How to Access OkuStim® Therapy

The first step takes you to a specialized ophthalmologist. There, the diagnosis is made and your therapy eligibility and individual tolerance threshold are determined. This allows assessment of whether transcorneal electrical stimulation (TES) is suitable for you. The therapy can be applied to many forms of RP – regardless of the genetic defect.

If treatment is appropriate, the ophthalmologist issues a prescription and enters the individual stimulation intensity required for you.

OkuStim® therapy is currently not part of standard statutory healthcare coverage. However, cost coverage by statutory health insurance is possible through an individual case decision.

You will need these documents:

• Prescription from the treating ophthalmologist
• Medical justification of medical necessity (physician’s letter)
• Cost estimate for the OkuStim® system (via the optician)

As early as 2017, a regional social court ruled that, based on § 2 Abs. 1a SGB V, a claim for cost reimbursement for treatment with transcorneal electrical stimulation (TES) using the OkuStim® system may exist when the disease is in an advanced stage and blindness is imminent. The rationale is that no approved medical therapy is currently available for retinitis pigmentosa and TES therapy offers a “not entirely remote prospect” of a noticeable positive effect on disease progression (decision of the LSG Rheinland-Pfalz dated November 10, 2017, case no.: L 5 KR 92/17).

This decision has also been confirmed in individual cases by additional rulings, most recently by the Social Court of Stuttgart (judgment dated June 18, 2019, S 9 KR 1689/18). Learn more here.

Tip: You can ask your treating practice for support with the application. Many practices offer such assistance, for example by providing medical documentation or expert opinions. Patient organizations such as PRO RETINA Deutschland e. V. are also available to advise you.

TES therapy with the OkuStim® system is currently a self-pay service. However, health insurance companies may decide, upon patient application, as part of a so-called individual case review, whether to cover the costs of the prescription. If an application is denied, it is possible to file an objection.

In the objection procedure, affected individuals can receive support from the legal advisory service of the German Federation of the Blind and Partially Sighted (DBSV), for example. For members of DBSV as well as PRO RETINA, DVBS, DUAG, LMU, and BEBSK, initial consultation on legal questions related to visual impairment or blindness is free of charge (during rbm office hours, by mail, or email). For further legal representation, modest fees apply as of January 1, 2023.