Statutory benefits are not known to all insured persons

27.02.2015 11:56

Since 2012, health insurance companies have been allowed to reimburse over-the-counter, pharmacy-only medications (so-called OTC medications). The basis for this is the statutory benefits defined for each individual fund. Currently, around 60 percent of health insurance companies reimburse their insured persons for OTC medicines as part of statutory benefits. However, many people with statutory health insurance do not know that their health insurance company covers the costs. This is shown by the current results of the German Health Monitor of the Federal Association of Drug Manufacturers (BAH). Accordingly, more than half of those surveyed do not know about the topic of statutory benefits and only about one in four know that their health insurance company offers corresponding statutory benefits.

Those with statutory health insurance can submit their pharmacy bill together with the doctor's prescription (e.g. a green prescription) to their health insurance company for reimbursement. The amount of reimbursement varies per health insurance provider. In addition, most health insurance companies have budget limits up to which the health insurance fund will cover the costs. The services themselves also differ significantly. Some health insurance companies only partially reimburse the costs for special therapies, such as herbal, homeopathic or anthroposophical medicines. Other health insurance companies reimburse all OTC medicines, but only in the 12 to 18 year old age group. For children up to 12 years of age, health insurance companies reimburse the costs of OTC medicines as part of the so-called standard care.

Importance of OTC medicines

As safe, effective and well-tolerated medications, OTC drugs have always had a high priority in drug therapy. They enjoy a good reputation among patients and doctors alike. That's why many family doctors use these medicines to treat illnesses. This is a great advantage not only for adults, but also for children and young people.

Insured persons can ask their health insurance company which statutory benefits are currently offered. Further information and an overview of the statutory benefits can also be found at www.bah-bonn.de.