Insured persons with statutory health insurance are entitled to digital health applications (DiGA) under certain conditions.
What are DiGA?
DiGAs are CE-marked medical devices in the low-risk class. These so-called “apps” or “prescription (health) apps” are based on digital technology. According to the Federal Institute for Drugs and Medical Devices (BfArM), these applications are intended for the “detection, monitoring, treatment, or alleviation of diseases, or the detection, treatment, alleviation, or compensation for injuries or disabilities.” A DiGA is used by the insured person alone or together with the healthcare provider in the form of apps on smartphones/tablets or directly as an application in a web browser. Coverage applies only to applications that have been reviewed in advance by the BfArM and are listed in the DiGA directory .
How do you get a DiGA?
Under the Digital Healthcare Act (DVG), doctors or psychotherapists may prescribe an appropriate digital health application (DiGA) when necessary. If there is no prescription from a doctor, insured individuals can also submit other documentation to their health insurance provider proving that there is a medical indication for the relevant DiGA. This documentation should not be older than 4 weeks.
The health insurance company then confirms the claim, generates an activation code and provides it to the insured person.
The insured person downloads the app to their device and can then activate it with the activation code and subsequently use it. Finally, the DiGA is billed directly between the health insurance company and the DiGA provider.
Important: Due to the statutory principle of benefits in kind, no subsequent reimbursement of costs is possible, so billing takes place exclusively between the health insurance company and the DiGA provider.
