What is a Long-Term Prescription for Physiotherapy?
In Germany, a long-term prescription (known as "Dauerrezept" or "langfristiger Heilmittelbedarf") is a special type of medical authorization for patients with chronic conditions. It allows you to receive physiotherapy or other therapeutic treatments for at least one year without constantly applying for new approvals from your health insurance provider (Krankenkasse).
Key Benefits at a Glance:
Uninterrupted therapy sessions
Less paperwork and bureaucracy
Better treatment planning for you and your therapist
No gaps in treatment due to expired prescriptions
Who Qualifies for a Long-Term Prescription in Germany?
According to German healthcare regulations, patients with severe, permanent functional or structural impairments are eligible for long-term prescriptions. The Federal Joint Committee (Gemeinsamer Bundesausschuss or G-BA) has established clear guidelines on qualifying conditions.
Automatically Qualifying Diagnoses Include:
Neurological Conditions:
Multiple Sclerosis (MS)
Spinal cord injuries and paralysis
Severe stroke with lasting effects
Advanced Parkinson's disease
Traumatic brain injuries
Orthopedic and Rheumatic Conditions:
Chronic polyarthritis
Severe spinal disorders
Congenital limb deformities
Post-amputation rehabilitation
Other Chronic Conditions:
COPD and chronic respiratory diseases
Lymphedema (especially post-cancer treatment)
Severe joint deformities
Long COVID with persistent symptoms
How to Apply for a Long-Term Prescription: Step-by-Step
Step 1: Consult Your Doctor
Start by having an honest conversation with your Hausarzt (general practitioner) or specialist. Discuss:
How long you've been in therapy
Your expected future treatment needs
How your condition impacts daily life
Step 2: Diagnosis Assessment
Your doctor will check if your condition appears on the official list of diagnoses eligible for long-term treatment:
If your diagnosis is listed:
Doctor issues the long-term prescription directly
No separate insurance application needed
You can start therapy immediately
If your diagnosis isn't listed:
Doctor creates an exceptional prescription with detailed justification
You'll need to submit an application to your health insurance
Step 3: Insurance Application Process
For unlisted conditions, you'll need:
Medical prescription with detailed reasoning
Previous therapy reports
Medical records and test results
Documentation of care level (Pflegegrad) or disability status if applicable
Important: German health insurers must respond within 4 weeks. If they don't, your application is automatically approved!
Which Therapies Can Be Prescribed Long-Term?
Germany's healthcare system covers various therapeutic treatments (Heilmittel) under long-term prescriptions:
Physiotherapy Services:
Movement therapy (Krankengymnastik): Traditional physical therapy
Manual therapy: Specialized joint mobilization techniques
Equipment-based therapy (KGG): Medical device training
Bobath therapy: For neurological conditions
PNF therapy: Proprioceptive neuromuscular facilitation
Massage and Physical Treatments:
Classic massage therapy
Manual lymphatic drainage for edema
Connective tissue massage
Electrotherapy and ultrasound
Heat and cold applications
Additional Covered Treatments:
Occupational therapy for daily living skills
Speech therapy for communication disorders
Podiatry for diabetic foot syndrome
Duration and Treatment Frequency
Individual prescriptions are valid for 12 weeks maximum, but your overall authorization lasts at least one year. Treatment frequency depends on your doctor's prescription:
1x weekly: 12 sessions per quarter
2x weekly: 24 sessions per quarter
3x weekly: 36 sessions per quarter
Example: With twice-weekly treatments, you'll receive 24 therapy sessions over 12 weeks. After that, you'll need a new prescription from your doctor.
Regular Doctor Visits Despite Long-Term Authorization
Even with a permanent prescription, you must visit your doctor every 12 weeks. These check-ups serve to:
Monitor your therapy progress
Adjust treatment if needed
Issue follow-up prescriptions
Maintain medical documentation
Warning: Missing your doctor's appointment automatically terminates your current prescription!
What If Your Application Is Rejected?
If your health insurance denies your application:
File an appeal: You have the right to challenge the decision (Widerspruch einlegen)
Continue treatment: You can still receive therapy with regular prescriptions during the appeal
Gather documentation: Keep detailed records of your treatment progress for future applications
Get a second opinion: A specialist might provide stronger justification
Insurance Coverage Across Different Providers
Good news: The treatment guidelines apply uniformly to all statutory health insurance providers in Germany. Whether you're with TK, Barmer, AOK, or another public insurer, the rules are identical.
Note for switching insurers:
Approvals only apply to the issuing insurance company
You'll need to reapply when changing providers
Keep all documentation for a smooth transition
Digital Prescriptions: The Future of German Healthcare
Starting in 2027, Germany will transition from paper prescriptions to e-prescriptions (E-Verordnung) for therapeutic treatments. Benefits include:
No more lost prescriptions
Direct transmission to therapy practices
Reduced bureaucracy
Simplified insurance billing
Until then, you'll continue receiving the traditional pink prescription form (Muster 13).
Practical Tips for Managing Your Long-Term Prescription
1. Plan Ahead
Talk to your doctor early when you realize you'll need ongoing therapy. Don't wait until your current prescription expires.
2. Keep Detailed Records
Maintain a therapy diary including:
Treatment dates and progress
Setbacks and improvements
Impact on daily activities
3. Communicate with Your Therapist
Inform your physiotherapist about your long-term prescription status. This helps them plan your treatment strategy effectively.
4. Track Important Dates
Set calendar reminders for doctor appointments – ideally with a two-week advance notice.
Frequently Asked Questions
Can I change therapists during my long-term prescription? Yes, you can switch therapists anytime. Your prescription remains valid.
What if I need to pause therapy? Short breaks (for vacation or illness) are fine. The 12-week period starts with your first treatment.
Are home visits covered? Yes, if medically necessary and prescribed by your doctor.
Do I have to pay co-payments? The standard co-payment of 10% of treatment costs plus €10 per prescription applies unless you have an exemption (Zuzahlungsbefreiung).
The Bottom Line: Long-Term Prescriptions Simplify Chronic Care
For patients with chronic conditions in Germany, a long-term physiotherapy prescription offers significant quality-of-life improvements. Continuous treatment without bureaucratic interruptions leads to better outcomes and peace of mind.
Key Takeaways:
Long-term prescriptions last at least one year
Certain diagnoses qualify automatically
Applications possible for unlisted conditions
Doctor visits required every 12 weeks
Rules apply uniformly across all public insurers
Talk to your doctor about a long-term prescription – it could transform how you manage your condition in Germany's healthcare system!
