Chronic Wound Care
Chronic wounds, such as pressure sores, diabetic foot ulcers or slow-healing surgical wounds, need regular treatment, dressings and sometimes specialist wound management. A comprehensive PKV tariff covers medically necessary wound care, including the dressings and materials, and the home nursing where it is prescribed to deliver the care at home.
Scar Treatment: Two Categories
Scar treatment splits along the medical-cosmetic line. Where a scar causes a functional problem, such as restricted movement, pain or a contracture, treatment to correct it is medically necessary and covered. Where the aim is purely to improve appearance with no functional issue, it is cosmetic and not covered.
Function is the test: a scar that limits movement or causes pain is a medical matter; a scar that only bothers you cosmetically is not. The clinical findings decide which category your treatment falls into.
Getting Cover Right
- Chronic wounds: covered as treatment, including dressings and prescribed home nursing.
- Functional scar correction: covered where a documented functional problem exists.
- Cosmetic scar treatment: not covered where there is no clinical issue.
- Approval: request a written cost commitment for planned scar surgery that straddles the line.
For anything on the boundary, the specialist’s documentation of the functional problem is what turns a contestable claim into a covered one, so build that record before requesting approval.
Frequently Asked Questions
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