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Apply for rehabilitation via the health insurance fund

Statutory health insurance fund (Krankenkasse) · Medical rehabilitation

OnlineBy postThrough the medical practice

Medical rehabilitation provided by the Krankenkasse applies where non-residential medical treatment alone is not enough to cure an illness, prevent it from worsening, or relieve complaints. The legal basis is § 40 SGB V.

The duration is set by law: non-residential rehabilitation for no more than 20 treatment days, inpatient rehabilitation for no more than three weeks. An extension is possible where it is urgently required on medical grounds. A further benefit is in principle only considered after four years – earlier only where there is urgent medical necessity.

The co-payment is €10 per calendar day. For follow-up rehabilitation directly after a hospital stay, it is limited to no more than 28 days per calendar year. Note: for rehabilitation provided by the pension insurance, a limit of 14 days applies instead – the two institutions have different rules, and the figures are regularly confused.

Last updated26 August 2026
Legal basis§ 40 SGB V · § 11 Abs. 2 · § 61
VerificationChecked against gesetze-im-internet.de
Written and reviewed byAndrés Sánchez Botta
Independent information page: we are not your Krankenkasse, not an authority and not paid advice — we do not submit applications for you. All information comes from official sources and is explained here in simple terms; binding information always comes from the competent body. If the pension insurance is responsible, the application is forwarded there. All information provided without guarantee. We are neither lawyers nor tax consultants: we document administrative procedures and check the information against the official source — this is information, not legal or tax advice.
Non-residential rehabilitation20 treatment daysExtension possible
Inpatient rehabilitation3 weeksExtension possible
RepeatAfter 4 yearsEarlier only where urgently needed
Co-payment€10/dayFollow-up rehabilitation: max. 28 days
Required documents

What you need

Medical findings report

The basis of the application. It must set out why non-residential treatment is not enough and which specific rehabilitation goal is being pursued. A report that only lists diagnoses often leads to refusal – what matters is the justification of why rehabilitation specifically is necessary.

Application forms from the Krankenkasse

The fund provides its own forms, often online too. These include a self-declaration on complaints, restrictions in everyday life and previous treatment. Take this part seriously: alongside the medical report, it is the second basis for the decision.

Previous discharge reports

Reports on past rehabilitation measures, hospital stays and operations. They show the course of the condition and prove what has already been tried without success – a strong argument for necessity.

Details of economic activity

Important for the question of jurisdiction. Where capacity for work is the main issue, the pension insurance is usually responsible; where general health is the issue – for instance for pensioners or people who are not economically active – the Krankenkasse is.

Proof of income for the exemption

Only needed if you are applying for an exemption from co-payments or have already reached the co-payment limit (Belastungsgrenze) under § 62 SGB V. The co-payment exemption certificate (Befreiungsbescheid) also applies to the rehabilitation co-payment.

Step by step

How to proceed

  1. 1

    Clarify jurisdiction

    Krankenkasse or pension insurance? Rule of thumb: where the aim is to maintain or restore capacity for work, the pension insurance is usually responsible; where the aim is general health, the need for care or people with no connection to economic activity, the Krankenkasse is. You do not need to decide this yourself – an application made to the wrong institution is forwarded.

  2. 2

    Have a medical findings report drawn up

    Discuss the rehabilitation goal explicitly with the practice and have it set out why non-residential treatment is not enough. This justification decides the approval more often than the diagnosis itself.

  3. 3

    Submit the application

    Submit the forms and findings report to the fund – online, by post or at a branch office. The fund examines the application, involves the Medical Service if needed, and decides. Allow for a few weeks’ processing time.

  4. 4

    Name your preferred facility

    You have a right to request and choose, which the fund must take into account to the extent that this is reasonable. Name your preferred facility already in the application and give a medical reason for it – for example a particular specialisation. Proximity to your home alone is usually not sufficient.

  5. 5

    Clarify the co-payment or an exemption

    The co-payment is €10 per calendar day. For follow-up rehabilitation it is limited to 28 days per calendar year. Anyone exempt from co-payments or who has reached the Belastungsgrenze presents the Befreiungsbescheid.

  6. 6

    Object in the case of a refusal

    You can lodge an objection (Widerspruch) against a refusal within one month of notification – an informal one is sufficient at first. Supplement it with more recent or more detailed findings. The Widerspruch and any subsequent proceedings before the Sozialgericht (social court) are free of charge for insured persons.

Fee information

Costs and payment

The Krankenkasse bears the costsYou pay a daily co-payment
Application and objection (Widerspruch)Free of charge
Co-payment per calendar day€10
Follow-up rehabilitationMax. 28 days in the calendar year
Under 18No co-payment
Non-residential rehabilitationUp to 20 treatment days
Inpatient rehabilitationUp to 3 weeks

The Krankenkasse bears the cost of the rehabilitation; you pay a co-payment of €10 per calendar day under § 61 Satz 2 SGB V. For follow-up rehabilitation – that is, rehabilitation starting immediately or within 14 days of hospital treatment – the co-payment is limited to no more than 28 days per calendar year (§ 40 Abs. 6 SGB V). These 28 days only apply where the Krankenkasse pays. If the same follow-up rehabilitation is borne by the pension insurance, § 32 Abs. 1 SGB VI applies instead, with a limit of 14 days. Both figures are set out in different social-code books and are regularly confused – so always first check which institution is paying. Co-payments already made in the same calendar year are credited, and a Befreiungsbescheid under § 62 SGB V also applies here.

Good to know

Important notes

The wrong institution is not a problem. If in doubt, submit the application wherever you first end up. If the fund is not responsible, it forwards the application to the correct institution – you lose no time and no entitlement as a result.

The four-year time limit is not a strict cut-off period. Further rehabilitation before four years have passed is possible if it is urgently required on medical grounds. The findings report must expressly justify this exception.

28 days with the fund, 14 with the pension insurance. The co-payment limit for follow-up rehabilitation differs by institution: § 40 Abs. 6 SGB V names 28 days, § 32 Abs. 1 SGB VI only 14. Anyone who applies the wrong figure miscalculates their personal contribution by up to €140.

Rehabilitation is not a health retreat. Rehabilitation under § 40 SGB V requires an existing illness and a specific rehabilitation goal. The preventive health retreat under § 23 SGB V, by contrast, serves prevention – different requirements, different time limits.

The right to request and choose must be reasoned. You may name a facility, and the fund must take this into account to the extent that it is reasonable. A medical reason – specialisation, therapy offering – carries far more weight than pointing to distance.

The Belastungsgrenze also applies here. Co-payments for rehabilitation also count towards the Belastungsgrenze under § 62 SGB V. Anyone already exempt presents the official notice (Bescheid) and pays nothing.

An extension is possible. Both the 20 treatment days and the three weeks can be extended if this is urgently required on medical grounds. The facility usually submits the application for an extension itself.

Refusals are often corrected. A significant proportion of objections are successful, especially where more detailed findings are submitted later in the objection proceedings. The deadline is one month from notification.

Avoid these mistakes

Common mistakes

Applying for rehabilitation as if it were a health retreat. Recuperation is not a ground for approval. Without a specific rehabilitation goal and without a justification of why non-residential treatment is not enough, the application is refused.

Submitting a thin findings report. A plain list of diagnoses does not convince. The report must set out which functional restrictions exist and which goal the rehabilitation is meant to achieve.

Trying to decide jurisdiction yourself. Anyone who spends weeks researching instead of submitting the application loses time. The wrong institution forwards it – that is provided for by law.

Assuming 14 instead of 28 days – or the other way round. The co-payment limit for follow-up rehabilitation depends on the institution. Clarify first who is paying before calculating your personal contribution.

Giving distance as the only reason for your preferred clinic. The right to request and choose is taken into account to the extent that it is reasonable – a medical reason carries far more weight than a wish to stay close to home.

Giving up after a refusal. The Widerspruch is free of charge and possible within one month. With supplementary findings it is often successful; anyone who lets the deadline pass has to apply completely afresh.

Frequently asked questions

Questions and answers

How long does rehabilitation via the Krankenkasse last?

Under § 40 SGB V, non-residential rehabilitation should last no more than 20 treatment days and inpatient rehabilitation no more than three weeks. An extension is possible if it is urgently required on medical grounds – the facility itself usually submits the application for this.

How often can I get rehabilitation?

In principle, only after four years have passed since a comparable benefit financed from public funds. Earlier rehabilitation is possible if it is urgently required on medical grounds. The medical findings report must expressly justify this exception; it is indeed granted, but not automatically.

How much is the co-payment?

€10 per calendar day under § 61 Satz 2 SGB V. For follow-up rehabilitation starting immediately or within 14 days of hospital treatment, the co-payment is limited to no more than 28 days per calendar year. Insured persons under 18 pay nothing, and a Befreiungsbescheid under § 62 SGB V also applies to rehabilitation.

Why do I sometimes read 14 instead of 28 days?

Because it depends on the institution. For follow-up rehabilitation provided by the Krankenkasse, § 40 Abs. 6 SGB V names a limit of 28 days per calendar year. If, however, the pension insurance bears the measure, § 32 Abs. 1 SGB VI applies, with only 14 days. Both figures are correct – within their respective legal framework. So clarify first which institution is paying.

Krankenkasse or pension insurance – who is responsible?

As a rule of thumb: where maintaining or restoring capacity for work is the main issue, the pension insurance is usually responsible; where it concerns general health, the need for care, or people with no connection to economic activity – for instance pensioners – the Krankenkasse is. You do not need to decide this yourself: an application made to the wrong institution is forwarded.

Can I choose the clinic myself?

You have a right to request and choose, which the Krankenkasse must take into account to the extent that this is reasonable. Name your preferred facility already in the application and give a medical reason for it – for example a particular specialisation or specific therapy offering. A reason based on distance from home alone is usually not sufficient.

What is the difference between rehabilitation and a health retreat?

Medical rehabilitation under § 40 SGB V requires an existing illness and a specific rehabilitation goal – it is meant to cure the illness, prevent it from worsening, or relieve complaints. The preventive health retreat under § 23 SGB V, by contrast, serves prevention, before an illness arises or becomes established. Both have different requirements, durations and repeat time limits.

What can I do if rehabilitation is refused?

Lodge a Widerspruch within one month of notification; an informal one is sufficient at first, and you can submit the statement of reasons later. Supplement it with more recent or more detailed findings that make the functional restrictions and the rehabilitation goal clearer. The Widerspruch and any subsequent proceedings before the Sozialgericht are free of charge for insured persons.

Related official procedures

Preventive health retreat
Preventive rather than curative
€10/day
Mother-and-child health retreat
Separate legal basis
€10/day
Exemption from co-payments
Also applies to rehabilitation
Free of charge

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