Facts
The insured person [A.] , born in 1969, is insured with Helsana Versicherungen AG. He applied for coverage of the costs of H.E.L.P. apheresis for the treatment of the consequences of a Post-Covid-19 illness. Helsana Versicherungen AG denied its obligation to provide benefits. The Insurance Court of the Canton of Aargau dismissed the insured person's appeal.Considerations
The Federal Supreme Court has decided that the Insurance Court has violated federal law by denying the obligation of Helsana Versicherungen AG to provide benefits, on the grounds that the effectiveness of H.E.L.P. apheresis for the treatment of Post-Covid-19 illnesses has (not yet) been sufficiently proven. The Federal Supreme Court states that, in application of Art. 33 para. 1 HIA, it is not sufficient for the health insurance provider to cast doubt on the effectiveness (or the other WZW criteria) to reject the benefits. In the case of a lack of evidence, the statutory presumption would apply, according to which the treatment carried out by a physician is considered effective, appropriate and economic, if…