Who pays for the doctor consultation?
National health doctor (NHS doctor)(Kassenarzt)
A NHS doctor (national health general practitioner)(Kassenarzt) is a doctor, who has a contract with one or more statutory health insurance companies. In the contract with the health insurance company,
the medical services covered by the health insurance company, are stipulated.
The medical insurance pays the doctor. For certain medical services, you may possibly have to pay yourself, because they are not covered by the health insurance company.
You doctor must inform you in advance, if you have to pay for a medical service yourself.
Doctor of your choice
A doctor of your choice does not have a contract with statutory health insurance companies.
He or she can determine his or her fee, but has to follow to the recommendations of the medical board.
You as the patient, first pay for the bill yourself. Upon application, you can get part of the cost refunded from your health insurance company. Ask the doctor of your choice in advance, how much the fee will be and how much the contract rate of the health insurance company is.
Make sure that your optional doctor gives a detailed description of all the services provided on the invoice. Flat rate invoices may be a disadvantage for you!
Private medical practice
In the case of private medical practices, there is no right for reimbursement of costs. Sometimes, doctors have a contract with a health insurance company and a “private medical practice” in addition. There is no upper or lower limit for private fees.
In any case, agree on the fee with the attending doctor before the treatment is commenced.
Health insurance companies divide the calendar year (12 months) for settlement with doctors into 4 quarters (of 3 months each).
1st quarter January, February, March
2nd quarter April, May, June
3rd quarter July, August, September
4th quarter October, November, December
