Aids Directive
| Basic data | |
|---|---|
| Title: | Directive on the prescription of medical aids in statutory health care |
| Short title: | Aids Directive |
| Abbreviation: | Auxiliary M-RL |
| Type: | Guideline of the G-BA |
| Scope: | Federal Republic of Germany |
| Issued on the basis of: | Section 92 (1) sentence 2 no. 6 SGB V |
| Legal matter: | Social law , statutory health insurance |
| Original version from: | June 17, 1992, BAnz No. 183b (supplement) of September 29 , 1992 |
| Entry into force on: | October 1, 1992 |
| Last revision from: | December 21, 2011/15. March 2012, BAnz AT 04/10/2012 B2 |
| Entry into force of the new version on: |
April 1, 2012 |
| Last change by: | 19 July 2018, BAnz AT 02.10.2018 B2 |
| Effective date of the last change: |
3rd October 2018 |
| Please note the note on the applicable legal version. | |
Aids are part of the benefits in kind provided by statutory health insurance as part of health treatment ( Section 33 SGB V). They are to be distinguished from the medicaments and bandages ( § 31 SGB V) as well as the therapeutic agents ( § 32 SGB V).
In the Medical Aids Directive according to Section 92, Paragraph 1, Clause 2, No. 6 of the SGB V , the Joint Federal Committee for the insured, the health insurance companies, the doctors participating in contract medical care and medical-managed institutions as well as the other service providers bindingly regulates which medical aids are used Securing sufficient, appropriate and economic care for the insured in Germany at the expense of the statutory health insurance companies.
The Central Federal Association of Health Insurance in accordance created § 139 SGB V, a resource directory , which lists the covered by the obligation aids.
details
The aids include, in particular, glasses, contact lenses, magnifying glasses and loupe glasses (visual aids), hearing aids to improve hearing, tinnitus devices to reduce annoying noises in the ears as well as transmission systems for early language support and ensuring school attendance as part of compulsory schooling for children and adolescents with hearing impairments up to completion of the 18 years of age (hearing aids), prostheses and orthopedic aids such as wheelchairs or insoles and other aids, such as inhalation devices.
Aids can, for example, be purchased from opticians , hearing care professionals and medical supplies stores , or they can be made available on loan from health insurances.
Aids are not prescribable if they are to be regarded as general objects of daily use or if the costs are not covered by the health insurance companies due to their low or controversial therapeutic benefit or low sales price according to Section 34 (4) SGB V.
The demarcation to the general objects of use is judged solely by the intended purpose of the object in question from the point of view of the manufacturer and the actual user. Devices that have been developed and manufactured for the special needs of sick or disabled people and that are used exclusively or predominantly by this group of people are not to be regarded as general objects of daily use. This applies even if they are used a million times over (e.g. glasses, hearing aids). Conversely, despite its low distribution among the population and despite its high sales price, an object can be classified as a general object of daily use if its conception is not primarily intended for the sick and disabled. Personal computers and notebooks with standard equipment are not prescribable aids. Computer-aided reading systems for blind and visually impaired people, however, can very well be an aid.
The ability to prescribe in detail is the subject of extensive case law, since the list of resources is not exhaustive.
Individual evidence
- ^ Federal Social Court judgment of September 16, 1999 - B 3 RK 1/99 R = SozR 3-2500 § 33 No. 33
- ↑ Federal Social Court judgment of January 30, 2001 Az .: B 3 KR 10/00 R and of August 23, 1995 - 3 RK 7/95 = SozR 3-2500 § 33 No. 16
- ↑ Rehadat : Aids for blind and visually impaired people Status: 2016
- ↑ REHADAT aids: overview of the case law of the Federal Social Court . Retrieved November 18, 2014.
Web links
- Information archive of the Federal Joint Committee: Aids Directive (PDF; 159 kB)
