Burned out in the job – Which achievements offer GKV and private health insurance with Burnout?Complex job demands, stress, a lot of responsibility, but also high demands on oneself can lead to mental stress in many people. You feel exhausted, tired and lacking in energy – in short: burned out.
The legal and private health insurances help with broad offers for prevention and support therapies or preventive cures. Affected people should find out exactly which costs the providers reimburse, because to what extent burnout is a disease is still not bindingly clarified for all.
Tired, exhausted and burnt out – what does burnout mean?
The term burnout syndrome refers to a State of exhaustion as a result of persistent long-term stress, which is mainly related to the profession. Typical for this are increasing physical and mental exhaustion and a declining performance. Because sufferers can no longer recover and recharge from work stress, burnout symptoms gradually increase. They increase from a normal state of exhaustion to a depressive mood. Can thus lead to real depression.
The following signs indicate burnout:
Lack of energy and drive
Increasing indifference towards job and other people
Burnout – a disease or just a medical condition?
When describing burnout, health insurers currently refer to the valid Classification list ICD-10 the World Health Organization (WHO). In it the exhaustion condition is listed under the diagnosis group Z73 as "Problems related to difficulties in coping with life". Burnout is not a recognized disease, such as depression.
This could change from 2022, when the new List ICD-11 comes into effect. WHO has changed the assessment of burnout in 2019. In the new list, the state of exhaustion is recognized as a disease that is due to a permanent stress load at work.
Until then, however, nothing will change in the evaluation of the health insurances.
Sick leave for burnout – what you should know
Since burnout is not currently considered an illness, it is not easy to get a sick note for it from your family doctor. If you finally receive a certificate, you should use the time to start therapy. The employer does not have to know the reason for the illness.
How to treat burnout?
Burnout has characteristics that are not uncommon in depressive moods either. Especially, if affected persons seek medical help only after a longer period of continuous stress and the exhaustion already leads to a regular collapse doctors advise that burnout patients psychotherapeutic treatment.
What does the statutory health insurance (GKV) cover in the case of burnout??
Statutory health insurance companies pay the costs for ambulatory and inpatient psychotherapies to the full extent. The prerequisite is that the patient suffers from symptoms that belong to recognized psychological diseases. These can be anxiety, but also depression or obsessive-compulsive disorder. In addition, the therapist must have licensed by a panel doctor own.
The following Forms of therapy are recognized and reimbursed by the health insurance company:
Depth psychologically based psychotherapy
EDMR therapy for post-traumatic stress disorder
In some cases, inpatient therapy may be better than outpatient treatment. The health insurance also covers these costs, but only if there is a referral from a specialist doctor.
How does private health insurance support therapy for burnout??
It is not possible to say in general terms which services are covered by private health insurance (PKV). They offer Equivalent support to that provided by statutory health insurance. Nevertheless, the insurers handle the reimbursement of psychotherapeutic treatments very differently. It refers to the Collective agreement which each PKV member agrees upon individually.
For example, a private health insurance provider can limit the costs in a tariff up to a fixed number of sessions. A number of 30 therapy sessions is usual. In another tariff with the same insurer, the cost of a session may only be covered on a pro rata basis, either from the start or only after a set number of sessions. Privately insured persons should therefore contact the insurance company before beginning therapy. Clarify the reimbursement for burnout treatment.
Unlike the GKV, private health insurances also pay for psychological treatment in the form of talk therapy. This opens up another treatment option for insured persons.
How to find a good therapist for burnout?
A sympathetic relationship between patient and therapist is an important prerequisite for successful therapy. Before the actual treatment is therefore a Trial period granted. Up to five trial sessions can take affected persons for it. If they don't "warm up" to the therapist in that time, they can see another psychologist. There again five trial sessions apply. The health insurance company also reimburses these sessions in full.
Attention, waiting time for appointments
People with statutory health insurance may only seek the help of a psychotherapist who is licensed by a panel doctor. For this purpose, many health insurance companies offer information and address databases on their website. Also the Appointment service centers of the National Association of Statutory Health Insurance Physicians (KBV) helps interested parties to find an appointment for an initial consultation.
In theory, the search for a therapist and finding an appointment should otherwise be very easy for SHI members: with the insurance card they can go directly to the therapist of their choice. Everything else about the application for reimbursement is handled by the psychologist.
However, the reality is different. Thus the Places for therapies rarely free. Those affected must Waiting times of several months to accept.
Private patients have two advantages here: They are not dependent on psychotherapists with cash admission. In addition, they usually get an appointment with a doctor more quickly. With long waiting periods they do not need to fight.