Health insurance fund (Krankenkasse) · one month after notification

Decision of your health insurer: calculate the objection deadline and deemed approval

Your health insurance fund decides on an application, e.g. aids, rehab or sickness benefit.

How to recognise the letter

The sender is your statutory health insurance fund.
It is about an application: aids, rehab, sickness benefit, travel costs …
At the end, the instructions on legal remedies: objection within one month.

Which deadline applies?

Objection (Widerspruch): one month after notification (§ 84 Abs. 1 S. 1 SGG). If the end falls on a Saturday, Sunday or public holiday, the deadline ends on the next working day (§ 64 Abs. 3 SGG). The calculator on this page works out the exact day – step by step.

If the insurer does not decide within three weeks of receiving the application (five with an expert opinion), the benefit is deemed approved (§ 13 Abs. 3a SGB V).

What happens if you do nothing?

Once the objection period has passed, the decision becomes final.

Your options

Ask for the Medical Service's expert opinion
Object (Widerspruch) – reasons can follow later
Check whether the insurer decided in time
Advice: UPD, VdK

Who can help?

Independent Patient Advice (UPD), VdK

Terms in this letter

GenehmigungsfiktionAn application counts as approved because the authority decided too late.WiderspruchYour objection to a decision, e.g. from the Jobcenter or health insurer.

Frequently asked questions

What is the deemed approval (Genehmigungsfiktion)?

If the insurer does not decide within three weeks of receiving the application (five weeks if it obtains an expert opinion) and gives you no sufficient reason, the benefit is deemed approved (§ 13 Abs. 3a SGB V). If you then obtain it yourself, the insurer must reimburse the costs. This does not apply to rehabilitation.

How much time do I have?

One month after notification (§ 84 Abs. 1 S. 1 SGG). If the end falls on a Saturday, Sunday or public holiday, the deadline ends on the next working day (§ 64 Abs. 3 SGG). The calculator above shows the exact day with every step.

Who can help me?

Independent Patient Advice (UPD), VdK.

General information, not legal advice. Whether this decision is correct and what is right in your case is for an advice centre or a lawyer to say. Laws link to the official German text at gesetze-im-internet.de.