinates assistance and can help avoid hospital stays (§ 37a SGB V).

Who is entitled?

Insured persons with severe mental illnesses who, because of their illness, are unable to use the necessary services on their own. The need is medically established and the sociotherapy prescribed.

How do I get sociotherapy?

Through a medical prescription that is submitted to the health insurer for approval. If the benefit is refused, you can file an objection within the deadline. A medical justification of the need supports the application.

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.