Travel expenses (health insurance)

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According to § 60 SGB ​​V, travel costs are under certain circumstances a benefit of the statutory health insurance in Germany.

requirements

Since the health reform in 2004, travel expenses for outpatient treatment are no longer included in the catalog of services provided by statutory health insurances. The insured person must therefore bear these costs himself.

Travel costs will continue to be reimbursed for inpatient and partial inpatient treatment. However, only the cheapest means of transport is financed by the health insurance. As a rule, it is assumed that the insured person starts the journey for medical treatment himself using a private vehicle or public transport. Only if this is not possible for medical reasons (lack of public transport is not a medical reason) can the costs of an ambulance ( taxi ), ambulance or ambulance be financed, depending on the medical necessity . The attending doctor has to fill out a form according to the ambulance transport guidelines and obtain approval from the health insurance company in advance. Only in emergencies can the permit be applied for retrospectively.

The ambulance transport guideline also contains exceptions, for which travel expenses for outpatient treatment are reimbursable by the health insurance company. In patients with shopping mark (gehbehindert exceptional) aG, H (helpless) or Bl (blind) this journey costs are generally recoverable, as well as in patients with care level II or maintenance of grade 4 (care grade 3 only when the maintenance level is solely based on physical impairments) . Otherwise, these travel costs will only be reimbursed for very specific therapies that are not exhaustively listed in Appendix 2 of the guideline, including dialysis treatment , radiation therapy and cancer therapy . Here too, prior approval from the health insurance company is required.

Travel costs are subject to additional payment up to the individual load limit . In contrast to all other facts of the statutory health insurance, children and young people also have to pay the additional payment; they are not exempt.

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