Medical care gaps does not justify going to the podiatrist

Medical care gaps does not justify going to the podiatrist

The insured can an ingrown toe nail on a cash cost of just let the doctor handle it, even if you find no doctor. Since it is medical Care, may report to the statutory health insurance funds, not the cost of treatment at a qualified medical chiropodist, held on Tuesday, 18. December 2018, the Federal social court (BSG) in Kassel (Az.: B 1 KR 34/17 R).

A Berliner on the treatment costs are sitting at a Podiatrist. She had tried in vain to find a doctor for treatment of their chronic ingrown toenail ready. Then she went to a medical podiatrist. This treated the woman with a customized toe nail clip made of wire.

The cost want to leave the Berliner from your health insurance company to reimburse. The Podiatrist was also sufficiently qualified.

The health insurance Fund, the applicant assumed the material costs but not the cost of treatment for the Podiatrist in the amount of 152 Euro. It was a medical supply performance, which may only provide Doctors on Fund performance. The cashier acknowledged that Doctors this therapy “is not flächendeckend“ provide, as these will not even taught in medical training. The statutory provisions are clear.

The social court of Berlin-Brandenburg, spoke to the applicant the reimbursement of the costs. There is here a “Systemversagen“. She was entitled to treatment, but no doctor was willing to perform. In such a case, the insurance company must also reimburse the costs of treatment at the podiatrist.

However, the BSG annulled the decision. It was “a the doctor reserved Leistung“. That the applicant was not Doctors for the treatment of your medical Fußproblems, giving rise to no claim for reimbursement for the Podiatrist to independently performance. Possibly the woman would have been able to carry out the treatment at a private doctor and the cost of the cash refund.

An exception, only in diabetic foot ulcers. Here it is allowed podiatrists, exceptionally, to deal with this on a cash cost independently. fle/mwo