Do you live in Germany, you are covered by a German Statutory Health insurance and you aim to get medical treatment abroad? Which rights and duties do you have?
If you have statutory health insurance, you can also receive treatment within the European Union. Let’s take a common example: if you want to have your teeth fixed in a neighbouring country because it is cheaper there then in Europe, you should be aware of the following facts:
Certain services – such as dentures or cures – must be approved by the health insurance fund beforehand, as is the case with treatment in Germany. In the case of dentures, a cost estimate, the so-called treatment and cost plan, must be submitted to the health insurance fund, otherwise it will not cover the costs. This requirement was confirmed by the Federal Social Court (Case No.: B 1 KR 19/08 R) on 30 June 2009. Planned hospital stays – with the exception of emergencies – must also always be approved by the competent health insurance fund.
Even if the upcoming outpatient treatment abroad does not require authorisation, it is advisable to contact the health insurance fund before the start of the trip in order to obtain detailed information about benefits and possible cost coverage. There are various possibilities of cost assumption or cost reimbursement. The health insurance fund advises insured persons on the most favourable alternative.
Have you forgot doing one of the above-mentioned steps and you are now facing legal problems against your health insurance? Get in touch with our team of international medical and insurance law experts.