A woman can hardly tolerate food without a specific dietary supplement. Because the capsules cost a lot, the health insurance should pay. But she refuses. A court had to decide.
Whether for muscle building, the supply of vitamin D or simply to improve well-being – for many people, dietary supplements are part of everyday life. According to a ruling, however, they are not reimbursable medicines. Statutory health insurance companies do not have to cover the costs for dietary supplements. This emerges from a decision by the state social court of Lower Saxony-Bremen.
Food supplements are – with a few exceptions – excluded from the supply by the health insurance companies. A drug does not become a drug because of a high price or a special personal need, it said (Ref.: L 16 KR 113/21).
Woman wanted health insurance to cover the costs of dietary supplements
A 50-year-old woman who had applied to the health insurance company to cover the costs of daosin capsules because of histamine intolerance had complained. She explained that she could hardly tolerate any food without it. Her symptoms could only be limited with daosin, since she lacks an important enzyme for breaking down histamine.
However, the health insurance company refused to accept the costs. The reason she gave was that, in contrast to pharmaceuticals, no approval procedure was required for food supplements and that it was therefore generally not a health insurance benefit. Billing is not possible.
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What about very expensive preparations that really help?
The Higher Social Court has now confirmed this view. The drug guidelines provide for a general exclusion, with no individual case-by-case assessment being provided, it said. Health insurance does not have to cover the cost of the dietary supplement.
It also plays no role that the preparation is expensive and leads to economic burdens for the plaintiff. The woman’s appeal against a court order from the social court in Osnabrück was rejected, and an appeal was not allowed.
With material from dpa