How do you treat chronic diseases

A chronic illness is a long-lasting, difficult to cure illness. In the statutory health insurance, the definition of "severe chronic illness" within the framework of hardship regulations has an impact on the level of the insured person's load limit within a calendar year.

Seriously chronically ill people who are in long-term treatment for a serious illness generally only have to pay an additional payment of a maximum of one percent of the limit of the annual gross income to support themselves (chronicler regulation). Since April 1, 2007, the Statutory Health Insurance Competition Enhancement Act has stipulated stricter requirements for the use of the regulation for the chronicler.

The Federal Joint Committee has defined in a guideline that someone who has been undergoing medical treatment for the same illness at least once per quarter for at least one year and who also fulfills one of the following criteria is to be classified as seriously chronically ill:

  • There is a need for care of degree 3, 4 or 5 according to SGB XI.
  • There is a certain degree of disability of at least 60 percent, also caused by the chronic illness, or a reduction in earning capacity of at least 60 percent according to the standards of the Federal Pension Act or SGB VII.
  • Because of the disease, continuous medical care (e.g. medical or psychotherapeutic treatment, drug therapy, supply of remedies and aids) is required without the medical assessment of a life-threatening worsening of the disease, a reduction in life expectancy or a permanent impairment of the quality of life is expected. The continuous need for medical care and the necessary therapy-appropriate behavior of the patient must be certified by a doctor. Therapy-appropriate behavior includes, for example, the regular intake of prescribed medication or participation in seminars on chronic illnesses offered by health insurance companies.

The following persons are exempt from the need to determine behavior appropriate to therapy:

  • Children and young people under 18 years of age
  • Insured persons who are in need of care grade 3, 4 or 5 according to SGB XI
  • Insured persons with a degree of disability of at least 60 percent or a disability of at least 60 percent.

The health insurance companies offer disease management programs to provide better care for the chronically ill.