More mother cures approved by the health insurance

Health insurance grants more maternal and mother-child cures

27.09.2012

The rejection rate of the health insurance companies for mothers or mother-child cures has dropped significantly in the past year, according to the mothers' recovery work. „Finally, more mothers can again take urgently needed treatment measures for prevention or rehabilitation“, This is the message from the mothers' welfare organization in Berlin.

In the first half of 2011, the health insurance companies had still rejected 35 percent of applications for maternal or mother-child cures. In the first half of 2012, the rejection rate has now dropped to 21 percent, according to the Müttergenesungswerk. For the affected women, a very gratifying development, but the proportion of rejected applications still seems relatively high.

Trend reversal in the approval of mother-child cures?
In view of the significant decline in the rejection rate of the mother cures, the Board of Trustees of the Müttergeneswerkwerk and Member of the Bundestag, Marlene Rupprecht, was extremely pleased. „We have been very committed to this trend reversal“, said Rupprecht on Thursday in Berlin. Last year, thanks to massive policy support, the prospects for overworked and recovering mothers would have improved significantly. Today, the mothers could „assume that their application for a course of action is duly examined and decided by the health insurance fund“, explained the Board of Trustees. „16 percent more mothers in the first half of the year are a good start. We expect a further increase“, so Rupprecht.

The audit report revealed significant shortcomings in the licensing practice
The director of the mothers' welfare organization, Anne Schilling, reported that 73 percent of mothers with rejected applications in the first half of the year in the opposition and 65 percent were successful. The high rate of legitimate contradictions show, „that work on improvements for mothers is not over yet“, so shilling on. An essential factor is the demanded by the Bundestag introduction of new uniform certificate forms, which is still outstanding. Which deficits exist in the licensing practice of mother cures, had uncovered in June 2011, a test report of the Federal Court of Audit. This noted massive deficits in the approval practice of health insurance for maternal and mother-child cures. Most recently, only 39,000 corresponding health measures were approved by the health insurance funds in 2011. Twelve years (1999) before, the number was still at a total of 57,000.

Improving the licensing practice for mother cures
The most frequent reasons for refusing the cures were in the opinion of the health insurance funds inadequate previous exhaustion of outpatient measures and other reasons, such as „no connection with the mother-child role“, „no medical need“, „no psychosocial stress situation“ or that „efficiency principle“. In particular, the significant increases in the other grounds for refusal must be critically assessed here, as they allow a relatively broad interpretation. To counteract this inadequate practice in the spa permit, the German Bundestag had decided at the beginning of the year, a specific list of tasks for the GKV-Spitzenverband. In February 2012, a newly adapted assessment guideline of the Medical Service of the GKV came into force with the aim of improving the licensing practice for mothers' treatment measures.

More than two million mothers need a cure
According to Marlene Rupprecht, the high refusal rate for mother cures is particularly critical because mothers often decide to apply for it relatively late anyway. „In the clinics of the Müttergeneswerk, we clearly see that mothers usually think of their health very late“, explained the Board of Trustees. Rupprecht estimates the number of needy mothers in Germany at around 2.1 million. Mothers should now be expressly encouraged to apply for a maternal or maternal cure when feeling exhausted. „I strongly recommend that women contact the counseling centers at the charities. These help mothers free and competent in all questions of application and clinic selection“, according to the statement of the board of trustees of the maternal healing work. In more than 80 clinics of the Müttergeneswerk in Germany mothers and their children can take appropriate health measures. There are also numerous private health clinics that work together with the health insurance companies. (Fp)

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Easier application of mother-child cures
Better chances for mother-child cures
Mother-child cures in danger
Health insurance companies grant fewer and fewer cures
Frequent rejection of mother-child cures

Image: Lucie Kärcher