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If you undergo treatment in Germany provided by a healthcare provider within the framework of the European Patient Mobility Directive, the range of services provided by the doctor is not limited to those which may be provided by the healthcare provider in Germany for persons with statutory health insurance. Public vaccination programmes, organ transplantation as well as long-term care are completely excluded from the range of the Directive. If you need information on cross-border healthcare regarding these three topics, please contact your healthcare insurer.
The range of benefits provided for persons with statutory health insurance in Germany includes all medically-necessary benefits, but some benefits are excluded. These include treatment by the head doctor in the hospital, some dental and dental laboratory services or cosmetic surgery. These restrictions do not apply if you take up the benefits privately. In this case you should also clarify in advance whether your healthcare insurer might meet the costs of such treatment in Germany in full or in part. You can naturally also take up all benefits from the range of benefits for persons with statutory health insurance in Germany privately. The healthcare provider is however no longer bound in such cases by the cost rates that are applicable to persons with statutory health insurance. You may therefore also incur considerable co-payments here, too.
As a rule, the healthcare provider will require you to pay for the benefit upfront if you undergo private treatment.
As you can see by this, treatment within the European Patient Mobility Directive on the one hand offers more types of treatment than treatment with the prior authorisation of your healthcare insurer within the EC Regulation. On the other hand, there is a risk that some of the benefits provided will not be subsequently reimbursed by your healthcare insurer. Where possible, therefore, you should always obtain a cost estimate from the healthcare provider prior to undergoing treatment. This will enable you to ask your healthcare insurer in advance whether and if so what amount of the costs it will reimburse to you. You will therefore know precisely what share of the treatment costs you have to meet yourself.
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