Patients with German statutory health insurance

Costs for patients with German statutory health insurance

Usually, diagnostics (exceptions) and therapy (exceptions) are free of charge for SHI patients, as long as no artificial insemination is performed. This includes, for example, hormonal stimulation alone in preparation for domestic intercourse (VZO intercourse to the optimum), or such diagnostic methods as laparoscopy or HSSG (contrast medium sonography).

Artificial insemination

Since the health reform of January 1, 2004, patients with statutory health insurance are subject to certain mandatory requirements concerning the reimbursement of costs for artificial insemination methods.

The primary condition is that the treatment centre must be licensed by the health authority of its federal state.

If artificial insemination (insemination, IVF or ICSI) is planned, the patient must first submit an application for confirmation of coverage to the health insurer.

The health insurers will cover up to 50 % of the costs for each of the following

  • up to eight inseminations without stimulation (this can be done with clomiphene if needed),
  • up to three insemination cycles with hormonal stimulation (Gonal F, Puregon, Menogon)
  • three IVF or three ICSI cycles

The coverage is conditional on the following:

  • The couple must be married to each other.
  • The wife must be at least 25 and no older than 39 years old.
  • The husband must not be older than 49.
  • IVF and ICSI

Approximately 1100.00 to 2200.00 Euros (depending on the medications required)

What are the anticipated costs per cycle?

  • The costs for insemination in a stimulated cycle total 150.00 to 500.00 Euros, depending on the medications required. However, in individual cases, the costs may be much higher if the hormonal stimulation needs to be at a higher dose and if prolonged stimulation is required.
  • The costs to the patient for IVF generally amount to approximately 1500.00 Euros.
  • The costs to the patient for ICSI (conventional ICSI) generally amount to approximately 1700.00 Euros.

The prices listed correspond to the patient’s deductible of 50 % per cycle.

Additional benefits that are excluded from reimbursement:

  • HALO sperm test (160.00 Euros)
  • Cryopreservation of inseminated egg cells (approximately 400.00 Euros)
  • Rent for a storage period of 6 months (125.00 Euros)
  • Cryo cycles in order to transfer previously frozen inseminated egg cells (approximately 450.00 to 600.00 Euros), plus the cost of medication of approximately 100.00 to 500.00 Euros.
  • Assisted hatching (laser assisted embryo hatching): approximately 170.00 Euros
  • Polar body diagnostics: between 900.00 and 1600.00 Euros.

An application has been submitted for approval after licensing of the centre in accordance with § 27a.