What your insurance covers
From January 2027 the German statutory health insurance austerity act takes effect — changing the margins of outpatient care. We believe you have a right to know what you are entitled to. This page lists it — completely and without ulterior motive.
What you are entitled to
- Cancer screening: yearly genital examination from 20, Pap/HPV by age scheme, breast palpation from 30, mammography screening 50–75 (invitation), from 45 actively possible
- Pregnancy: complete antenatal care incl. three basic ultrasounds and all guideline labs
- Contraception: prescription methods until your 22nd birthday; counselling always
- With symptoms: every medically indicated diagnostic and treatment — ultrasound, labs, clarification. "Statutory patient" does not mean waiting-list medicine
- Vaccinations: HPV to 17 (catch-up partly to 26, insurer-dependent), influenza, others per STIKO
- Chronic conditions: endometriosis, PCOS, menopausal symptoms with disease value — diagnostics and guideline therapy are covered
What changes in 2027 — and what does not
The austerity act tightens budgets and intensifies efficiency audits — but it does not cut the benefits catalogue above. What changes for practices: tighter quarterly budgets, more documentation duties, less scheduling leeway. What we make of it you can follow on our reality-check page: digitalising routine so medicine keeps its time.
Our promise is simple: we will never sell you a covered service as a private one. If you are entitled to something, we tell you — even if the practice budget gains nothing. And where a service truly is not covered, we tell you beforehand in writing, with the price, so you decide freely.
Your rights as a patient
- Second opinion: before plannable procedures you are entitled to an independent second view — we actively support it
- Access: your findings belong to you; you receive copies of your file on request
- Appointment service (116 117): arranges specialist appointments within deadlines for statutory patients
- No service against your will: screening too is an offer, not a duty — informed decision also means: no is a valid answer
Frequent questions about insured services
Do I have to buy extras to be well cared for?
No. Statutory medicine covers what is medically necessary — that is its legal mandate, and 2027 does not change that. Extras can offer comfort or extended diagnostics; necessary for good care they are not.
Why do I get some examinations only once a year?
Because the catalogue intervals rest on studies, not thrift — more frequent examinations without cause demonstrably do not improve outcomes. With any indication, the interval does not apply anyway.
What if the insurer rejects a service?
You can appeal — and we support you with reports and justifications. Many rejections fail on formalities, not on the medicine.
Will you treat statutory patients worse because of the act?
No — and that is not a platitude but the core of our practice model: digitalise routine so consulting time suffices for everyone. Whether we succeed you can verify with real numbers on the reality-check page.
Your question not here?Write to us — directly and securely via the online reception.
Ask your questionUnsure what you are entitled to?
Ask us — with us, the answer to "does insurance pay?" comes before the service, not on the invoice.
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