"Two brothers need the same treatment. One gets it at home, the other has to travel 30 kilometres to hospital every week," criticised Ombudsman Bernhard Achitz in September 2024. Now there is finally a solution: Georg B., who is insured with BVAEB, can finally be treated at home - just like his brother Karl B. Achitz: "It's great that there's finally a solution and that Georg B. can also receive treatment where it makes the most sense for him: at home. But it would be even better if such cases were not carried out on the backs of those affected from the outset. In future, the service must be available immediately, and the state and the health insurance fund should agree in the background who will cover which part of the costs."
Looking back: Mother had to take Georg B. 30 kilometres to hospital each time
Brothers Karl and Georg B. have Hunter's disease, a metabolic disorder. Both therefore require the same treatment: enzyme replacement therapy, in which the drug Elaprase is administered by infusion. Karl B. is insured with ÖGK. This enables him to have the weekly infusion administered at home by a carer.
His brother Georg B. worked in the kitchen of a state nursing home and is therefore insured with BVAEB. She refused him home therapy. His mother Marianne B. had to take him 30 kilometres to the hospital each time, and back home again after the five-hour treatment.
Ombudsman Bernhard Achitz criticised in September 2024 in the ORF programme "Bürgeranwalt": "While ÖGK has apparently reached an agreement with the state of Lower Austria on settlement and cost sharing, BVAEB has not. This is a prime example of the absurdity of the fragmented social insurance system. The often-promised standardisation of benefits is obviously still a long way off."
In future, services will be available immediately, and the state and the health insurance fund will work out in the background who will cover which part of the costs. (Symbolic image/photo credit: Pixabay/stux)