Get ill in Germany

Got ill in Germany - what to do?

How to get to a doctor fast. The German doctor's bill - what must it contain?


dentist germany, dentist bill Screenshot 1. (Source: Kostenfalle-zahn.de)


Your long-term insurance in Germany

As a bluecard holder or just a foreign professional with a work permit, you are most likely to have one of three types of insurance:

1: a travel insurance (Reiseversicherung) - usually if you have recently arrived into Germany or
2: a statutory health insurance (gesetzliche Krankenversicherung) or
3a: a private health insurance (private Krankenversicherung), especially if you are self-employed or
3b: a voluntary insurance (freiwillge Versicherung) in a statutory health insurance company.

Notes:
- a travel insurance is only a temporary insurance. You need it to cover the period between the border crossing and the beginning of your employment (or studies).
- 3b is a more affordable alternative to 3a.

Further on in the text, if you see "health insurance", you can consider it one of three types of long-term health insurance:
- statutory health insurance for employees;
- private health insurance for self-employed persons*;
- voluntary health insurancealso for self-employed persons.

Important!
The medical services covered by a travel insurance are very moderate compared to a long-term insurance. Therefore, it is recommended to contract a long-term health insurance as soon as possible.

An acute medical case

Step 1: call an ambulance 911 when it's really serious and urgent.

By the way, ambulances in Germany are obliged to help everyone, even if it is not obvious whether he or she has health insurance.

Step 2: If you have acute toothache, call your dentst or just any dentist. Say that the pain is unbearable and ask for immediate treatment. You can simply go to the practice directly (and pray that it would be open). However, it is advisable, first of all call the practice because it helps the staff to start looking for a gap earlier.

If immigrants complain about Germany (and most of the emigrants somewhy love to insult their receiving country), one of the arguments is: "in Germany I have to schedule a visit to the doctor several weeks or months in advance. And what if I have acute pain?"
I find such complaints just stupid. If you have acute pain, just call your doctor or even come without calling if you know for sure that the practice is open. A German doctor is not a monster. He also has empathy and mercy. He will find the time to perform painkilling treatment between scheduled patients.
.

Step 3: Clarify your own cost share. Show the doctor your insurance card before the treatment. So the doctor knows what is covered by your health insurance and what is not. By the way, the painkilling treatment is covered by any insurance, even with moderate services.

Some travel insurances companies (especially which were purchased not in Germany) require you to first pay the doctor's bill yourself, then send the original bill to the insurance company and hope that the insurance company will cover the bill.

Tip: Choose an insurance company where you do not have to pay in advance. This means that doctors have to invoice the insurance company directly.

The dentist bill - what must it contain

The dentist bill explained in simple terms.


dentist germany, dentist bill Screenshot 2. (Source: Kostenfalle-zahn.de)

This information presented by German Consumer Protection (Verbraucherzentrale). Complete original version in German here: https://www.kostenfalle-zahn.de/die-zahnarztrechnung-was-muss-drauf-stehen-22227

1: Invoice header

The following information must always be included in the header of the dental invoice: name of dentist, name of patient, invoice date.

An invoice number does not have to appear on the invoice. The dentist does not have to note the diagnosis either. However, if the diagnosis is required for reimbursement by your private insurance company, the dentist is obliged to indicate a diagnosis.

If the invoice does not come from the dentist

More and more dentists are not billing themselves, but are instead hiring external billing agents. These send the invoice under their own name and are also the payee. However, this can be problematic for medical confidentiality, as the dentist must pass on your personal patient data to the billing company so that the latter can issue the invoice.

Important!
Before the invoice is issued, the dentist needs your written consent that you agree to the transfer of your treatment data to the billing company. If, on the other hand, you do not give your written consent, you as a patient are entitled to refuse payment to the billing company.

2: Medical services

2a Date of treatment;
2b Teeth;
2c Quantity;
2d Fee no.;
2e Service;
2f Factor (rate of increase);
2g Justification for the rate of increase;
2h Single amount.

3: Invoice amount, material and laboratory costs, Bema fee

Invoice amount

Each invoice must show a total invoice amount, which includes the following items and lists them individually, where applicable:

- Doctor's fee;
- Deduction of cash portion after Bema fee (see below);
- Material and laboratory costs;
- Costs for compensation and expenses.

Before starting treatment, you should obtain a written cost estimate (including the rates of increase (Steigerungssätze)). This will allow you to compare the invoice later and provide you with proof if the amount differs from the previously mentioned costs.

Notes:
- The cost estimate and the final invoice may differ by a maximum of 20% if there were unforeseen difficulties;
- Medical services are generally exempt from VAT. Exception: cosmetic treatments (e.g. bleaching).

Material and laboratory costs

In addition to the actual dental fee, the patient will be invoiced for material and laboratory costs in addition and depending on the work involved.

The costs for material and laboratory are added separately to the dentist's fee at the end of the invoice. The material costs must be accompanied by the patient's own receipts, which provide information on the type, quantity and price of the material used.

Important!
If dental technical services were ordered, a corresponding invoice from the third-party laboratory or a receipt from the practice's own laboratory must be enclosed.

Bema fee

The assessment standard for dental services (short: Bema) is the basis for billing for services of the statutory health insurance. In some dental bills, such as those for fillings, you may find a reference to a Bema amount that is deducted from the invoiced amount.

This is because the statutory health insurance companies also cover at least part of the costs of higher quality fillings (e.g. plastic in the posterior region) for which the patient receives a private invoice. This is the amount of the comparably cheapest filling formed in the tooth. The invoice amount is therefore reduced by the Bema amount.

Example: (screenshot 1) 13b Bema is the deduction for the comparably cheapest two-layer filling.

4: GOZ as basis for calculation

The scale of fees for dentists (GOZ) regulates the reimbursement of dental services for privately insured persons and also the amount of the bill for treatments that legally insured persons must pay for themselves. The GOZ lists the fees for all services with the simple (1.0), 2.3-fold and 3.5-fold rate of increase.


* - Blue card holders are in the most cases insured by statutory health insurance. However a private health insurance would also be possible. As soon as the price of the private insurance can be significantly higher, the question is whether is worth it? For more information, contact an insurance agent. Or write me an email.

Health insurance (gesetzliche Versicherung) - Completion Help

Go UP
30.04.20 ©️ Jaroslav Plotnikov ( All articles )
Copy & share: migwork.com/blog/ill.html