Apply for cost coverage for measures to induce pregnancy

Normally, the procedure is as follows:

• If your fertility treatment has a chance of success, your gynaecologist will usually refer you to a fertility center.
• The fertility center will draw up a treatment plan.
• The treatment plan serves as an application for cost sharing.
• You can submit the application by post and - with many statutory health insurance companies - online or in person at the office.
• Send the completed sample form of the treatment plan with both copies as well as any other required documents by post to the health insurance company of the woman and the man (if you are insured with different health insurance companies).
• The health insurance company will check your application and issue you with a cost coverage certificate.
• The authorizations are issued on forms and hard copies.
• You give the cost coverage certificate to your doctor.
• Your doctor will bill your health insurance fund directly via your electronic health card. You will receive an invoice for your own contribution.

• Your doctor has diagnosed you with a fertility disorder. This means that you are unable to conceive naturally.
• Your doctor confirms that fertility treatment has a chance of success.
• Both partners are married.
• Only your own egg and sperm cells may be used. The statutory health insurance companies cannot cover artificial insemination with sperm or egg donation from a third party.
• If you are a woman, you must be at least 25 years old and no older than 39.
• If you are a man, you must be at least 25 and no older than 49.

• Original treatment plan with a copy from the attending physician or fertility center.

Depending on the special case, further documents may be required. Please contact your health insurance company for more information.

You do not have to pay anything for the application.

You must submit the application before artificial insemination or cryopreservation of your sperm or eggs.

Processing normally takes around 3 to 14 working days.

In order to process and decide quickly, your health insurance fund must have the necessary information and any required documents in a complete and meaningful form.

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.

The Medical Service may need to be involved. This can then lead to a processing time of up to 5 weeks.

• § 27a Fünftes Buch Sozialgesetzbuch (SGB V)
• § 8 Zweites Gesetz über die Krankenversicherung der Landwirte (KVLG 1989)

• Contradiction
• Action before the social court
  

Under certain conditions, you can receive further grants from the federal government and some federal states, for example if you are in a same-sex relationship or are unmarried. Information on this can be found on the "Information portal on the desire to have children" of the Federal Ministry for Family Affairs, Senior Citizens, Women and Youth.

In addition to the statutory subsidy of 50 percent of the costs of approved artificial insemination measures, health insurance companies can regulate higher subsidies in their statutes. Simply contact your health insurance provider for advice.

06.05.2025