Medical Supply Stores in the German Healthcare System

Sanitätshäuser occupy a distinctive and important position in Germany's healthcare system as the primary access point for medical aids and rehabilitation equipment. Unlike in some other countries where medical equipment is supplied directly by hospitals or through mail-order catalogues, the German system relies heavily on the Sanitätshaus as a local expert retailer that combines product supply with professional consultation, fitting, adjustment and follow-up care. A Sanitätshaus is not simply a shop: it is a certified service provider subject to quality requirements, operating with trained technical staff who are qualified to fit complex aids such as custom prostheses, functional orthoses and individually compressed compression garments. This service-oriented model is supported by the German statutory health insurance system, which reimburses Sanitätshäuser for both the product and the associated fitting service when a valid prescription is presented. The Hilfsmittelverzeichnis (aids directory) maintained by the GKV Spitzenverband lists all reimbursable aids and defines the product specifications and quality requirements that must be met.

Authorisation Under Section 126 SGB V

To be able to supply medical aids and bill statutory health insurance directly, a Sanitätshaus must be admitted as an authorised service provider (zugelassener Leistungserbringer) under Section 126 of SGB V (Sozialgesetzbuch V, Germany's Social Code Book V). Authorisation is granted by the GKV Spitzenverband (National Association of Statutory Health Insurance Funds) or by individual health insurance funds, depending on the product category. The authorisation process requires proof that the Sanitätshaus holds the necessary professional qualifications for the aids it wishes to supply, that its premises and equipment are suitable, and that it complies with the quality requirements of the relevant supply contract (Versorgungsvertrag). Supply contracts between Sanitätshäuser and health insurance funds set out the reimbursable products, prices and quality standards for each product category. Authorisation must be maintained through ongoing compliance and periodic review. A Sanitätshaus that loses its authorisation cannot bill health insurance directly.

Key Product Categories and Services

German Sanitätshäuser offer an extensive range of product categories. Orthopaedic products include custom and prefabricated orthoses for all body regions, custom-made prostheses for upper and lower limb amputees, orthopaedic footwear and insoles (Einlagen). Mobility aids encompass manual and electric wheelchairs, rollators, forearm crutches, walking sticks and stairlifts. Compression therapy covers custom-fitted compression stockings and bandaging systems for venous insufficiency and lymphoedema, which require precise measurement and fitting by trained staff. Home nursing equipment includes height-adjustable care beds, pressure ulcer prevention mattresses, patient lifts and shower chairs. Incontinence aids include absorbent products, catheters and drainage systems. Respiratory aids encompass CPAP devices for sleep apnoea and oxygen equipment. Many larger Sanitätshäuser also offer custom fitting of breast prostheses and mastectomy bras for patients following cancer treatment, an area requiring particular sensitivity and specialist expertise.

Specialisations and New Care Models

The range of services offered by modern orthotic and prosthetic suppliers (Sanitätshäuser) extends far beyond traditional medical device retail. Orthopaedic technology workshops manufacture custom-made prostheses and orthoses using painstaking craftsmanship combined with state-of-the-art CAD/CAM milling processes. Suppliers specialising in rehabilitation technology advise on electric wheelchairs, stairlifts and barrier-free bathroom design. Compression fitting by specialist staff (compression stockings class I–IV) is particularly important for patients with lymphoedema and thrombosis. Incontinence care, stoma supplies and enteral nutrition round out the portfolio of many establishments. Home delivery services and telephone consultations enable care for immobile patients. Digital measuring systems for insoles and orthoses improve fit and efficiency. The GKV medical aids catalogue lists all reimbursable products with product group numbers; suppliers must hold separate health insurance authorisation under Section 126 SGB V for each product group.