Palliative medicine - the question of costs

Luise Heine has been an editor at since 2012. The qualified biologist studied in Regensburg and Brisbane (Australia) and gained experience as a journalist in television, in the Ratgeber-Verlag and in a print magazine. In addition to her work at , she also writes for children, for example for the Stuttgarter Kinderzeitung, and has her own breakfast blog, “Kuchen zum Frühstück”.

More posts by Luise Heine All content is checked by medical journalists.

Intensive medical care incurs considerable costs. This also applies to care-intensive palliative medicine. What do hospice and palliative centers cost and what services can you apply for?

Depending on which palliative care someone has to take advantage of, the costs are very different. Basically, everyone who wants to take advantage of such offers has a right to palliative care - regardless of their financial resources.

Legal basis

The legal framework for those with statutory health insurance who would like to experience their last days at home is provided, among other things, by the Social Security Code (SGB V). Since April 1, 2007, it has stated that there is also a right to specialized outpatient palliative care (SAPV) if particularly complex care is required. This also includes specific services, such as symptom relief or pain therapy. The prerequisite is that a doctor prescribes the corresponding services.

Specifically, this means that the costs for palliative medical care by the family doctor, the pain therapist or palliative physician in private practice as well as for palliative nursing at home or the medically prescribed, specialized outpatient palliative care (SAPV) are covered by the statutory health insurance.

In the case of privately insured patients, the deciding factor is what has been contractually agreed - it is worth taking a look at the small print here. In addition, some health insurers reimburse services on goodwill, they are not obliged to do so.

If the medical service of the (statutory) health insurances determines a need for care within the meaning of the long-term care insurance, benefits from the long-term care insurance funds are added. These also grant subsidies if modifications are necessary for palliative care at home. It is recommended that you make a clearly visible note of “palliative patient” on a corresponding application to the health insurance company. This ensures that it is processed at short notice, usually within a week.

Hospice costs

Even those who want to celebrate their retirement in the hospice are covered by their health insurance and long-term care insurance. However, a few prerequisites must be met for this. For example, a cure must be ruled out and the expected remaining lifetime must be in the range of a few weeks or months. And: a doctor must confirm the need for inpatient hospice care. Then the health insurance companies cover up to 90 percent of the costs for adults. The remaining 10 percent is usually borne by the hospice or its provider - mostly financed by donations. In the case of children's hospices, the share for the health insurance companies is 95 percent. Since August 1, 2009, legally insured persons may no longer be billed for hospice costs.

The situation is different for those with private insurance. They do have a certain entitlement to nursing services, but any additional costs will only be reimbursed as a goodwill gesture. Private health insurers are not obliged to do so.

If care in the palliative care unit of a hospital is required in the last few days of life, this will also be covered by the health insurance. Usually, however, the goal is to stabilize the condition of those affected in such a way that they can be released and, for example, die at home.

Outpatient hospice services

It is particularly important to many that people are well cared for in their last phase of life. That is why there are a large number of voluntary helpers who voluntarily provide psychosocial support for the dying and their relatives. The offers are free of charge for those affected. However, if they meet certain criteria, the hospice services can apply for staff cost subsidies from the health insurance companies. These are incurred, for example, for full-time workers whose task it is to coordinate the volunteer helpers. Often they are also financed by donations.

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