The DiGA are also called “apps on prescription” because a doctor usually has to prescribe them. Getty Images / d3sign
Millions of people with statutory health insurance in Germany are entitled to health apps without necessarily having to pay for them themselves.
There are the so-called digital health applications (DiGAs) and prevention apps that patients can have reimbursed by their health insurance company. However, this offer is used relatively little by insured persons.
Business Insider asked the largest statutory health insurance companies how much they spend on DiGAs and prevention apps. The answers are surprising: the Techniker Krankenkasse doesn’t even spend one euro per insured person per year on DiGAs.
Patients no longer have to go to the practice for more and more treatments. You can request sick leave over the phone, attend consultation hours via telemedicine or carry out treatments on an app. The smartphone is becoming increasingly central to healthcare – and so are numerous healthcare apps.
What many people don’t know: There are health apps that are reimbursable for everyone with statutory health insurance. They are called digital health applications (DiGA) and are prescribed by doctors so that patients can then use them at home. An example: Men with erectile dysfunction can use the app Cranes Edera get prescribed. The app offers a twelve-week program of pelvic floor training, cardiovascular endurance training and sex therapy exercises.
There are also prevention applications. They are intended to help prevent illnesses such as diabetes or obesity. Prevention applications, the criteria of one checkpoint can be booked without a doctor’s prescription. The cost of the course will usually be reimbursed.
Although hundreds of health apps have been available for years, health insurance companies spend relatively little money on them – even though millions of insured people could use them. We explain to you how little money the health insurance companies actually spend on DiGAs and how you can get health services via the app.
Health insurance companies spend around one euro per insured person on DiGAs every year
Business Insider asked the largest statutory health insurance companies about their DiGAs spending. The answer from the health insurance company with the largest number of members (around 11.4 million insured people) shows that they only spend a fraction of their budgets on DiGAs:
When asked, the Techniker Krankenkasse explains that only around 10 million euros were spent on DiGAs in 2023. 62,000 insured people would have received reimbursements. Spending on prevention apps was also low. “The TK has covered the costs for digital health apps (prevention and health offers according to Chapter 7 of the Prevention Guide) for 814 insured persons in 2023,” explains a spokeswoman for the company. The total costs amounted to a good 61,000 euros.
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The situation is similar with other cash registers. The DAK, Germany’s third largest health insurance company, only had DiGAs expenses worth 5.7 million euros in 2023, despite its around 5.4 million insured people, explains a spokesman. Only 16,000 insured people received reimbursements here. The second largest health insurance company, Barmer, did not comment for competitive reasons.
AOK Bayern (around 4.6 million insured people) says it has “supported the participation of its insured people in digital prevention offers (online courses) with almost 933,000 euros”. That would have affected more than 10,000 insured people. Around 3.2 million euros would have been spent on DiGAs for 9,000 users in 2023.
In Baden-Würtemberg (also around 4.6 million insured people), the AOK says it has spent around 3.5 million euros on DiGAs. According to a spokesman, AOK Lower Saxony spent 2.6 million euros. AOK Plus spent around 3.2 million euros on DiGAs and only 65,000 euros on prevention applications.
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But why are the expenses so low? In the past there have been allegations that the health insurance companies would interfere with doctors’ DiGA regulations and delay them, for example through examinations. The Federal Office for Social Security (BAS) warned the health insurance companies in 2023, that they are “in principle” not allowed to interfere with DiGA regulations in the “regulation decision”..
DiGA: This is how you get the “app on prescription”
The DiGAs are also called “app on prescription” because a doctor usually has to prescribe them. However, before the regulation, all DiGAs must be checked by the Federal Institute for Drugs and Medical Devices (BfArM). They must comply with data protection and therapeutic standards and demonstrate a “positive care effect,” it is said on the Ministry of Health website.
If the application has passed the test, it will be included DiGA directory of the BfArM. All apps that are approved for medical prescription and reimbursement are listed there.
So if patients want to use a DiGA, they should first visit their doctor. There you will receive either a prescription or written proof of your diagnosis. Both can then be submitted to the health insurance company to receive a prescription code for the DiGA prescribed by the doctor. You can then use this code to unlock and use the app. What is important is that the doctor must determine that the app could be a useful support for the patient’s treatment.
Alternatively, insured people can independently apply for a DiGA from their health insurance company. Here, too, the health insurance company requires medical evidence of the medical indication and, if necessary, other indications must also be excluded.
Prevention courses and other health apps
In addition to DiGAs, those with statutory health insurance can also take advantage of prevention courses via the app. Here too, the health insurance companies will subsidize you. The AOK Bayern writes in its statutes that courses offered by the Central Prevention Testing Center (ZPP) certified can be subsidized with up to 150 euros. Barmer writes that she would subsidize two digital prevention courses per year, each with up to 100 euros. What’s important is that these courses do not require a diagnosis from a doctor – you can simply book them and then have them reimbursed by your health insurance company.
Nevertheless, if you would like to take a prevention course, it is best to ask your health insurance company and look for the ZPP certificate. Because often only the ZPP-certified courses are actually reimbursed. By the way, the statutory health insurance companies finance the ZPP, which in return is intended to ensure that the insurance companies only finance sensible and helpful courses.
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Health insurance companies often also cooperate with special health apps that are not classic DiGA or prevention apps. These are often individual partnerships that health insurance companies enter into with companies. This means: If you also look at your health insurance company’s website, you could discover other apps that you can use without having to pay an additional fee.
Despite the supposedly low expenditure on DiGA, health apps are on the rise. In Germany, according to a Civey survey from last year, almost one in three (31.6 percent) uses low-threshold health applications, such as meditation apps or step counters. However, these do not fall into the categories of DiGA or prevention courses.