What Does the Health Insurance Company Pay?
Urinary incontinence can have a significant effect on the life of the people concerned. For many, the subject of incontinence is a taboo. For many, incontinence is a step towards isolation. However, those affected can continue to have an active social life with appropriate incontinence aids.
The supply of medical incontinence aids falls within the compulsory obligations of statutory health insurances. If you are suffering from incontinence, we recommend that you consult intensively with your treating physician to see if, and which, incontinence products are suitable for you.
Your doctor will then fill out a special prescription for you which should include
- the diagnosis,
- the exact name of the item prescribed and
- the quantity.
Conditions for the Assumption of Costs for Incontinence Aids
The medical products required for absorption and/or drainage care are supplies in accordance with Volume V of the Social Insurance Code (SGB V). They are therefore billable to the health insurance company. In order for your health insurance company to cover the cost of incontinence aids (e.g. catheters, urinal condoms, urine collection bags), some conditions must be met:
- Your incontinence disorder has been diagnosed by your treating physician and he/she has prescribed appropriate remedies.
- The chosen aid must be one of those registered in the list of medical appliances.
- The incontinence aid must meet one of the following conditions:
- enable participation in social life
- prevent serious functional damage or consequential damage
- be important for the treatment of a disease
- An authorisation is sometimes required from your health insurance company prior to the aids being delivered.
You will receive the prescribed and (if applicable) approved products from the manufacturers and service providers with whom your health insurance has concluded a contract.
With UROMED as a leading supplier, you can count on a partner that provides the necessary aids safely and reliably!
What Will You Have to Pay?
As in other areas of health care, you must also contribute to the cost of incontinence aids. The top-up payment is ten per cent of the product price, but a minimum of 5 and a maximum of 10 Euros per month. Furthermore, the top-up payment may not exceed the cost of the aid. The obligation to pay is not applicable to persons who are exempt from paying.
If you choose products from manufacturers that do not have a contract with the health insurance companies, you will have to cover the additional costs yourself. In addition, there are fixed limits for incontinence aids, which apply nationwide. These are the maximum amounts that the health insurance companies will pay.
Please do not hesitate to contact us for further information. We will be happy to explain the agreed terms of supply with your health insurance company.