No reimbursement of over-the-counter medication



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Lawsuit of a chronically ill person dismissed by the Federal Constitutional Court: Medicines that do not require a prescription must continue to be paid out of one's own pocket

In Germany, patients have to pay for over-the-counter medications out of their own pockets, even if the doctor has issued a prescription for a product. This also applies, "if a patient has a serious chronic illness", currently ruled the Federal Constitutional Court in Karlsruhe. The current legal regulation was thus confirmed by the highest constitutional authorities and a complaint by a person concerned to the main hearing was not permitted (Federal Constitutional Court, AZ: 1 BvR 69/09).

The regulation, according to which patients have to pay for prescribed but over-the-counter medicines themselves, was confirmed by the Federal Constitutional Court today. Today's decision dismissed a constitutional complaint from a chronically ill person.

No reimbursement even for chronic illnesses
In the specific case, a permanently ill complained. His doctor regularly prescribes plaintiff's prescription drugs for chronic respiratory disease. According to the patient's own information, “this results in costs of EUR 28.80 every month”. Since the health care reform in 2004, non-prescription drugs have no longer been financed by the statutory health insurance companies, even if a doctor prescribes them. The funds were removed from the service catalog. This includes, for example, cough syrup, pain medication or throat tablets.

The Federal Social Court had previously dismissed the man's complaint. Because there was no prospect of success for the confirmation of the complaint, the complaint was not admitted to the Federal Constitutional Court. "The financial burden on the insured person is proportionate to the goal of containing health care costs," the decision released today said. A so-called special sacrifice would not be made by health insurance patients because the amounts are "spent on themselves". On the other hand, it would be a special victim if insured persons would have to provide special benefits for others. The constitutional court could not recognize this fact.

Principle of equal treatment not violated
According to the judges, the principle of equal treatment enshrined in the Basic Law was not violated. The plaintiff had argued that the fundamental law of equal treatment would be violated because the costs of prescription medication would be borne by health insurance companies, but the over-the-counter medicines would have to be paid for. The court also recognizes that the differentiation between prescription and over-the-counter medications is not only used for medical monitoring of highly effective medications, but is also an important factor in reducing cash expenditure. However, this fact is “proportionate” because “the over-the-counter medications are usually much cheaper than the prescription-only ones.” In the case of serious illnesses, the health insurance companies could also be obliged to pay for medicines that do not require a prescription following an application.

In addition, in the case of serious illnesses, non-prescription drugs could exceptionally be paid for by the health insurance companies. The court could not see any particular hardship. The applicant did not show that his own case was "socially unjustifiable". A ruling by the Federal Social Court in Kassel, however, had recently ruled that Hartz IV recipients have no claim to reimbursement from their job center. Here, too, those affected should contact the health insurance company. (sb)

Also read:
Over-the-counter medicines are by no means safe
No over-the-counter cold remedies for children
Cough can indicate serious illness

Image: Paul-Georg Meister / pixelio.de

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