Cures abroad - Same quality and same performance?

A cure abroad - in the European Union - is possible in principle. More and more German health insurance companies have already concluded contracts with Eastern European health resorts. Every fourth health insurance is already taken abroad - mainly because prices are up to 70 percent lower than those of cures in Germany. Cures - or as it is today called rehabilitation, prevention and health promotion - are even regulated by law in the Social Code. The cure is based on the principle of activating the body's own healing powers. Contact person No. 1 for the cure is the attending physician, ie general practitioner, specialist or company doctor, who must certify to the health insurance fund by means of a form the necessity of a cure.

Save costs in Carlsbad & Co.

The health insurance companies now also approve cures abroad. Some funds, most notably the company health insurance funds (BKK), have concluded contracts with institutions in other EU countries, for example in Poland, the Czech Republic and Hungary. This is possible since the EU accession of the Eastern European countries on 1 May 2004. The contracts with Eastern European spas have been concluded on the grounds that they have negotiated better discounts and special services. Above all, the cost factor counts for all health insurances: in the Czech Republic, cures are considerably cheaper than in Germany.

An example: Carlsbad was founded around the year 1350 by the Roman Emperor and Czech King Charles IV. The town became famous around the world for its warm medicinal springs. About one hundred of these springs spring here, twelve are currently used for drinking cures. The spring water is especially beneficial for metabolic disorders. The costs for accommodation and meals are around 40 percent lower than those in German spas. And: There are hardly any language problems, one speaks German from the sister to the chief physician. This is not surprising, because about the quarters of spa guests now come from Germany.

The program "Plusminus" of the ARD from April 2005 reported that the savings potential abroad is huge, the quality comparable and the experience good. Up to 70 percent cheaper are spa treatments in the Czech Republic or Poland compared to German spas. With the competition from Eastern Europe, the competition will take on a new dimension and the first German spas would already be felt.

More competition - and wellness

But the competition also has its benefits: German health resorts - there are 320 in Germany - rely on quality - such as Bad Elster and Bad Brambach: both spas are right on the border with the Czech Republic and have the competition right in front of their eyes. Their concept is based on more quality and "modern appearance".

Bad Brambach offers, among other things, a 21-day healthy premium cure, which should meet demanding requirements - here, the line between classic spa and wellness offer is flowing. With this form, the spa doctor puts together an individual treatment program for the patient. In addition, the patient benefits from additional offers such as Ayurveda, massages with hot stone and other wellness offers. These applications must be paid for privately

, The new seal of quality of the German Spas Association "Wellness in the spa" stands for a special health offer. This means that places bearing the seal offer a range of medical applications, as well as newer spa offers. In addition to holistic medical and therapeutic expertise, the ten quality requirements also include state-recognized quality features such as a natural healing climate.

Also important are good service and good cultural offer. According to the spa association, the concept is intended for those who want to preventively do something for their health. But: The costs have to be paid out of pocket.

Outpatient and inpatient cures

With a cure one distinguishes between an "outpatient care benefit" and "inpatient care or rehabilitation benefit". Together with the doctor one selects the suitable health resort - also a place abroad. The doctor informs in advance about the necessary forms of treatment at the spa. The outpatient treatment plan is applied for in cooperation with the doctor at the health insurance. After approval, it must be started within six months.

Accommodation and meals are subsidized by the health insurance company with an amount up to 13 EURO per day (depending on health insurance). The costs of the bath doctor are taken over completely up to the practice fee. For therapeutic benefits, the prescription fee and an equity contribution of ten percent are added.

Outpatient cures:
Outpatient cures can be approved at intervals of three years. Outpatient care may be indicated in the presence of proven risk factors if the measure removes or interferes with it or if the patient can be helped to manage these factors. Examples are obesity, high blood pressure, a tendency to somatic diseases and recurring pain of the musculoskeletal system. In this case, the patient must apply for leave from the employer.

Stationary cures:
For inpatient treatment in a preventive or rehabilitation facility health insurance recommends a corresponding contract house. Inpatient cures are indicated when, for example, after recovering from serious illnesses, the ability to work should be restored - for example, after a cardiac infarction that has come to an end. In this case, cure means: you are still sick, so you do not have to apply for a vacation.

Inpatient retreats are usually granted after four years. However, there are also - depending on the course of the disease - medically indicated exceptions to undershooting this interval. With a stationary cure, the patient has to pay 10 EURO daily.

As with an outpatient cure in Germany, the health insurance fund covers the costs of medical care and the applications - and calculates directly with the institutions abroad. In 2004, around 30, 000 cures in other European countries were paid by the health insurance companies. Based on the approximately 118, 000 outpatient precautionary measures approved in Germany, the proportion of foreign cures is around one quarter.

Incidentally, there are around 1, 100 spas and spas in the EU, around 190 in the new Eastern European member states.

Criticism of Kurexport

The German Spa Association, however, criticized the "Kurexport". The coffers would endanger Germany as a business and service location, according to a press release from the association. "Thus, German spas and spas that meet high cost-demanding quality standards, spa guests deprived. The economic impact is already noticeable. "A 22.8 percent decrease in outpatient cures was expected in 2004. The association calls for uniform quality standards for the whole of Europe, but costs are initially lower for the health insurances, but significantly lower in many Eastern European countries are as in this country.

For the patient, it ultimately matters whether quality and performance meet the standards in German health clinics. This applies in the medical-therapeutic area and in accommodation and meals. Already before the doctor visit one should therefore inform about possible health resorts in EU countries. In the application you can only specify a desired spa.

The health insurance company reimburses only the costs of a cure abroad, which they would also take over in Germany. Additional costs must be paid by the patient. Among the health insurance funds, which were one of the first to approve the foreign treatment, is the Hanseatische Ersatzkasse.

According to the HEK, the health resorts are quality-tested - the patients are accommodated, for example, in Marienbad in houses of the Danubius Group. The experiences so far have been positive. Indirectly, the patients are benefiting from the fiercer competition from abroad, because the spas and health resorts in Germany are responding with additional offers and high quality standards. Information about approved spas at the medical office 44141 Dortmund, Westfalendamm 67 Tel.0231-94117920

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