Sociotherapy; information on cost coverage

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

Are you seriously mentally ill and unable to make independent use of medical or medically prescribed services? 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 so that you can manage without sociotherapeutic care in the long term.

Sociotherapy can be prescribed if it avoids or shortens hospital treatment or if it is necessary but not feasible.

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

• You have statutory health insurance
• You are unable to make independent use of medical or medically prescribed services due to severe mental illness.
• The service must be approved by the health insurance company

You can lodge an appeal against the health insurance company's decision. If the appeal is not upheld, you can take legal action at the competent social court.

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

• Required Documents
  • prescription