New Judgment Health Insurance does not have to pay health tourism to Turkey

LSG Celle: Borreliosis treatment also possible in Germany
The statutory health insurance companies do not have to finance patients with health tourism abroad. If a patient needs to treat his Lyme disease in Turkey, he has to pay for it himself, the Landessozialgericht (LSG) of Lower Saxony-Bremen decided in Celle in a ruling announced on Monday, 9 October 2017 (Ref .: L 16 KR 284 / 17). Because the treatment can also be carried out well in Germany, it continues in the judgment of 21 September 2017.

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This failed a 40-year-old, Turkish-born man from the district of Vechta with his lawsuit. This was due to a tick bite suffering from a so-called Lyme disease. Borrelia bacteria transmitted by the tick bite can lead to numerous symptoms such as fever, heart problems or late-stage painful joint inflammation.

The plaintiff was dissatisfied with the treatment of his Lyme disease in Germany and was therefore treated further in Turkey. The treatment costs in the amount of around 860 euros, he wanted to be reimbursed by his statutory health insurance.

The health insurance company refused this. He had the treatment carried out without prior authorization. It was not an emergency.

Without success, the man pointed out that the doctors in Germany knew no advice and they have recommended him only a psychiatric treatment. After the treatment in Turkey, he was now halfway pain free. In addition, the costs are also low, especially as he takes more expenses such as flight and travel expenses on their own cap.

The LSG ruled that the plaintiff was not entitled to reimbursement. Lyme disease is also treatable in Germany. The plaintiff, however, only visited doctors in his immediate vicinity to the place of residence and did not even consult specialists.

Nor is it an "unnecessary formality" that the health insurance company demands a reimbursement request from the insured person, not just after treatment in Turkey. Because such an application would have also allowed for advice on further specialist medical treatment in Germany. fle / mwo