Service Finder
Receive partial reimbursement of costs in statutory health insurance
Service Description
Certain employees of statutory health insurance funds and their associations are subject to the principles of civil service law, even if they are employed under private law. If you are subject to so-called service regulations, you can opt for partial reimbursement of benefits from your health insurance fund. You can also opt for partial reimbursement of costs
- civil servants who work for a company health insurance fund or a miners' health insurance fund
- pension recipients for whom a service regulation applies - for example company pensioners.
With partial reimbursement, you pay for services that would otherwise be billed via the electronic health card on account. You submit the invoice to your health insurance fund and then receive full or partial reimbursement of your expenses.
The statutes of your health insurance company determine whether and to what extent you can choose partial reimbursement, as well as for which services and how the procedure works exactly.
As a rule, you will agree in advance with your health insurance company on the partial reimbursement of costs for a specific area of care.
Process flow
Please contact your health insurance company for information on the exact procedure for partial reimbursement of costs.
You can apply for partial reimbursement of benefits by post or - with many statutory health insurance companies - in person at the office or online.
- Submit the required documents and your bank details to the health insurance company.
- If necessary, provide the health insurance company with the account details for the reimbursement.
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The health insurance company will check your application and pay you the reimbursable amount if all requirements are met.
Requirements
You are employed by a statutory health insurance fund or one of the health insurance associations and a service contract has been concluded for you. You have opted for partial reimbursement of costs at your own request.
Partial reimbursement is also possible for
- Pension recipients of statutory health insurance funds and their associations
-
civil servants who work for a company health insurance fund or a miners' health insurance fund.
Which documents are required?
- Invoice for the medical service
- Proof of payment
In special cases, further documents may be required. Please contact your health insurance company for more information.
What are the fees?
You do not have to pay anything for the application for partial reimbursement.
What deadlines do I have to pay attention to?
You do not have to observe any deadlines for the application. How long you are bound to the partial cost reimbursement for a care area is determined by your health insurance fund's statutes. The statutory period is 2 years.
Processing duration
Processing normally takes around 1 to 4 working days.
Your health insurance company must have the necessary information and any required documents in a complete and meaningful form in order to process and decide quickly.
The health insurance company decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time stated is an average value for all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer. The same applies if documents or records are sent to you or your health insurance company by post.
Applications / forms
- Appeal against a negative decision by the health insurance company
- Action before the social court
Appeal
Forms: no
Online procedure possible: Many statutory health insurance companies offer an online procedure.
Written form required: no
Personal appearance necessary: no
Author
The text was automatically translated based on the German content.
- Partial reimbursement of costs Authorization
Remark: Display of performance in the source portal
Technically approved by
Federal Ministry of Health
Professionally released on
25.10.2021
Source: Zuständigkeitsfinder Thüringen (Linie6PLus)