Obesity cure

What is an obesity cure?

“Cure” is an obsolete term for medical measures that are used to prevent or rehabilitate (“rehab”) after illnesses. The official names for the cure are accordingly provision and rehabilitation, and the term healing is common.

Pension benefits are health services designed to prevent the onset of a disease. Rehabilitation services, on the other hand, are intended to alleviate the negative consequences of an already existing illness and avert consequential damage. All important information on the legal framework of “cures” can be found in the Social Code V and VI. These legal texts specify exactly which goals a cure should pursue and which conditions must be met for the claim.

A cure usually takes three weeks. An extension is possible in individual cases on application. As part of an obesity treatment participants usually complete a multimodal therapy concept: this very often includes methods of psychosomatic and behavioral therapy. In addition, participants learn a fundamentally different way of dealing with food.

Practical exercises such as cooking together and sports are therefore part of the basic concept at many adiposity clinics. The focus of the obesity cure is that the participants should not only lose weight with a diet in the short term. Rather, the focus is to discover wrong habits and eating habits and replace them with newly learned behaviors. The offers and the concrete course of an obesity treatment differs depending on the obesity clinic.

Obesity treatment: who pays you?

For insured persons: The insurance provider for an obesity treatment is either the health insurance or the statutory pension insurance. For employees who pay into the statutory pension insurance, the pension insurance is usually responsible for the approval and reimbursement of an obesity treatment. For people of retirement age, however, it is usually the health insurance. Which cost unit is responsible in each individual case depends on the individual case. For this, the counseling centers of the pension insurance and health insurance companies, as well as the family doctor, provide information. For private health insured, it depends on the insurance contract, whether and to what extent the costs for an obesity treatment are taken. Insured persons receive information directly from their private insurance company.

Obesity treatment: outpatient or inpatient?

A “cure” is basically in question, if the usual outpatient medical measures for the prevention or treatment of a disease are not sufficient. Many preventive and rehabilitation measures are offered both outpatient and inpatient. In the outpatient setting, the measures usually take place close to the place of residence. The costs for accommodation and meals will not be covered. In a stationary obesity treatment, the participants for a certain period (usually three weeks) in the appropriate obesity spa clinic.

In recent years, the cost bearer for cures (pension insurance, health insurance) has begun to promote especially outpatient preventive and rehabilitation measures. Stationary measures, however, are increasingly being rejected. Ambulatory measures are usually much cheaper for the payers. Especially for the treatment of obesity is a hospital treatment usually much more effective than an outpatient.

Apply for obesity treatment

Obesity treatment is only granted upon request to the responsible insurance provider. First, you should inform yourself whether the own health insurance or pension insurance is the right recipient for this application. The insurance provider then receives the application documents. These are filled out together with an applicant doctor. Eligibility means that the doctor must meet certain requirements in order to be able to submit applications (for example, for an obesity treatment). As a rule, the right contact person for a spa application is the family doctor.

In the application, the doctor must justify in writing why he considers an outpatient or inpatient obesity treatment to be urgently necessary from a medical point of view. You then submit the completed application documents to the responsible insurance provider. Most of the application documents are forwarded from there to the Medical Service of the health insurance funds (MDK), which gives an opinion on this. Based on the assessment of the MDK, you will receive a decision after about two to six weeks. The decision contains the decision of the payee whether to approve or reject the obesity treatment.

With a permit you have four months to take the cure. If you do not do this, the claim will be forfeited. In most cases, the payer specifies the facility (obesity clinic, obesity spa clinic) in which the treatment is to take place. Some health insurance companies also provide a selection of potential contract partners, among which the applicant can select. In some cases, the specification of a desired location is possible. Most of the time, applicants receive a letter from the health clinic shortly after the approval letter with information on the further course of action.

In the case of a refusal of the obesity spa application, you can object in writing. It is important that you comply with the deadline granted (usually 28 days from receipt of the notification). In many cases, initially rejected applications for an obesity treatment at the second attempt are successful.

Both in the first application and in the opposition, the formal requirements must be met in every case very carefully. These include, first and foremost, complete application documents. You should also note that an outpatient cure can only be applied for every three years and a hospital cure only every four years. If the opposition is also rejected, it is sometimes necessary to go to the social court to enforce the right to a cure. In individual cases, this can take several years to reach a final decision. Applicants should, therefore, before the first application intensively deal with the issue and in detail about the process of the application to a Obesity cure to inform.