Sociotherapy for those with health insurance Financing

Insured persons who are seriously mentally ill and are unable to make use of medical or medically prescribed services independently are entitled to sociotherapy.

Are you seriously mentally ill and unable to make use of medical or medically prescribed services independently? Then you are entitled to sociotherapy as a person with statutory health insurance.

Sociotherapy includes practical life instructions that enable you to make use of outpatient medical and psychotherapeutic services. The aim is to strengthen your personal responsibility in such a way that you can manage without sociotherapeutic care in the long term.   

Sociotherapy may be prescribed if it avoids or shortens hospital treatment or if it is necessary but not practicable.

Depending on the case of illness, you are entitled to 120 hours of sociotherapy within three years. The health insurance funds conclude contracts with suitable persons or institutions for the provision of sociotherapy.

Please contact your health insurance fund or your panel doctor.

• medical prescription

• You are legally insured
• Due to severe mental illness, they are unable to make use of medical or medically prescribed services independently.
• The benefit must be approved by the health insurance fund

You can appeal against the decision of the health insurance fund. If the objection is not remedied, you can file a complaint with the competent social court.

• If you are at least 18 years old and are not exempt from the statutory co-payments, you pay a co-payment of ten percent for each calendar day.
• However, the own contribution is at least five and a maximum of ten euros per day of treatment