Helmet therapies in asymmetric baby head no cash benefit

BSG: So far there is a lack of recommendation by the responsible doctor-Kassen-Panel
The so-called helmet therapy for the treatment of an asymmetrical or deformed head of an infant is not part of the service catalog of the statutory health insurance. It concerns a new treatment method, for which no agreement of the responsible joint federal committee of the physicians and health insurance companies exists yet, decided the Federal Social Court (BSG) in Kassel in several on Friday, 12. May 2017, announced judgments from the previous day (Az .: B 3 KR 17/16 R and others).

In the disputed therapy, babies get a kind of helmet (medical: Kopforthese) on. This leaves room only at certain points, so that the skull primarily grows there and thus gets a uniform shape. Therapy should start between the fourth and the twelfth month of life at the latest and lasts for two to three months for minor irregularities, and longer for severe deformities. The helmet should be worn 23 hours a day.

(Image: esben468635 / fotolia.com)

In the four cases decided by the BSG, the costs for such treatment were between € 1,300 and € 2,000. The parents of the children had each applied to their health insurance to take over this. The coffers refused this.

And rightly so, as the BSG decided. A slight asymmetry of the head should not be regarded as a disease anyway. However, severe forms could not be discussed from the outset of any illness. However, there are recognized treatment methods through storage and physiotherapy. The "helmet therapy", however, is a "new treatment", for a positive assessment of the Joint Federal Committee is still missing.

In this Federal Committee, doctors, hospitals and health insurance funds decide together on the benefits catalog of the statutory health insurance. Consumer and patient representatives are involved, but have no voting rights. Without the recommendation of the Joint Federal Committee, the statutory health insurance funds usually do not have to pay for a treatment method.

According to a statement of the Society for Neuropediatrics and the German Society for Social Paediatrics and Youth Medicine from 2012, the treatment success in severe deformities with a head is better than the recognized therapies. However, there is no evidence that non-treatment of a deformed head could later have adverse medical consequences. Therefore, it is questionable, "whether the helmet therapy beyond the purely cosmetic improvement of the asymmetry of the skull has a medical benefit." mwo