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Co-payments

Your overview of co-payments in statutory health insurance

With co-payments, you contribute financially to certain healthcare services you use under statutory health insurance (GKV). Co-payments are in addition to your insurance contributions and are intended to encourage personal responsibility within the insured community.

Co-payment rules at a glance:

A co-payment of 10% of the price applies, with a minimum of €5 and a maximum of €10. In any case, the co-payment never exceeds the actual cost of the item.

Examples:

  • Medication price €12: co-payment €5
  • Medication price €80: co-payment €8
  • Medication price €150: co-payment €10
  • More information about medications and dressings can be found here.

    Insured persons receiving out-of-hospital intensive care at home or another suitable outpatient location (e.g., assisted living) pay 10% of the costs plus €10 per prescription, limited to 28 days per calendar year.

    Insured persons cared for in a nursing home or shared accommodation pay €10 per day for a maximum of 28 days.

    More information about out-of-hospital intensive care can be found here.

    Travel costs may include, for example, emergency transport to the hospital or patient transfers. A co-payment of 10% of the cost applies, with a minimum of €5 and a maximum of €10 per trip.

    Exception: For certain recurring trips (e.g., oncology chemotherapy or radiation therapy), co-payments apply only to the first and last trip.

     

    Examples:

  • Taxi transport €60: co-payment €6
  • Ambulance €654: co-payment €10
  • Rescue helicopter €1,042: co-payment €10
  • Important to know:

  • Co-payments for travel apply only to children and adolescents under 18.
  • Co-payments apply for ambulance, emergency physician, air, and water rescue services—even if no transport takes place.
  • More information on travel costs can be found here.

    A daily co-payment of 10% of the costs applies, with a minimum of €5 and a maximum of €10.

    Examples:

  • Loss of earnings per day €89 net: co-payment €8.90
  • Support from social service per day €125: co-payment €10
  • More information on home help can be found here.

    A co-payment of 10% of the costs plus €10 per prescription applies. For home nursing, the 10% co-payment is limited to the first 28 days per calendar year.

    Example:

  • Prescription cost €10 and putting on/taking off compression stockings €2.63 per day: co-payment €10.26
  • More information on home nursing can be found here.

    A co-payment of 10% of the costs plus €10 per prescription applies. The 10% co-payment is limited to the first 28 days per calendar year.

    Example:

  • Prescription cost €10 and physiotherapy €21.11 per session: co-payment €12.11
  • More information on remedies can be found here.

    A co-payment of 10% of the price applies, with a minimum of €5 and a maximum of €10. In any case, the co-payment never exceeds the actual cost of the aid.

    Examples:

  • Compression stockings €96: co-payment €9.60
  • Incontinence diapers €11.50: co-payment €5
  • Important: For consumable aids (e.g., incontinence diapers), the co-payment is limited to €10 per month, and there is no minimum of €5.

    More information on medical aids can be found here

    A co-payment of €10 per day applies, limited to a maximum of 28 days per calendar year.

    Examples:

  • Hospital stay 2 days: co-payment €20
  • Hospital stay 31 days: co-payment €280
  • More information on hospital treatment can be found here.

    A daily co-payment of 10% of the costs applies, with a minimum of €5 and a maximum of €10.

    Example:

  • Group therapy €36 per day: co-payment €5
  • A co-payment of €10 per day applies.

    Examples:

  • Inpatient rehab/preventive stay 10 days: co-payment €100
  • Hospital stay 10 days and follow-up treatment 31 days: co-payment €280
  • Important: For follow-up treatment immediately after a hospital stay, the co-payment applies for a maximum of 28 days in total.

    More information on inpatient preventive and rehabilitation measures can be found here.

    Co-payment exemption

    In certain cases, you can be exempted from co-payments. The conditions and how to apply for an exemption are explained on the page:

    To co-payment exemption

     

    Use the co-payment calculator to easily check whether you may be exempt from co-payments. This depends on the so-called co-payment limit.

    To co-payment calculator

    Do you have questions?

    Your personal SBK consultant is also available to advise you on co-payments. Use our SBK Consultant Search to get in touch.

    0800 072 572 572 50

    Mon - Fri | 8 a.m. - 6 p.m. toll-free within Germany 

    0800 072 572 587 00
    Mon - Fri | 8 a.m. - 8 p.m. toll-free

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