Hospital treatment

You should discuss whether hospital treatment is necessary with your attending doctor. This can be your family doctor or a specialist. If there is no emergency, you will need a hospital referral from your treating doctor (GP or specialist) to be admitted to hospital. As a rule, you do not need to contact your health insurance fund in advance in order to be admitted to hospital.

Statutory health insurance funds

The responsibility lies with your health insurance company.

For inpatient hospital treatment, the principle of "outpatient before inpatient" applies. Insured persons are thus only entitled to full inpatient treatment in an approved hospital if the treatment objective cannot be achieved by partial, pre- or post-inpatient or outpatient treatment including home nursing care.

If there is no emergency, you need a hospital referral from your attending physician (general practitioner or specialist) to be admitted to a hospital.

Insured persons who have reached the age of 18 pay 10 euros per calendar day to the hospital from the beginning of the full inpatient hospital treatment within a calendar year for a maximum of 28 days. If, without compelling reason, insured persons choose a hospital other than one named in the medical referral, they may also be charged for all or part of the additional costs.

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• § Section 39 Fifth Book of the German Social Code (SGB V)

If the health insurance company refuses to pay the benefit, you can lodge an objection. If the objection is not upheld, you can take legal action against it before the social court.

If there is no emergency, you need a hospital referral from your attending physician (general practitioner or specialist) to be admitted to a hospital.

12.01.2021