Information valid from 2006-01-09 through 2006-01-31

Information for English-speaking patients with German state-run health insurance ("Krankenkasse")

German state-run health insurance ("Gesetzliche Krankenkassen") - out-patient treatment

German state-run health insurance companies and corporations ("Gesetzliche Krankenkassen") do not list hyperbaric oxygen therapy (HBO) done as out-patient therapy as part of their coverage manual in any indication. This means, that regardless of disorder and disease and possible or ascertained therapeutic value of HBO, HBO is not covered on an out-patient basis. Additionally, any costs in relation to HBO out-patient therapy as e.g. transfer cost of patients from home to treatment facility remain uncovered, too.

No exception is made towards this rule since 2000-04-11. German Federal Committee for regulatory affairs in state-run health insurance coverage ("Gemeinsamer Bundesausschuß; GBA") quitted coverage of out-patient HBO on state-run insurance expense for any indication. For more information on this issue and underlying decision, a detailed report is available on the GBA homepage (German language only).

German state-run health insurance ("Gesetzliche Krankenkassen") - in-patient treatment

In contrast to complete abadonment of HBO on out-patient basis, HBO therapy for selected diseases and disorders requiring in-patient treatment in German hospitals are covered by German state-run health insurance ("Gesetzliche Krankenkassen"). As of 2006-01-09 these disorders and diseases are listed below:

• acute diving accident expressing as decompression sickness type I and II
• acute carbon monoxide intoxication
• acute gaseous embolism (AGE) and cerebral acute gaseous embolism (CAGE) *
• clostridial myonecrosis *
• neuroblastoma INSS stage IV relapse **

Conditions marked with * are covered only if combination therapy consisting of HBO, surgery, and antibiotics as well as intensive care are administered. Conditions marked with ** require application of 131I-metaiodobenzylguanidine (MIBG) as radionuclide therapy, where HBO is supposed to serve as radiosensitizer.

Some diseases and disorders may be treated with HBO in combination with standard modalities, as e.g. chronic osteomyelitis refractory to standard treatment alone, osteoradionecrosis, acute tinnitus, and acute idiopathic hearing loss, where HBO has proven beneficial to the patient. However, any HBO treatment must be commenced as in-patient treatment. Additionally, in-patient treatment is not allowed to be based on necessity of HBO. Hence, pursuing of other treatment modalities as e.g. systemic antibiotics or prevention of acute danger as suicidal tendencies in severe cases of tinnitus are to be evident in order for HBO coverage. If latter conditions do not apply, HBO therapy will not be covered.

Information for English-speaking patients with German private health insuranceGerman private health insurance

companies and corporations provide coverage for HBO therapy in general terms. However, ideally prior to commencement of HBO an application for cost coverage should be addressed to individual private health insurance company. Coverage of costs is still limited based on selected indications, i. e. diseases and disorders. Compared to coverage spectrum of German state-run health insurance, a significantly higher number of indications are covered as listed below:

• acute diving accident expressing as decompression sickness type I and II
• acute carbon monoxide intoxication
• acute gaseous embolism (AGE) and cerebral acute gaseous embolism (CAGE) *
• clostridial myonecrosis *
• neuroblastoma INSS stage IV relapse **
• chronic non-healing wounds
• acute tinnitus (time from initial presentation less than 3 months)
• acute idiopathic hearing loss (time from initial presentation less than 3 months)
• chronic osteomyelitis, refractory to standard treatment alone
• osteoradionecrosis (mandible)

Conditions marked with * are covered only if combination therapy consisting of HBO, surgery, and antibiotics as well as intensive care are administered. Conditions marked with ** require application of 131I-metaiodobenzylguanidine (MIBG) as radionuclide therapy, where HBO is supposed to serve as radiosensitizer.

In case of acute treatment indication as e.g. decompression sickness or acute carbon monoxide intoxication application for cost coverage can be initiated by HBO team. Due to medical necessity, commencement of HBO therapy will take place regardless of cost coverage assertion by private health insurance company.

Information for patients with Non-German private or public health insurance

In-patient treatment

In-patient treatment at theUniversity Hospital of Düsseldorf requires prior cost coverage assertion of health insurance company. Please note, that in most instances pre-payment of presumed costs is required prior to admission at the University Hospital of Düsseldorf. Presumed costs do vary according to disease and therapy regime. Therefore they have to be calculated on an individual basis.

For more detailed information on payment procedures and necessities, please do contact our international patients coordinating office staffed by Mr. Doerscheln and Mrs. von Borries. They will certainly provide any help and information you might need.

Out-patient treatment

Out-patient treatment at the University Hospital of Düsseldorf HBO institution is possible. Similar to provisions outlined for in-patients, pre-payment has to be deposited prior commencing HBO therapy. Costs requiring pre-payment do vary according to disease and treatment regime. Therefore they have to be calculated on an individual basis. Please do consider the necessity for organizing a place to stay.

For more detailed information on payment procedures and necessities, please do contact our international patients coordinating office staffed by Mr. Doerscheln and Mrs. von Borries. They will certainly provide any help and information you might need, including accommodation of hotels or appartements.