New health insurance benefits from October 2021


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There are new benefits in statutory health insurance starting October 2021. These affect expectant parents, people with mental health problems and everyone over the age of 35. The details at a glance.

More tests for newborn screening, health check-ups and a new range of psychotherapy services: these new health insurance benefits will be available to those with statutory health insurance from October 1, announced the Federal Joint Committee ( G-BA ) of doctors, health insurance companies and clinics . Find out what is changing below!

New health insurance benefits for Newborn screening

health insurance benefits from October

In future, blood tests will also include tests for sickle cell disease and spinal muscular atrophy. In this way, 16 instead of 14 congenital disorders are covered within the scope of the screening.

For the examination, a few drops of blood are usually taken from the baby’s heel. Ideally, the collection takes place between the 36th and 72nd hour of life, i.e. one and a half to three days after birth. Participation in the screening is voluntary.

What is Sickle Cell Disease and Muscle Atrophy?

The cause of sickle cell disease, which affects around 150 children in Germany every year, is a congenital genetic defect. It ensures that the red blood cells twist and take on a sickle shape. According to the G-BA, the disease is often only recognized after months or years without an early blood test. Discovered shortly after birth and carefully monitored and treated, complications and “acute organ crises” as a result of the disease could be avoided.

Spinal muscular atrophy is also a rare disease. It is estimated that 80 to 120 children are born in this country every year. The genetic disease leads to the progressive death of motor nerve cells in the spinal cord. The consequences are muscle weakness and skeletal deformities. If left untreated, it can lead to death. If the disease is treated early, affected children can develop motor skills such as sitting, crawling or walking better, according to the G-BA.

Importance of early detection of rare congenital diseases

Other diseases, the signs of which the blood is examined for during this screening, include maple syrup disease and certain fatty acid metabolic defects. According to the G-BA, an estimated one in 1000 newborns has a rare congenital disease that is not yet recognizable by external signs.

According to the professional association of pediatricians, early detection and treatment can often prevent disabilities and deaths. Please note: The screening test result is not yet a medical diagnosis.


Hepatitis B and C at check-up

health insurance benefits from October

Insured persons aged 35 and over are entitled to a comprehensive health examination, known as a check-up, every three years. As part of the new benefits of the health insurance companies, they can also be tested once for the viral diseases hepatitis B and hepatitis C in the future.

By then, it is possible that asymptomatic infections should be discovered and treated with antiviral drugs in good time. According to the G-BA, chronic untreated hepatitis can have long-term effects such as liver cancer.

Innovations in psychotherapy

health insurance benefits from October

The so-called group psychotherapeutic basic care is, according to the Federal Committee, a “new care offer in outpatient psychotherapy”. What’s behind it?

According to this, patients with statutory health insurance can gain their first experience with group therapy and decide whether it is suitable for them. In up to four 100-minute or up to eight 50-minute sessions, according to the G-BA, therapists explain mental disorders and explain how group therapy works and what it can achieve.

In addition to providing information, this is also about initial symptom relief. Access should be low-threshold, so no notification or application process at the health insurance company is necessary.

The advantage of group trial sessions

The German Psychotherapists Association (DPtV) welcomes the introduction as a new service of the health insurance companies: Basic group psychotherapeutic care can be used with little bureaucracy after a psychotherapeutic consultation, if the indication is there. It offers the possibility of an initial relief of the symptoms.

According to the G-BA, it is also new that in the future so-called probationary sessions, i.e. trial sessions, can take place in a group. Patients and therapists get to know each other. Patients can find out, for example, whether the chemistry is right.

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