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English Insurance & Service Services Recovery Co-payments and reimbursement Co-payments

Co-payments

Your overview of co-payments in statutory health insurance

You get most services from doctors and therapists directly through your SBK health care card. Sometimes you have to pay part of the costs for these services yourself – this part, which is governed by law, is called a co-payment. Get an overview here: 

Co-payment rules at a glance:

Type of co-paymentRuleNote
Medication, dressings and medical aids

Co-payment of 10% of the price, at least €5.00 and no more than €10.00; the co-payment never exceeds the actual cost of the item in each case

Examples:
Price of medication: €12.00, co-payment: €5.00.
Price of medication: €80.00, co-payment of 10% of the price: €8.00.
Price of medication: €150.00, co-payment: €10.00.
In the case of medical aids that are consumable (such as incontinence pads), the co-payment is capped at €10.00 per month and there is no minimum payment of €5.00.
Travel costs (e.g. rescue services to the hospital)Co-payment of 10% of the cost, at least €5.00 and no more than €10.00 per tripCo-payments for travel costs are incurred when rescue and emergency services are required, including rescue vehicles, emergency personnel, air and water rescues – even if no patient transport actually takes place.
Remedies and home nursing care

Co-payment of 10% of the cost plus €10.00 per prescription; in the case of nursing care, the 10% co-payment is capped at the first 28 days per calendar year.

Example: prescription for six massages, co-payment: 10% of the price of the massage plus €10.00 for the prescription
Home help, social therapyCo-payment of 10% of the cost per calendar day, at least €5.00 and no more than €10.00
Inpatient care and rehabilitation measures, medical rehabilitation for mothers and fathersCo-payment of €10.00 per dayIn the case of rehabilitation measures that take place immediately after and in connection with treatment in hospital, the co-payment must be paid for a total of no more than 28 days.
Hospital staysCo-payment of €10.00 per day, capped at 28 days per calendar year

Co-payments for children and adolescents

For children and adolescents under the age of 18, co-payments are only incurred in the case of travel costs. We will cover the full costs for all other services. 

Co-payment exemption

In certain cases you can get exemption from co-payments. The conditions for exemption can be found on the Co-payment exemption page. 

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