Reimbursement instead of health insurance card in accordance with §13 SGB V
If you choose reimbursement, the services you use will no longer be billed directly via your SBK healthcare card. Instead, you will receive private invoices for your doctor, dentist, or hospital treatments, which you must pay yourself first. Only then can you submit the invoices to us for reimbursement.
Overview of cost reimbursement
We will reimburse you for a maximum of the costs that would have been incurred if you had used your health insurance card to claim the service. Please note that this is only part of the costs.
You can choose to have the costs reimbursed for all or only some of the following services:
Approved medical practices, therapy centers, and hospitals
You can visit any SBK contract partner. This includes all doctors' offices, dental practices, therapy facilities, and other service providers that are authorized to bill using the SBK healthcare card. You can find out whether this applies to your medical facility or clinic by calling the SBK Health Telephone.
We can only contribute to the costs of treatment provided by non-contractual partners in justified exceptional cases and with prior approval. Please be sure to speak to your personal SBK consultant before starting treatment. You can find the contact details here.
Amount of reimbursement
We will reimburse you for all costs that would have been incurred if you had used your health insurance card to pay for the service – but no more than the actual costs. Statutory co-payments are taken into account.
As processing private invoices involves more work for us, we deduct an administrative fee of five percent from the reimbursement amount – up to a maximum of 40 euros.
We can only reimburse services covered by our contract. We are not permitted to reimburse services that are not included in the statutory health insurance catalog of services, such as individual health services (IGeL).
Please note that private invoices are usually significantly higher than the standard amount covered by health insurance. You are responsible for the difference, unless it is covered by private supplementary insurance.
Approval of benefits
Please apply to us in advance for services that require approval, such as the provision of medical aids, dentures, or orthodontic treatment. To do so, please contact your personal SBK consultant.
How to participate in the cost reimbursement program
Before you can claim reimbursement for expenses, you must sign a written declaration of choice. We will be happy to advise you on the various options available and how reimbursement will affect you. Your decision to opt for this solution is valid for at least one quarter.
By the way: You do not necessarily have to choose cost reimbursement at the beginning of a quarter. It is also possible to choose to start during a quarter. In this case, the commitment period is extended until the end of the following quarter. For example, if you participate in cost reimbursement from March 8, you are bound by your choice until June 30.
Please send us the original invoices that have already been paid by post: you can find our address and a prepaid envelope here.
You are also welcome to submit your invoices online. To do so, take a photo of the documents with the Meine SBK app and upload the photos. This means we will receive your invoices immediately and can process them straight away.
For invoices for medically prescribed services—such as massages or medication—we also require the corresponding doctor's prescription.
Once we have processed your invoices, we will forward them to your supplementary insurance provider. They will cover the additional services covered by your policy. If you would like to use our free forwarding service, simply indicate this on your election form.
After the minimum participation period of one quarter, you can cancel your participation in the reimbursement program at any time. To do so, please contact your personal SBK consultant. You can find the contact details here.
