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New judgment: health insurance does not have to pay for health tourism in Turkey


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

A 40-year-old man of Turkish descent from the Vechta district failed with his lawsuit. As a result of a tick bite, he suffered from so-called Lyme disease. The Borrelia bacteria transmitted during the tick bite can lead to numerous symptoms such as fever, heart problems or painful joint inflammation in the late stage.

The plaintiff was dissatisfied with the treatment of his Lyme disease in Germany and therefore continued to be treated in Turkey. He wanted the statutory health insurance to reimburse the treatment costs of around 860 euros.

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

The man pointed out without success that the doctors in Germany no longer knew what to do and they only recommended psychiatric treatment. After the treatment in Turkey, he was now reasonably painless. In addition, the costs are also low, especially since he takes other expenses such as flight and travel expenses on his own.

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

It is also not an “unnecessary formality” that the health insurance company requests the insured person to apply for reimbursement before and not only after the treatment in Turkey. Because such an application would also have made it possible to provide advice on further specialist treatment in Germany. fle / mwo

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