Assistive products are prescribed by a doctor. Ideally, there should be coordination between the physician, therapist and/or nursing staff, medical supply retailers or assistive product consultants and the person affected.
The required assistive product should be described on the prescription, as accurately as possible, special functions required should also be described. It is also advisable that the physician explains the necessity of the prescription in more detail on the prescription. The SHI 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 doctors and there are no guidelines (monetary value of assistive products, that a doctor can prescribe per quarter and patient) for assistive products.
An entitlement to be supplied with an assistive product by the health insurance company does not automatically result from the prescription by a doctor! The principle of the obligation to provide benefits is that the care must be economical, satisfactory, necessary and appropriate (see § 12 SGB V). Furthermore, it must not be a commodity of everyday life.
The statutory health insurance funds regularly approve assistive products that are listed in the GKV list of assistive products, provided that all necessary requirements are met.
Important note on the list of medical aids: As confirmed by various court decisions, the GKV-Registration of Medical Devices does not have a conclusive character, but is only an orientation and interpretation aid! Therefore, it is also possible that aids that are not listed in the SHI list of aids are covered by the statutory health insurance funds. For this purpose, the treating physicians must usually provide a detailed explanation of the prescription.