{"id":2123,"date":"2025-06-17T15:36:29","date_gmt":"2025-06-17T13:36:29","guid":{"rendered":"https:\/\/okuvision.de\/news\/lsg-kostenerstattung-krankenkassen\/"},"modified":"2026-05-03T14:08:02","modified_gmt":"2026-05-03T12:08:02","slug":"lsg-cost-reimbursement-health-insurance","status":"publish","type":"post","link":"https:\/\/okuvision.de\/en\/news\/lsg-cost-reimbursement-health-insurance\/","title":{"rendered":"Retroactive reimbursement of OkuStim\u00ae for RP"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;0&#8243; top_padding=&#8221;0&#8243; bottom_padding=&#8221;0&#8243; back_color=&#8221;color-206913&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;100151&#8243; back_color_type=&#8221;uncode-palette&#8221;][vc_column width=&#8221;1\/1&#8243;]\n<div id=\"cvc-hero_image-6a0233476a3b2\" class=\"cvc-element cvc-hero-image cvc-hero-image--violet cvc-hero-image--headline-hl-xl cvc-hero-image--text-large cvc-pattern-top-right-pattern2\" role=\"region\" aria-label=\"Impending blindness is an emergency-like situation\">\n    \n    <!-- Background Patterns -->\n                <div class=\"cvc-hero-image__pattern cvc-hero-image__pattern--right\" aria-hidden=\"true\"><\/div>\n        \n    <!-- Content Container (max-width, centered) -->\n    <div class=\"cvc-hero-image__container\">\n        \n        <div class=\"cvc-hero-image__inner\">\n            <div class=\"cvc-hero-image__content\">\n                \n                                    <div class=\"cvc-hero-image__meta\">\n                                                    <span class=\"cvc-hero-image__meta-item cvc-hero-image__meta-reading-time\">\n                                Lesedauer ca. 3 Min.                            <\/span>\n                                                                            <span class=\"cvc-hero-image__meta-item cvc-hero-image__meta-date\">\n                                17. June 2025                            <\/span>\n                                            <\/div>\n                                \n                                                        <h1 class=\"cvc-hero-image__headline font-714446 fontsize-431854\">\n                        Impending blindness is an emergency-like situation                    <\/h1>\n                                \n                <div class=\"cvc-hero-image__text-wrapper\">\n                                        \n                                    <\/div>\n                \n                                    <div class=\"cvc-hero-image__categories\">\n                                                    <span class=\"oku-pill\">Therapy &amp; Application<\/span>\n                                            <\/div>\n                                \n            <\/div>\n            \n            <!-- Image (breaks out to right edge) -->\n                            <div class=\"cvc-hero-image__image\">\n                    <img width=\"1200\" height=\"497\" src=\"https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw.webp\" class=\"attachment-full size-full\" alt=\"Drohende Erblindung ist eine notstands\u00e4hnliche Situation\" loading=\"lazy\" decoding=\"async\" srcset=\"https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw.webp 1200w, https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw-300x124.webp 300w, https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw-1024x424.webp 1024w, https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw-768x318.webp 768w, https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw-350x145.webp 350w, https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw-uai-720x298.webp 720w, https:\/\/okuvision.de\/wp-content\/uploads\/2022\/03\/iStock-1207748593_sw-uai-1032x427.webp 1032w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/>                <\/div>\n                    <\/div>\n        \n    <\/div>\n    \n<\/div>\n\n\n[\/vc_column][\/vc_row][vc_row row_height_percent=&#8221;0&#8243; override_padding=&#8221;yes&#8221; h_padding=&#8221;2&#8243; top_padding=&#8221;3&#8243; bottom_padding=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; gutter_size=&#8221;3&#8243; column_width_percent=&#8221;100&#8243; shift_y=&#8221;0&#8243; z_index=&#8221;0&#8243; content_parallax=&#8221;0&#8243; uncode_shortcode_id=&#8221;174490&#8243; row_name=&#8221;Einleitung&#8221;][vc_column column_width_percent=&#8221;70&#8243; gutter_size=&#8221;3&#8243; overlay_alpha=&#8221;50&#8243; shift_x=&#8221;0&#8243; shift_y=&#8221;0&#8243; shift_y_down=&#8221;0&#8243; z_index=&#8221;0&#8243; medium_width=&#8221;0&#8243; mobile_width=&#8221;0&#8243; width=&#8221;1\/1&#8243; uncode_shortcode_id=&#8221;705359&#8243;][vc_column_text uncode_shortcode_id=&#8221;651814&#8243;]A recent court ruling by the Regional Social Court of Lower Saxony-Bremen (LSG) paves the way for the retroactive reimbursement of OkuStim\u00ae therapy for Retinitis pigmentosa (RP). A patient had filed a lawsuit because her health insurance company refused to cover the costs, arguing that impending blindness was not to be expected and that the therapeutic benefit of TES had not yet been evaluated by the Federal Joint Committee (G-BA).[\/vc_column_text][vc_custom_heading heading_semantic=&#8221;h3&#8243; text_size=&#8221;h3&#8243; uncode_shortcode_id=&#8221;115847&#8243;]Retinitis pigmentosa: Health insurance must retroactively cover costs for OkuStim\u00ae therapy[\/vc_custom_heading][vc_column_text uncode_shortcode_id=&#8221;627258&#8243;]The LSG bases its decision on the unquantifiable specific prognosis period for Retinitis pigmentosa (RP). Accordingly, the irreversible loss of residual vision and impending blindness constitute an emergency-like situation, even if the time at which the irreparable damage occurs is not predictable. The disease had reached a stage in the plaintiff, with a visual field constriction to 10 degrees, where further waiting would no longer be reasonable. Transcorneal electrical stimulation (TES) with the OkuStim\u00ae system would no longer have any medical benefit for the plaintiff at a later stage. The plaintiff&#8217;s health insurance company must now reimburse the costs for the acquisition of the OkuStim\u00ae system and cover her future therapy costs.    <\/p>\n<p>In December 2017, the plaintiff unsuccessfully applied to her health insurance company for coverage of the costs for OkuStim\u00ae therapy. At that time, she still had a visual field of 10 degrees and a visual acuity of 0.8. Meanwhile, the plaintiff had started OkuStim\u00ae therapy at her own expense. Following a medical opinion, the Regional Social Court stated in its judgment that a noticeable positive effect of TES on the course of the disease had already occurred.   <\/p>\n<p>OkuStim\u00ae therapy can slow down the progressive loss of the visual field in Retinitis pigmentosa. A current trial study, commissioned by the G-BA, is investigating the effectiveness and long-term benefits of the therapy. Only with a positive benefit assessment can regular coverage of therapy costs by health insurance companies take place. For self-payers, the CE-marked OkuStim\u00ae system is available through clinical competence centers in several European countries.[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>The LSG Lower Saxony-Bremen considers impending blindness in Retinitis pigmentosa (RP) to be an emergency-like situation and obliges a health insurance company to retroactively reimburse the OkuStim\u00ae therapy.<\/p>\n","protected":false},"author":10,"featured_media":853,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[176],"tags":[],"class_list":["post-2123","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-therapy-application"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>LSG: Retroactive reimbursement 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