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Who pays for rehab for retirees - and what to do if an application is rejected

2023-01-31T16:54:13.992Z


If necessary, pensioners are also entitled to have the costs of rehabilitation measures covered. Who pays for the treatment and how pensioners claim their rights in the event of a dispute.


If necessary, pensioners are also entitled to have the costs of rehabilitation measures covered.

Who pays for the treatment and how pensioners claim their rights in the event of a dispute.

Hamburg - Getting fit in old age and doing something good for your health - sometimes even to protect against the need for care: Pensioners are also entitled to claim benefits from rehabilitation measures.

In order for health insurance to be considered as a potential cost bearer, however, certain requirements must be met, as reported

by 24hamburg.de

.

What they are and how those affected can react to initially rejected applications.

Social insurance:

German pension insurance

Founding:

October 1, 2005

Insured:

56.7 million (December 31, 2020)

Pensioner:

21.2 million (as of July 1, 2022)

Right to rehabilitation: when pensioners are entitled to reimbursement for treatment

The German pension insurance promises consumers a variety of relief in old age.

Starting with the disability pension, through the Riester pension to a pension settlement for widows and widowers.

What the social security system is not committed to: rehabilitation.

According to the pension insurance, those responsible only make it possible to cover the costs in exceptional cases - among other things, when it comes to applying for oncological rehabilitation after cancer.

And yet: even pensioners who are not affected can have rehabilitation paid for if necessary.

A social benefit is firmly anchored in the social code and thus in the statutes of the country.

The full excerpt of SGB V § 11 states: “Insured persons are also entitled to benefits for medical rehabilitation as well as maintenance and other supplementary benefits that are necessary to avert, eliminate, reduce, compensate for, or worsen a disability or need for care to prevent or mitigate its consequences.”

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Rehabilitation for pensioners: when the health insurance pays treatment costs.

(icon picture)

© Addictive Stock/Imago

According to the median clinics, in 2017 the legitimacy of the rehabilitation stress was worked out even more explicitly.

Paragraph 40 of SGB V, which legally stipulates the “benefit for medical rehabilitation”, now states that the assumption of costs by the statutory health insurance companies is mandatory in certain cases.

Applying for rehab for pensioners: which basic requirements must be met

Succinctly summarized: This means that pensioners are also allowed to bear the costs of rehabilitation treatments.

Likewise, such a process does not happen without the affected person fulfilling certain requirements.

Pensioners can only hope for grants as a result of a rehabilitation stay if other healing measures do not bring any improvement.

In the course of this, medical examinations are necessary.

As with claiming retiree benefits, official proof must be provided.

In this case, it must be proven that only rehabilitation could free those affected from pain and illness.

A cure can therefore only take place by means of rehabilitation measures.

This proof must then be submitted to the health insurance company together with the application, the corresponding form that is available from the potential payer.

Rehab rejected: How pensioners claim their rights with the declaration of objection

The processing of a rehab application takes a processing time of three to a maximum of five weeks for health insurance companies.

Applicants will then be informed of the respective status by the person responsible.

An application is often rejected for the following reasons: There are alternative outpatient methods that promise healing success, healing through rehabilitation is categorically questioned, or a rehabilitation program has already been completed within the last four years.

If the health insurance company concerned provides the same information after the application has been received, pensioners have the opportunity to declare their objection within 30 days.

Especially in urgent cases, which could be responsible for the need for care without rehabilitation, it is advisable to seek medical help.

An explicit listing of all complaints and the need for rehabilitation measures could help an application to be successful in a second attempt.

Rubric list image: © Addictive Stock/Imago

Source: merkur

All life articles on 2023-01-31

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