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Treatment subject to advance approval in accordance with the German legislation

The information below is intended to provide you with an overview of the treatment that is already subject to certain preconditions under German law, such as prior authorisation on the part of the competent German health insurance fund.

So that a German health insurance fund can provide a benefit in kind in accordance with German law - or is able to effect a cost refund for a medical service, it is sometimes necessary for insured parties to meet certain preconditions. These preconditions also need to be satisfied if the treatment is not to be carried out in Germany, but in another EU country.

In accordance with German law, insured parties can go to a specialist physician directly as a rule. No special preconditions apply. A 52-year-old woman can therefore also have the mammography to which she is entitled every two years carried out by a suitable specialist physician in another EU country at the expense of her health insurance fund and submit the invoice to the German health insurance fund for a refund at the German rates.

If however you wish to be treated in Germany for instance by the following groups of physicians, you absolutely must have a referral in accordance with the German legislation: laboratory medicine physicians, microbiologists and infection epidemiologists, nuclear medicine, pathology, radiological diagnostics and radiology, radiotherapy and transfusion medicine. So that your German health insurance fund can refund at least part of the treatment costs, you also need to obtain this referral before you go to such a specialist physician in another EU country.

We have compiled information for you below on specific medical services which are often deliberately taken up in another EU country by individuals who have statutory health insurance in Germany. All of these services have in common that certain preconditions already have to be satisfied in accordance with German law so that they can be provided or charged at the expense of the German health insurance funds.

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Team EU-PATIENTEN.DE

Pennefeldsweg 12 c
53177 Bonn

Phone
+49 228 9530-802/800

Fax
+49 228 9530-801
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