10 tips for patients in Germany – Great tips to help Expats in Germany


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Doctors in Germany have to adhere to rules at IGeL. The health insurance benefits must not be devalued across the board, patients must not be unsettled or pressured into private services.

Germany has a great healthcare system. However, you have to be aware of the basics when you visit the doctor. When you as a patient in Germany have to visit the doctor, what should you be aware of?

  • Patients should ask critical questions, use a cooling-off period, and seek independent information or a second medical opinion.
  • Promotional advertising or scare tactics are not permitted.
  • For an IGeL, the doctor must present a treatment contract and also a cost estimate.
  • If you reject an IGeL, you do not have to sign a form.
patients in germany

1. First inform yourself, then decide

If your doctor offers you an IGeL, you don’t have to give your spontaneous consent. You have the right to ask critical questions. You have the right to a cooling off period. You can get independent information or a second medical opinion. And of course you can refuse the offer.

If you are interested in a self-payer service, the recommendation of the consumer advice centers also applies to obtain information from various sources.

2. Beware of advertising in the doctor’s office

Patients are not always adequately informed in the doctor’s office about the benefits and risks of paid services. Often there is more promotional advertising than factual information in practices or on the Internet. 

Physicians with a health insurance license are obliged to offer health insurance benefits and are not allowed to devalue them across the board. If IGeL are offered with terms such as “Large Body Check”, “Cancer Prevention Plus” or “Pregnancy Care Plus”, this is feigning inadequate benefits from the health insurance companies.

patients in germany

In fact, not every novelty is automatically better. If the doctor or at the practice reception gives you the feeling that you have not done everything necessary for your health without the chargeable additional service, you should in any case be skeptical. If fears are stoked or if a service is suggested to you without convincing justification, but with great emphasis, then doubts are appropriate as to whether the offer is a serious one. IGeL must not be imposed.

3. Doctors are obliged to provide the patient with information

patients in germany

Doctors need to give you full and understandable information about both the benefits and the possible risks of the medical service they recommend. And only doctors: According to § 630c and § 630e of the German Civil Code, patient information and education about medical measures is the sole responsibility of the practitioner. 

The healthcare professional is not allowed to provide this advice. Furthermore, doctors must inform those with statutory health insurance in advance if medical treatment is not paid for by the statutory health insurance.

You should not be afraid to ask the doctor important questions directly: What benefit does the additional treatment have for me and how well has this benefit been proven? What are the risks associated with the treatment? Why is the benefit not a cash benefit? 

In the end, however, you have to decide for yourself whether the service offered makes sense. In general, the following applies: The doctor may only act with your consent. The German Medical Association has established rules that doctors in Germany should adhere to.

4. As a patient, you have a right to reflection

Take your time with the decision. IGeL are never urgent. The doctor should give you sufficient time to think about it between the consultation and treatment. This period is important in order to obtain further information about the proposed therapy from the health insurance company, for example.

In general, before you take advantage of an IGeL offer, you should ask your health insurance company why the costs for this service are not covered. In individual cases – for example in the case of certain risk groups or existing previous illnesses – the health insurance company bears the costs if the doctor has given sufficient reasons. 

In addition, some insurance companies offer certain services outside of the catalog of services of the statutory health insurance funds as so-called statutory services. But if you have already paid privately, you will not get the money back from your fund. So don’t let yourself be rushed to agree.

5. You do not have to sign anything! No signature for a “no”

Many medical practices ask their patients to put their “no” to a chargeable service in writing on a form. The reason is usually: “Doctors should ensure that a patient cannot hold them liable for the fact that a certain treatment was not carried out.” You do not have to sign such a form. IGeL are voluntary and medically unnecessary services, the rejection of which the doctor does not have to document by means of a so-called disclaimer.

6. You have a right to a quote

You can ask for a quote before treatment so that you know what to expect financially. The doctor is obliged to inform those with statutory health insurance about the expected costs in writing.

The final invoice for the additional services may differ from the total in the cost estimate. The reason for this is that the difficulty and the time required for the treatment cannot be foreseen in advance.

7. A treatment contract is mandatory

Before treatment, the doctor must conclude a written contract with you, stating that the treatment is provided at your request and cannot be billed at the expense of the statutory health insurance. If no written agreement is made, you are entitled to refuse payment for the service.

8. An invoice is mandatory

patients in germany

Have a correct invoice issued. After the treatment has been completed, the treating doctor must issue an invoice based on the fee schedule for doctors (GOÄ) and listing the individual services. A calculation of flat fees or success fees is not permitted. Patients who pay a bill in cash after treatment should definitely ask for a receipt. You can state the costs as an exceptional burden on your tax return.

9. Check with your insurance company if you have private insurance

Anyone who is privately insured cannot assume that an IGeL service will definitely be covered by private health insurance. You should therefore check with your insurance company beforehand, otherwise you will be left with the costs. In addition, privately insured persons should also insist on a written agreement.

10. You can report dubious behavior from the practice

patients in germany

Patients must be informed about an IGeL in an appropriate and balanced manner. If you have the impression that a doctor or his team is not complying with the legal requirements, you should contact your health insurance company, a patient advice center or the consumer advice center. 

You can get rid of your anger about aggressive advertising methods, inappropriate behavior of the practice employees, cost problems and inadequate medical advice. 

Expaturm aims to help educate Expats in Germany on key issues that they will have to deal with while living in Germany by providing everything you need to know about Banking, Healthcare, Lifestyle, and Housing in Germany


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