Medicines & Dressings

Medicines and dressings are often an important component of therapy, whether to treat a minor infection or a more sustained illness. We support your recovery by covering a majority of the costs of your prescription medication. This page provides important information on medicines and dressings, discount agreements, co-payment rules, what prescription colours mean and much more.

If your doctor gives you a prescription covered by health insurance, we cover a majority of the cost. You pay a small amount towards it yourself – what’s known as a co-payment. The co-payment for prescription medication is generally 10% of the sales price – at least €5.00 and no more than €10.00. You will never pay more than what the medicine actually costs. This means that medication costing less than €5.00 is exempt from co-payments. 
 

Co-payment examples:

In general, no co-payment is made in the following cases:

In addition to these cases, individuals for whom their co-payments exceed their ‘co-payment limit’ are also exempt from co-payments. This co-payment limit is equal to 2% of their gross income for the calendar year. The co-payment limit is reduced to 1% for individuals with chronic illnesses. These people can request co-payment exemption for the current calendar year. Find out more about this rule on the ‘ Co-payment exemption’ page. 

We have concluded ‘discount agreements’ with pharmaceutical companies for many prescription medicines. When your doctor prescribes you a medicine, your pharmacist will then give you a discounted preparation with the same active ingredient from a participating SBK partner. 

These cost savings allow us to provide our insurants with high-quality care at affordable prices. You can also see the benefit of these savings specifically in the stability of your contribution rates. 

Your SBK consultant can provide you with information on our current discounted medicines.

In exceptional cases with a legitimate medical reason, your doctor can still prescribe you a specific medicine by crossing the ‘Aut idem’ (a Latin term used by medical professionals that means ‘or the same’) box on the prescription. So don’t worry: no SBK insurant will be forced to take medicines to which they have an intolerance or to pay for necessary medicines out of their own pocket.

The fixed amount is the maximum amount that statutory health insurers – including SBK – are permitted to cover for a prescribed preparation. Fixed amounts for medicines are defined by the National Association of Statutory Health Insurance Funds and are binding for all statutory health insurers across the board. 

If the price of a medicine as defined by the manufacturer exceeds the fixed amount, the patient must pay the difference out of their own pocket, in addition to the co-payment. The difference therefore represents an additional cost. In this case, you can ask your doctor to prescribe an alternative that would not come with additional costs, as such alternatives do generally exist.

As an SBK customer, you are entitled to a supply of prescription contraceptives until the age of 22 (i.e. until the day of your 22nd birthday).

The following contraceptives are available on prescription (pink version):

How to obtain contraceptives:

The gynecologist's office will issue you with an appropriate health insurance prescription. The preparation itself and the medical service will be billed - quite simply for you - via the SBK healthcare card.

Pharmacies have the option of offering the following additional services to patients with statutory health insurance, which we will cover:

Pharmacies that offer one or more of these pharmaceutical services can be found in the ApoGuide of the German State Chambers of Pharmacists.

We cover most of the costs for prescription medication - you only pay the statutory co-payment.

Simply present your doctor’s prescription to your pharmacist. You will then be given the prescription medication or dressing and pay the statutory co-payment. If the price of the medicine exceeds the fixed amount for statutory health insurers for this medication, you pay the difference from your own pocket. But your doctor will generally be able to prescribe you an alternative preparation that does not come with additional costs. 

You cover the cost of non-prescription medication and private prescriptions yourself. As a statutory health insurer, SBK is not allowed to cover these costs for you.