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Basic legal level: What does the statutory health insurance company pay?
Find out which services are covered by your health insurance company and which are not. A detailed overview of the health treatments that are covered and those for which you must pay out-of-pocket.
Basic legal level: What does the statutory health insurance company pay?
The statutory health insurance companies in Germany must finance certain basic health treatments for their insured persons. A recently planned law, the Health Care Strengthening Act, stipulates that homeopathy will continue to be paid for by health insurance companies. The services that statutory health insurance (GKV) typically covers include classic doctor's visits, medical treatments, standard vaccinations and the treatment of serious or long-term illnesses.
The exact regulations as to which costs the health insurance companies must cover are determined by the Social Security Code. The insured persons are entitled to appropriate medical treatment that meets their needs and is economically justifiable. However, there is no specific requirement regarding certain services, as the coverage of various services can vary depending on the health insurance company.
Health insurance companies typically cover the costs of the majority of medications, although a co-payment must be made. For inpatient treatment in the hospital there is usually a co-payment of 10 euros per day, whereby accommodation in a shared room and general care services including meals are guaranteed. Specific rules for reimbursement by health insurance companies apply to psychotherapeutic treatments, glasses or contact lenses, and cosmetic procedures such as bleaching.