Cover and benefits
Yes, when the prescription is pink or yellow. Barmer covers all medication that doctors prescribe as medically necessary. Prescriptions come in the colours pink, blue, green and sometimes yellow. The colour determines who will pay for the medication and how long the prescription is valid. Pink prescriptions are covered by public health insurance and are mostly valid for 28 days. Yellow prescriptions are covered, too, but are only valid for 7 days. Green and blue prescriptions are not covered. In Germany, statutory co-payments between 5 and 10 euro per package are charged for medication on pink or yellow prescriptions.
Yes. Barmer covers the costs for therapeutic treatments prescribed by a doctor. However, you are required to make a statutory co-payment of 10% of the cost of these treatments and an additional 10 euro per prescription. Therapeutic treatments include physiotherapeutic treatments and occupational, voice, speech and language therapies, podiatry therapy for diabetic foot syndrome as well as nutritional therapy for rare metabolic diseases.
You need therapeutic treatments over a long period of time?
The legislator has created regulations on this topic in the so-called Heilmittel-Richtlinie (Therapeutic Products Directive). The regulation specifies the maximum amount of treatment that can be prescribed in a regular case (the so-called "Regelfall"). If the amount of prescribed treatment is not sufficient because of serious and permanent damage to health, a long-term need for therapeutic treatments can be recognized under certain conditions.
There are two diagnosis lists that include the respective serious diagnoses:
| Diagnosis list of the "Heilmittel-Richtlinie" | List of special prescription cases |
|---|---|
Examples:
| Examples:
|
If your diagnosis is included in one of the diagnosis lists and other additional conditions are met, the requirements for a longer-term or long-term need for therapeutic treatment are fulfilled. In this case, Barmer does not require any application.
What if my diagnosis is not included in the lists?
If your doctor has diagnosed you with a serious health condition and long-term impairment lasting longer than one year, you can apply to Barmer for the individual approval of a long-term therapeutic treatment requirement.
Please submit the following documents to us for the assessment of your application:
- Your application in free form and
- A copy of the medical prescription with medical justification.
- If available, further medical documents such as hospital reports, medical findings.
We may obtain a neutral expert opinion from the "Medizinische Dienst" (Medical Advisory Service) to review your application. If the requirements for a long-term therapeutic treatment are met, your application will be approved.
If the requirements are not met, you will receive a written rejection, which you should also submit to your doctor. This rejection does not mean that your doctor is no longer allowed to prescribe therapeutic treatments. The doctor can, for example, continue a medically necessary treatment beyond the "orientierende Behandlungsmenge" (indicative treatment quantity).
People with statutory health insurance should always receive medically necessary therapeutic treatment. Exclusion only applies if the doctor determines that the prescription is not economical. This would be the case, for example, if the treatment objective can also be achieved with medical aids, medication or personal measures, taking into account the respective therapy risks – for example, through self-exercise programs, sporting activities or a change in lifestyle. The doctor decides on this in each individual case as part of their therapeutic responsibility.
Yes. You can receive psychotherapy easily and free of charge via your e-health card, but your therapist needs to be registered within the public health insurance system.
The Barmer Doctor Finder is a good place to start when looking for an approved psychotherapist in your area – especially one who speaks your preferred language.
On the website of the Kassenärztliche Bundesvereinigung (National Association of Statutory Health Insurance Physicians), you can also search for psychotherapists in your area. You can find all approved psychotherapists under the heading “Tipps zur Online-Arztsuche: So finden Sie Ihren Arzt oder Psychotherapeuten”. Please note that this website is only available in German.
You can also receive telephone support to find a psychotherapist by calling the special appointment service hotline of the Kassenärztliche Bundesvereinigung. You can reach this service at the nationwide number 116117 or at www.116117.de. Agents on this special hotline will try to support you in English, but the menu choices given at the beginning of the call are only in German.
Barmer-App and Meine Barmer
Your personal online service centre. With the Barmer-App and Meine Barmer, you can easily manage your health insurance online – quickly and securely from wherever you are in the world. You can access the Meine Barmer online service centre directly from the Barmer website – or via the Barmer-App from a mobile device. As a registered user of our online service centre, you can:
- Fill out and download applications and certificates digitally
- Update personal data
- Receive reminder services for preventive medical checkups and vaccinations
- Use your personal online mailbox for secure, digital communication with us
- Submit sick notes and keep track of sickness benefit payments
- Stay informed about the processing status of your maternity pay
- Enjoy attractive online courses and apps for your health
- Access many other digital services and apps for Barmer members
Would you like to know more? Simply contact us for further support.
* On weekdays from 8:01 PM to 6:59 AM, weekends and national public holidays, our telephone hotline is operated by our partner asf gmbh. The company’s team is specially trained in matters surrounding social insurance. We have specifically chosen them to ensure that you receive the best service possible outside of our business hours. The protection of your data is of course ensured.
