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Advantages and disadvantages of the cost reimbursement methods in case of planned treatment as if you had statutory or private health insurance in Germany

Both variants entail advantages and disadvantages. You will find an overview below of the areas in which these are to be found as a rule. We will be happy to answer any queries you may have.

Regulation (EC) No 883/2004 (treatment as a patient with statutory health insurance in Germany)

Advantages Disadvantages
You may receive benefits beyond the range of benefits available in your home country, if they are covered by the range of benefits according to the German law. You always (thus for every out-patient or in-patient treatment) need prior authorisation from the health insurance fund of your home country.
Costs incurred do generally not exceed the co-payment applicable to persons with statutory insurance according to the German rules. An entitlement only arises when a prior authorisation has been granted.
Costs are settled directly between the healthcare provider and the healthcare insurers involved. You may only consult healthcare providers with a contract, e.g. doctors, dentists and hospitals having entered into a contract with the statutory health insurance in Germany. Your entitlement is limited to benefits within the range of benefits of the German statutory health insurance.
In cases of malpractice you will be treated like a person insured with the German statutory health insurance system.

Since the health insurance fund of your home country does not have a contract with the German healthcare provider, it will not be able to assist you directly in cases of malpractice.
No costs will incur for translations of invoices.  
If the treatment costs that are covered by health insurance in Germany are lower than the costs that your insurance in the home state would have covered, you may request a reimbursement for the share which you have paid from your healthcare insurer. The competent healthcare insurer may also be able to reduce the amount of the reimbursement by any co-payments that you would have had to pay had the treatment been carried out in the home state.
 
   

Directive 2011/24/EU (treatment as a patient with private health insurance in Germany)

Advantages Disadvantages
You may also consult private healthcare providers (e.g. private doctors and private hospitals) in Germany. Costs may exceed the amount that is reimbursed by the healthcare insurer of your home country.
The range of benefits you may receive is not limited to those benefits that persons with statutory health insurance in Germany may receive. You will thus be able to receive benefits that are covered by the range of benefits in your home country, but that are not covered in Germany. You will initially have to pay the costs yourself and you will only subsequently receive reimbursement of a part of the costs.
In many cases, prior authorisation is not necessary. Your healthcare insurer may be able to require you to have the invoice translated at your expense if the invoice was not issued in the national language of your home country.
If no prior authorisation is required, you may quickly receive healthcare services. Liability and warranty claims are exclusively governed by the German legislation, and you need to pursue them under German law. Your health insurance fund cannot support you with this.
  Language problems may come up. It may be necessary to arrange for a translation of the results of prior examinations carried out in your home country, parts of your medical records or – after treatment – for a translation of results of your medical records from Germany, at your own expense.

Contact

Team EU-PATIENTEN.DE

Pennefeldsweg 12 c
53177 Bonn

Phone
+49 228 9530-802/800

Fax
+49 228 9530-801
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Information on treatment in Germany at a glance