Applying for a Cure in 7 Easy Steps
No matter whether it is for prevention or rehabilitation – first you have to apply for the cure. You can find out how to do that here.
Applying for a cure: Introduction
- In principle, every person with statutory health insurance can apply for a cure or rehabilitation. Whether the application is ultimately granted depends, of course, on the necessity and care of the application.
- Even if the cure is rejected at the first attempt, you should in any case file an appeal. The chances of success are good. In the latter case, all that would remain would be a complaint to the relevant social court.
Types of cure
Outpatient preventive cure: With this option you do not have to stay in a clinic as a participant of the cure. You are free to choose your accommodation at the health resort, but you also have to pay the costs for accommodation and meals yourself. As an employee, you have to take a holiday for the duration of the cure. Your health insurance company will pay the costs for the spa care as well as 90 percent of the spa funds.
In-patient preventive cure: With this type of cure you also live directly in the clinic where you are taking your cure. As an employee you are on sick leave for the in-patient preventive cure. Costs for board and lodging are covered by the health insurance. This type of cure is usually available as a parent-child cure or for nursing relatives.
Out-patient rehabilitation: You complete your rehabilitation near your place of residence. Therefore, you live at home and visit the facility at agreed dates. The costs of rehabilitation are covered by health insurance or the German Pension Insurance. During the time of rehab you are also on sick leave.
In-patient rehabilitation: In this case you live directly in a rehabilitation facility and the costs for board and lodging are paid by the health insurance or pension insurance.
1. Contact the doctor
After you have decided that a cure or rehabilitation could really help you, it is important to talk to your doctor about it and, especially in the case of an outpatient preventive cure, to see which facilities might be suitable. The prerequisite is that all therapy possibilities at your place of residence have been exhausted and that there is a real need for the cure.
2. Application form
The second step in applying for a cure is to request the relevant application forms from your health insurance company.
3. Complete the application with a doctor
Now you will make an appointment with your doctor to discuss and determine the goals of the cure and the treatments required. The doctor fills out the form of the health insurance company and explains the necessity of the cure for you.
4. Submit application
Now it is time to submit the completed application and the enclosed documents (findings, justifications, etc.) to the health insurance company. The health insurance company can consult the Medical Service of the Health Insurance Company (MDK) to assess the situation and, on recommendation, order the visit of another doctor.
5. Opposition
As already mentioned, it is not unusual for the first application for a cure to be rejected by the health insurance company. Now you have one month to file an appeal. The deadline for doing so usually starts three days after the letter is sent. Talk to your doctor again, what other reasons you could give.
6. Start cure
A cure is usually approved for three weeks. After this has happened, it is necessary to choose the exact spa resort together with the doctor. You have four months from the date of approval to start the cure.
7. Regulate holidays and calculate expenses
In contrast to rehabilitation, you cannot take sick leave during an outpatient preventive cure. Therefore, you should make sure that you take a vacation from your employer in time. You should also think about the costs for board and lodging at the spa, which are not covered by the outpatient preventive cure. However, health insurance companies can grant an allowance of up to 16 euros per day.