The principle of outpatient care before inpatient care applies to preventive medical services.

Outpatient preventive care services

On application and subject to certain conditions, your statutory health insurance fund will cover the costs of the medical treatment and spa treatment for outpatient preventive care. Accommodation and meals are paid for by you as the insured person.

Outpatient preventive medical services are medical and therapeutic treatments, for example therapeutic baths or physiotherapy, which are carried out by therapy centers in state-approved health resorts. You can choose the spa and therapy center together with your doctor. You organize your accommodation and meals yourself.

Inpatient preventive care services

If outpatient preventive care at a state-approved spa is not sufficient, for example because you are physically severely impaired or require intensive medical care, your health insurance provider must approve an application for inpatient preventive care. In addition to treatment, this also includes accommodation and meals at the spa clinic.

Medical necessity

Your health insurance company can only approve outpatient or inpatient preventive care if you have previously exhausted all treatment options at your place of residence. Your doctor must justify the necessity of the preventive treatment to your health insurance company in the application.

A cure can be considered medically necessary if

• it can prevent an impending illness or avoid its worsening or
• the need for care is avoided or
• a risk to the health development of a child can be counteracted.

Duration

The duration of outpatient preventive care services should be provided for a maximum of 3 weeks. An extension can only be considered if this is urgently required for medical reasons in order to achieve the preventive care objective.

Inpatient preventive care services should be provided for a maximum of 3 weeks - unless an extension of the service is urgently required for medical reasons.

In individual cases, spa stays abroad are also possible; please contact your health insurance fund for more information.