At a glance
Personal situation
Describe mobility needs and the reason for travel fully.
Merkzeichen and Pflegegrad
Have relevant German disability and care-level documents available.
Individual decision
Prescription and approval requirements depend on the individual case.
Why Pflegegrad and Merkzeichen can matter
German statutory health insurance covers rides to outpatient treatment only under specific conditions. A Pflegegrad (German care level) or Merkzeichen (German disability marker) can affect whether patient transport may be prescribed and whether prior approval is required. Neither automatically establishes coverage for every journey.
German care levels 3, 4 and 5
According to the KBV, special rules apply to people with care level 4 or 5, and to people with care level 3 when a permanent mobility impairment is also documented. The specific journey must still be medically necessary. Clarify transitional and individual rules with the treating practice and health insurer.
German disability markers aG, Bl and H
- aG indicates an exceptional walking disability.
- Bl indicates blindness.
- H indicates helplessness.
For people with one of these markers, rides to outpatient treatment may be prescribed when the applicable requirements are met.
German disability markers and care levels may be relevant, but the individual assessment and specific transport needs remain decisive.
Prior approval depends on the case
Whether the health insurer must approve patient transport in advance depends on the type of ride and personal circumstances. The German Patient Transport Directive sets out exceptions and conditions. If in doubt, request written information from the health insurer.
What to take to the medical practice
- Details of the treatment appointment
- German severe-disability card or care-level documentation, where relevant
- Description of mobility and assistance needs
- Questions about the type of transport and prior approval
From eligibility questions to a ride request
Once the medical and formal requirements are clear, PrimaFahrten needs the pickup and destination addresses, times, wheelchair or walking aid, and building-access information. You can then request a medical ride in Berlin and add the stair-chair service if stairs need to be managed.
