Special therapies ("Heilmittel") and medical aids ("Hilfsmittel") in Germany
Special therapies ("Heilmittel") and medical aids ("Hilfsmittel") in Germany
Note: This information describes the situation in Germany. Other countries will have different rules regulating the use and coverage of therapies and medical aids.
In Germany, special therapies ("Heilmittel") and medical aids ("Hilfsmittel") can be prescribed by doctors to relieve the symptoms of a medical condition or to make it easier to cope in daily life, for example. If prescribed by a doctor, they are covered by statutory health insurers.
Special therapies: What exactly are "Heilmittel"?
In the German health care system, Heilmittel are defined as medical treatments that
do not involve the use of medication and are applied to the outside of the body, and
are paid for by statutory health insurers.
These therapies can be prescribed by a doctor in order to treat an illness, to prevent it from getting worse, or to relieve its symptoms. They may also be used to prevent illnesses from developing in the first place and, for instance, to help prevent developmental disorders in children or dependence on nursing care in elderly people.
The following treatments can be prescribed as Heilmittel by doctors in Germany:
Only certified healthcare professionals who have the proper training are allowed to offer these Heilmittel therapies. They mainly include:
Physical therapists (physiotherapists)
Masseurs and hydrotherapists (healthcare professionals who use water to treat medical problems)
Podiatrists (foot care specialists)
How can you get a "Heilmittel" treatment?
If your doctor thinks that one of these Heilmittel treatments will help, they will give you a prescription. The prescription states how many treatment sessions the doctor has prescribed and how often they should take place (which depends on the illness and the type of treatment). Once you have a prescription, you can make appointments with a suitable healthcare professional. If the symptoms still haven’t gone away after the last appointment, your doctor can prescribe more sessions.
Heilmittel treatments are often part of a treatment plan during a hospital stay. They might be used for rehabilitation purposes, for example. In these cases, statutory health insurers cover all the costs of this treatment. But if you’re prescribed a Heilmittel treatment in an outpatient setting, you have to pay part of the costs yourself: 10 euros plus 10% of the treatment costs per prescription. You don’t have to pay if the prescription is for a child or teenager, though, because statutory health insurers always pay for Heilmittel treatments up until the age of 18.
Normally, the treatment has to start within 28 days of the date on the prescription. Otherwise, the prescription becomes invalid. If the treatment is needed urgently, it must start within 14 days of the date on the prescription. The doctor has to specify this on the prescription. The prescription also becomes invalid if the treatment is stopped for more than 14 days without providing a reason.
The healthcare professionals might also offer treatments that you have to pay for yourself.
Medical aids: What exactly are "Hilfsmittel"?
In the German health care system, Hilfsmittel are defined as products that are mainly used to help people cope better in daily life if they have an illness, a disability or need nursing care. These aids include glasses, hearing aids, artificial limbs, wheelchairs, nursing beds, bath seats and disposable supplies like syringes and bandages. Hilfsmittel aids can help to
prevent or compensate for disabilities and conditions that make nursing care necessary,
prevent developmental disorders in children (using a hearing aid, for example),
These aids can be prescribed by your doctor. Once you’ve got the prescription, you can take it to a supplier of that kind of medical aid. Depending on what you need, suppliers include:
Opticians, e.g. for glasses
Audiologists (Hörgeräteakustiker), e.g. for hearing aids
Medical supply stores (Sanitätshaus), e.g. for elastic bandages, inhalers, walking aids and bathing aids
Orthopedic technicians, e.g. for artificial limbs and braces
Podiatrists (medizinische Fußpflege), mainly for foot and toe pads
Orthopedic footwear specialists, e.g. for insoles and made-to-measure orthopedic shoes
If you don’t need these medical aids for very long, you can sometimes borrow them from a health insurer or supplier. For instance, if you’re recovering from an acute illness and need a wheelchair for a while, you can borrow it and return it later.
Some medical aids, like glasses or insoles, have to be adjusted especially for you. For others, you need to attend training to learn how to use them properly. Examples include ventilators and breathing masks designed to make sure heavy snorers don’t stop breathing when they’re asleep (sleep apnea). In some of these cases, the health insurer won’t pay for the medical aid until you’ve done the training.
Who pays for "Hilfsmittel" medical aids?
The question of who pays for these aids depends on what they’ve been prescribed for. For instance, is the aim to relieve symptoms, support nursing care or make working life easier? Usually, your health insurer or nursing care insurer (Pflegeversicherung) pays – but it could also be your pension fund (Rentenkasse), accident insurance provider (Unfallversicherung), the employment agency (Arbeitsagentur) or the social welfare office (Sozialamt).
If your health insurer covers these costs, you have to pay a prescription fee of 10 euros per prescription plus a co-payment of 10% of the price of the Hilfsmittel aid. The co-payment will be at least 5 euros and at most 10 euros. For example, if the medical aid costs 70 euros, you’ll have to pay 17 euros (10 euros for the prescription plus 7 euros for the co-payment). The co-payment isn’t allowed to be more than the price of the medical aid, though. If the aid costs less than 5 euros, you will have to pay for it yourself. If the prescription is for disposable supplies such as bandages or syringes, the co-payment is limited to 10 euros per month. If you’re prescribed a Hilfsmittel medical aid, you must buy or order it within 28 days of the prescription date. After that, the prescription is no longer valid. As with Heilmittel treatments, children and teenagers under the age of 18 don’t have to pay anything for Hilfsmittel aids. Statutory health insurers cover all of their costs.
If you need nursing care and are prescribed a Hilfsmittel aid, your nursing care insurer (Pflegeversicherung) will cover the costs. You then have to pay 10% of the price yourself, but no more than 25 euros. Where Hilfsmittel aids are needed both for nursing care and treatment, the costs are sometimes divided between the health insurer and the nursing care insurer.
These rules may be different if the costs are covered by pension funds, accident insurance providers, the employment agency or the social welfare office.
Bode H, Schröder H, Waltersbacher A. Heilmittel-Report 2008. Ergotherapie, Logopädie, Physiotherapie: Eine Bestandsaufnahme. Stuttgart: Schattauer; 2008.
IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.
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