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No payment for over-the-counter neurodermatitis drugs
In the case of neurodermatitis, there may be numerous different non-prescription treatment methods available, which, according to a decision by the Federal Social Court, must still be paid by the patient himself.
Many neurodermatitis patients use over-the-counter medications such as ointments or oil baths to relieve their symptoms. Since 2004, the cost of these preparations has had to be paid out of one's own pocket. In contrast, a 38-year-old sufferer, who is also a board member of the German Neurodermatitis Federation, had sued before the Federal Social Court. However, she now had to accept a defeat in the legal dispute there. The judges ruled that over-the-counter neurodermatitis medication still does not have to be covered by statutory health insurance.
Over-the-Counter Medicines for Basic Therapy for Neurodermatitis With the GKV Modernization Act from 2004, the financial burden of many neurodermatitis patients changed significantly due to their illness. This is because the over-the-counter creams and ointments that are used relatively frequently and have been reimbursed by the health insurers so far have not been covered and have since been funded by the patients themselves. According to the law, only over-the-counter medicinal products, which serve as standard means of treating a serious illness, are now being financed by the health insurance companies. The Federal Joint Committee determines which medicines are affected. Here the plaintiff saw the basis for still being able to pay for her over-the-counter neurodermatitis medication. As part of the proceedings, the lawyer for the 38-year-old patient from the Hanover region had pointed out that her client relied on the medication, since the ointments and creams were absolutely essential as basic therapy for neurodermatitis.
Legally, the judges did not want to follow this argument in an initial trial at the State Social Court in Celle-Bremen and decided that the refusal to pay for over-the-counter neurodermatitis medication was legal. The 38-year-old had appealed to the Federal Social Court against the corresponding judgment, but here too the judges decided against the applicant. From a legal point of view, the refusal to cover the costs of over-the-counter preparations such as fat cream (eg "Linola") or oil baths (eg "Balneum Hermal F") is therefore okay. Neither the statutes of health insurance nor the law can be said here The Federal Social Court also argued that there were no well-founded tests for the above-mentioned over-the-counter neurodermatitis medications for the above-mentioned neurodermatitis drugs, and that the responsible Federal Joint Committee (GBA) had so far not found any exceptions for over-the-counter neurodermatitis drugs.
The judgment has far-reaching financial implications for the 38-year-old applicant with severe atopic dermatitis, since in future she will not only have to spend around 500 euros per month for over-the-counter atopic dermatitis products herself, but also because she may face the reimbursement of the costs previously borne by her health insurance company. During the multi-year legal dispute, the latter had provisionally paid for the over-the-counter ointments and oil baths, so that, according to the applicant, there are now reimbursements amounting to several tens of thousands of euros.
Also in naturopathy there are different treatment methods for neurodermatitis, which are not financed by the statutory health insurance companies, despite some notable successes. First of all, there are methods of traditional Chinese medicine (TCM), homeopathy as well as ointments and creams from the field of herbal medicine. An extension of the assumption of costs in the sense of neurodermatitis patients would also be conceivable in this direction. But the verdict of the Federal Social Court has put a final line under the discussion for the time being. In the future, neither over-the-counter medicines nor naturopathic treatment methods for neurodermatitis will be covered by health insurance companies. (fp)
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