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🦽 Aids and appliances and therapies: prescription and cost coverage

A wheelchair, blood glucose meter or compression stockings are aids and appliances (Hilfsmittel); physiotherapy, occupational therapy or speech therapy are therapies (Heilmittel) – both are prescribed by a doctor and paid for by the health insurer, often subject to a co-payment.

Aids and appliances Therapies Hilfsmittelverzeichnis Deemed approval Physiotherapy § 33 SGB V § 32 SGB V

In brief

Aids and appliances (Hilfsmittel, § 33 SGB V) are items such as wheelchairs, hearing aids, blood glucose meters, inhalers or compression stockings that are meant to secure the success of treatment, prevent an impending disability or compensate for a disability. Therapies (Heilmittel, § 32 SGB V) are personally provided medical services such as physiotherapy, occupational therapy, speech therapy or podiatry. Both need a medical prescription; for many, but not all, aids and appliances, approval from the health insurer is also required.

Step by step

  1. Have a prescription issuedThe doctor issues the prescription stating the diagnosis and the aid or therapy needed.
  2. Check whether approval is requiredWhether an aid or appliance must be approved in advance depends on the Hilfsmittelverzeichnis and the insurers' list of items requiring approval; for many therapies, no separate approval is needed.
  3. Choose a providerFor aids and appliances, choose a medical supply shop (Sanitätshaus) or another contract partner of the insurer; for therapies, an authorised practice (physiotherapy, occupational therapy, speech therapy, podiatry).
  4. Pay the co-paymentThe statutory co-payment of 10% of the costs applies (at least 5, at most 10 euros per item; for consumable aids and appliances 10% per pack, at most 10 euros per month) – up to the burden limit.
  5. File an objection if refusedIf the insurer refuses or does not decide within the statutory period, consider an objection (Widerspruch) or rely on deemed approval (Genehmigungsfiktion).

Deadlines

3 weeks
Standard period for the health insurer to decide on a benefit application from receipt of the application§ 13 Abs. 3a SGB V
5 weeks
Extended period if the insurer obtains an expert opinion from the Medizinischer Dienst§ 13 Abs. 3a SGB V
Watch out – common mistakes
  • Deemed approval under § 13 Abs. 3a SGB V does not apply equally to all types of benefit and not to benefits that do not require approval anyway – whether it applies in an individual case is often legally disputed; advice helps.
  • Which aids and appliances specifically require approval changes with amendments to the Hilfsmittelverzeichnis by the GKV-Spitzenverband – a leaflet from a few years ago may be out of date.
  • For consumable aids and appliances (e.g. test strips, catheters), a different co-payment capped per month applies – do not rely on the general co-payment rule for one-off aids and appliances.
In depth · legal basis, figures and practice – for advisers and professionals

Aids and appliances: legal basis

Under § 33 SGB V, insured people are entitled to hearing aids, prostheses, orthopaedic and other aids and appliances that are necessary in the individual case to secure the success of medical treatment, to prevent an impending disability or to compensate for a disability, unless the items are to be regarded as general everyday objects or are excluded under § 34 SGB V. The Hilfsmittelverzeichnis of the GKV-Spitzenverband lists reimbursable products but is not exhaustive – aids and appliances that are not listed can also be reimbursable in individual cases.

Therapies: legal basis

§ 32 SGB V governs the entitlement to therapies in accordance with the Heilmittel-Richtlinie of the G-BA. For certain serious, long-term illnesses (so-called "long-term therapy need"), the insurer can grant an approval that secures the prescription volume over a longer period without renewed individual review.

Deemed approval

If the health insurer does not decide within three weeks of receiving the application (five weeks if an expert opinion from the Medizinischer Dienst is obtained) and does not give a sufficient reason for the delay, the benefit is deemed approved under § 13 Abs. 3a SGB V. The scope of this provision has been clarified several times by case law and is complex in the individual case.

Who is responsible
  • Statutory health insurer
  • Prescribing doctor's practice
  • Medical supply shop (Sanitätshaus) or authorised therapy practice
Further reading
Home nursing care (§ 37 SGB V)Co-payment exemption and burden limit (§ 62 SGB V)Travel costs for treatment (§ 60 SGB V)

Quick questions

Worum geht es bei „Aids and appliances and therapies: prescription and cost coverage“?
A wheelchair, blood glucose meter or compression stockings are aids and appliances (Hilfsmittel); physiotherapy, occupational therapy or speech therapy are therapies (Heilmittel) – both are prescribed by a doctor and paid for by the health insurer, often subject to a co-payment.
Which deadlines and figures matter?
  • 3 weeks: Standard period for the health insurer to decide on a benefit application from receipt of the application (§ 13 Abs. 3a SGB V)
  • 5 weeks: Extended period if the insurer obtains an expert opinion from the Medizinischer Dienst (§ 13 Abs. 3a SGB V)
What should I do first?
  • Have a prescription issued: The doctor issues the prescription stating the diagnosis and the aid or therapy needed.
  • Check whether approval is required: Whether an aid or appliance must be approved in advance depends on the Hilfsmittelverzeichnis and the insurers' list of items requiring approval; for many therapies, no separate approval is needed.
  • Choose a provider: For aids and appliances, choose a medical supply shop (Sanitätshaus) or another contract partner of the insurer; for therapies, an authorised practice (physiotherapy, occupational therapy, speech therapy, podiatry).
What do I need to watch out for?
  • Deemed approval under § 13 Abs. 3a SGB V does not apply equally to all types of benefit and not to benefits that do not require approval anyway – whether it applies in an individual case is often legally disputed; advice helps.
  • Which aids and appliances specifically require approval changes with amendments to the Hilfsmittelverzeichnis by the GKV-Spitzenverband – a leaflet from a few years ago may be out of date.
  • For consumable aids and appliances (e.g. test strips, catheters), a different co-payment capped per month applies – do not rely on the general co-payment rule for one-off aids and appliances.
Evidence
  • § 33 SGB V (gesetze-im-internet.de)
  • § 32 SGB V (gesetze-im-internet.de)
  • § 13 Abs. 3a SGB V (gesetze-im-internet.de)
  • Hilfsmittelverzeichnis of the GKV-Spitzenverband (gkv-spitzenverband.de)
  • Heilmittel-Richtlinie of the G-BA (g-ba.de)
As of

As of: September 2026. · Sources and method

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