Assistive products are prescribed by a doctor. Ideally, there should be coordination between the doctor, therapist and/or nursing staff, medical supply retailer or medical aid advisor and the person affected.
The required assistive products should be described as precisely as possible on the prescription and any special functions required should also be described. It is also advisable for the doctor to explain the necessity of the prescription in more detail on the prescription. The GKV assistive product number for the specific product (if available) or an example product should also be listed.
Assistive products are among the compulsory benefits of the statutory health insurance (GKV). They are not budget-relevant for physicians and no reference values (monetary value of assistive products that a physician can prescribe per quarter and patient) are defined for assistive products.
An entitlement to the provision of assistive products by the health insurance fund does not automatically result from the prescription by a doctor! This is because the principle of the obligation to provide benefits is that the supply must be economical, satisfactory, necessary and appropriate (cf. § 12 SGB V). In addition, it must not be an object of daily use.
The statutory health insurance funds regularly approve assistive products that are listed in the Statuatory Health Insurance's Medical Technical aids register, provided that all necessary requirements are met.
Important note on the medical technical aids register. As confirmed by various court decisions, the Statuatory Health Insurance's Medical Technical Aids Register does not have a conclusive character, but is only an orientation and interpretation aid! It is therefore also possible that assistive products that are not listed in the Statuatory Health Insurance's Medical Technical aids register are covered by the statutory health insurance funds. In this case, the attending physician must usually provide a detailed justification for the prescription.