Windeln von Krankenkasse bezahlt?

Mich würde interessieren wie das abläuft wenn man gesundheitsbedingt Windeln in der Apotheke verschrieben bekommt. Hat man da dann immer ein Rezept und bekommt die “gratis” weil die Kosten übernommen werden oder muss man die ersteinmal selbst bezahlen und kann die irgendwie absetzen und hat man dazu dann eine Bescheinigung oder so die man in der Apotheke zeigen muss ?

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sumsehummel
10 months ago

Hi.

it is possible for the doctor to issue a prescription about the need for incontinence material which can be presented in the pharmacy if the health insurance is allowed to supply pharmacies at all (this is not always the case, some cash registers also gave their own suppliers).

Usually there is a first consultation, the need is determined, if necessary you will get samples of different products.

Each sickness fund has a flat rate of about €20 for inco-materials. Within this package, the patient can choose what he wants to have on products and does not have to pay. However, if more is required than covered by this package, this difference must be paid by the customer himself.

PlueschTiger
10 months ago
Reply to  sumsehummel

No the difference the customer does not have to pay, only the surcharge, of max. 10€, my knowledge. The customer is asked for the cash register because cash registers customer and supplier play out against each other. The cash register must provide numbers which are required or the supplier, for this it is paid. It is clear that it is not cost-covering above simple inserts, but the supplier has admitted that.

Schimeck
10 months ago

In the event of an incontinence, the health insurance fund shall pay the costs for:all aids provided in the basic supply. Since the incontinence material on prescription is one of the consumables, you usually have to use aPayment of 10%the costs per month – this is regulated by law in § 33 SGB 5. However, the maximum own contribution may not exceed 10 euros per month.

However, this payment can increase if you do not want to use the products specified by the health insurance. Because: Premium incontinence material is usually not provided in the basic supply. Here, however, a proportion of the costs can often be charged via the sickness insurance fund.

https://pflebo-pflegehilfebox.de/

Since you seem to have been suffering from incontinence for years, you should or at least Your doctor knows.

PlueschTiger
10 months ago
Reply to  Schimeck

Define Premium.

Schimeck
10 months ago
Reply to  PlueschTiger

Premium is everything above the basic health insurance. This is not what I define, but the health insurance.

Schimeck
10 months ago

Yes, that’s clear to me, I meant that I don’t know the content in this regard.

PlueschTiger
10 months ago

The tool catalogue lists all that is recognized as a medical product and can be prescribed.

Schimeck
10 months ago

There was no brand for me from the question. I don’t know the tools catalogue either.

PlueschTiger
10 months ago

Now the BetterDry mentioned here and again are in the help catalogue, so are approved medical aids. Actually, the cash register does not define anything, it pays a package that was it. For this reason, everything above the package is Premium whether the logically considered is enough for the month or not.

Wiesel
10 months ago

In most cases, there is a degree of care and therefore a monthly need for a so-called “flegehilfe box” of 40,-€. However, you should also compare providers or pharmacies.

sumsehummel
10 months ago
Reply to  Wiesel

Diapers or inserts do not belong to the care aids, but to the incontinence material and the package is usually less (about 20€). Nursing aids include bed inserts, aprons, gloves, disinfectants. So things that are used for the care (or the protection of the caregiver).