If you have statutory health insurance, you have to pay part of the costs of certain services - for example, hospitalization, medicines or remedies such as physiotherapy - yourself, the so-called statutory co-payments. However, you only have to pay these co-payments up to the so-called burden limit, after which you can be exempted. To do this, you submit an application to your health insurance company.
The burden limit is 2 percent of your annual gross income for living expenses. If you are seriously chronically ill, the burden limit is 1 percent. You prove your serious chronic illness by means of a medical certificate (sample 55). Further proof may be required. Your health insurance company will inform you about this.
If you are married, live in a registered partnership or have underage children or children with family insurance and live with them in the same household, the co-payments and income of all dependents are added together. Allowances for the members of your household are deducted from the family income, so that your family income to be taken into account is reduced.
You have to make co-payments for certain medical services that are covered by your statutory health insurance. These include:
- Home nursing care
- Remedies such as massages or physiotherapy
- Aids such as wheelchairs
- Inpatient hospital treatment
- Inpatient rehabilitation or preventive measures
- Travel costs
Not all costs for medical services are considered co-payments. Co-payments do not include, for example, your own contribution or additional costs for dentures, medical services without a doctor's prescription or individual health services.