No smoking cessation at the expense of health insurance – BSG, judgment of 28.05.2019 – B 1 KR …

Anyone who wants to stop smoking has a difficult time ahead. Good – there are aids. But is he entitled to a health insurance for smoking cessation drugs? Usually not.

Man is often guilty of his bad health. A secured community helps him a lot. The supply system, however, has limitations. Legal health insurance does not have to pay all. For example, those who maintain an unhealthy lifestyle need not be surprised if their insurance does not help them get away from it.

Simplified caseGuardian V. was a heavy smoker. General Practitioner H. among others has reported chronic obstructive pulmonary disease (COPD). In order to cope with the abuse of nicotine, H. der V. has prescribed smoking cessation therapy. After that, V. asked for her health insurance to pay the costs of withdrawal drugs for nicotine.

The problem isInsured persons under the law have the right "to heal if it is necessary to treat the disease … prevent it from worsening or relieving the disease". It also includes drug delivery if it is not – as in the case of "smoking cessation" – prohibited by law.

Judgment: "Secured by statutory health insurance are not eligible for the supply of drugs for smoking cessation." "Laws for termination of smoking by the constitution are excluded from the compulsory health insurance catalog" (BSG, judgment of 28 May 2019, B 1 KR 25/18 R, press release).

RepercussionsV. now needs to get their nicotine brakes at their own expense. Well, with cigarettes that work well. In addition, smoking cessation drugs are unlikely to cure COPD or prevent its deterioration. Certainly: It's not easy to stop smoking. But that is not a legal problem.