 Diagnosis & Therapy |
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Service |
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 Health Insurance Coverage and Legal Issues:
Non-German European Patients |
Privately Insured Non-German EU PatientsIn general, the situation for privately insured EU patients is similar to that of privately insured German patients. In principle, patients are entitled to full cost coverage. Thanks to increasing "Europeanisation", most health insurance companies do not differentiate between treatments that a patient receives at home or abroad. However, please note that in the majority of cases, the reimbursement is limited to the amount that the treatment would have cost at home. In addition, coverage exclusion(18) for treatment abroad may be stipulated in some insurance contracts - it is important to keep that in mind.
18) coverage exclusion = Leistungsausschluss |
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We recommend that you send your health insurance company a cost estimate prior to treatment. |
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State-insured Non-German EU Patients with a Private Supplementary InsuranceGenerally speaking, supplementary private insurance covers treatment needs beyond those covered by basic state coverage. However, the basic coverage in some EU countries is so high that the private supplementary insurance companies there are willing to cover the entire treatment cost in Germany - for example at the Alpha Klinik. Having said that, it is not possible to make general statements concerning cost coverage in such situations, as they vary from insurance contract to insurance contract, as well as from country to country. |
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Non-German EU Patients with State Health InsuranceIn this case, we would like to refer to a ruling by the European Court of Justice (case: C-157/99, Smits vs. VGZ) from July 2001 that allows for treatment abroad under certain circumstances. And in the case of such a treatment abroad, it does not matter whether the treatment is provided by a public or by a private clinic. According to the ruling, state health insurance organisations must approve treatment in Germany provided that: i) the planned treatment meets international medical standards and ii) that treatment or an equally effective one is not available in time in a domestic medical facility. |
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More articles about insurance and legal affairs:
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