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Glossary

Statutory Health Insurance in the state of treatment

Health insurance is regulated differently in the individual Member States, as well as in Switzerland and the EEA States Iceland, Liechtenstein and Norway.

The organisation may for instance be within a National Health Fund with one single health insurance organisation or, it may be spread over many individual health insurance funds as is the case in Germany.

Benefits-in-kind or cost reimbursement

Not all of these states operate by the benefits-in-kind principle as we know it in Germany. It is typical of this principle that those with statutory insurance do not have to pay for benefits upfront.

Some states have a cost reimbursement system, so that it is customary to initially pay for benefits yourself, at least in out-patient care. The bill is then submitted to the healthcare insurer for reimbursement.

Private or statutory health insurance

Most of the states named above do not distinguish between purely private and purely statutory health insurance, as we partly do in Germany. Here, as a rule everyone has statutory health insurance. These individuals with statutory health insurance can also conclude additional private health insurance for benefits which the statutory system does not provide.

Taxes or contributions

Both forms of funding, as well as mixed forms, can be found in the statutory health insurance systems of the individual states.

The varied landscape of the individual states leads to an equally varied structure of statutory health insurance and of the benefits which it covers. In order to enable you to clarify specific questions which you may have, for instance

  • on how to exchange a form E 112 or S2, or
  • on co-payments,
  • on upfront payments, or
  • on cost reimbursements,

either on the spot or in advance by telephone or e-mail, you need the contact details for the statutory healthcare insurers in the respective states. These are the same insurers whom you should also contact in the context of treatment with the European Health Insurance Card, for instance when on holiday in the state in question. The German Liaison Agency Health Insurance – International has drawn up leaflets (leaflets entitled “On holiday in …”) for this group of individuals. The contact details of the statutory healthcare insurers are listed at the end of each leaflet. They will be glad to help you with the above questions or should you have any other questions.

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Team EU-PATIENTEN.DE

Pennefeldsweg 12 c
53177 Bonn

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+49 228 9530-802/800

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+49 228 9530-801
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