Co-payments
Financial support from your BKK EWE
As a rule, insured persons over the age of 18 pay a co-payment of 10% of the costs, minimum €5.00, maximum €10.00. Children and adolescents (up to the age of 18) are exempt from co-payments.
Exceptional cases
- Co-payments for travel expenses must also be paid for children and adolescents.
- If the hospital copayment is not paid directly to the hospital, the hospital may charge the health insurance company a processing fee of € 8.50. This fee will be passed on to the insured person. This fee will be passed on to the insured person.
- Even if the costs were incurred as a result of an accident for which the insured person was not responsible, the amount must be paid by the insured person. Settlement with third parties, such as insurance companies by the health insurance company is not possible.
Copayment limited
To ensure that you are not excessively burdened, the co-payments are limited to a reasonable personal contribution. The individual burden limit is generally 2% of the annual gross income of all dependents living in the household for living expenses in a calendar year. For chronically ill persons who are undergoing permanent treatment for the same serious illness, the burden limit is 1% of the annual gross income for living expenses. If you exceed this burden limit, you are welcome to submit an application to us for partial reimbursement of the co-payments.
The co-payments at a glance
| Service type | Amount of the co-payment | Information and examples |
|---|---|---|
| Medicines and dressings | 10 % of the delivery price, min. € 5.00, max. € 10.00 | per drug (not exempt from co-payment) possibly plus additional costs above fixed amount |
| Home help /Sociotherapy | 10 % of the costs, min. 5,00 €, max. 10,00 € | per calendar day of performance |
| Home nursing | 10 % of the costs + 10,00 € per prescription | for max. 28 calendar days per calendar year |
| Remedy | 10 % of the costs + 10,00 € per prescription | e.g. massages, physiotherapy |
| Auxiliaries /Consumables | 10 % of the delivery price, min. € 5.00, max. € 10.00 | e.g. hearing aids, wheelchairs, prostheses; consumables 10 % per package, max. 10 € for the monthly requirement, possibly plus additional costs above fixed amount |
| Hospital treatment | 10,00 € daily (if necessary 8,50 € handling fee once per hospital stay) | for max. 28 days per calendar year, no co-payment for partial inpatient and outpatient hospital treatment |
| Medical prevention/rehabilitation service | 10,00 € daily | in case of follow-up rehabilitation for max. 28 days per calendar year (crediting of hospital co-payment) |
| Travel costs | 10 % of the costs, min. 5,00 €, max. 10,00 € | per trip (outward and return) in the case of outpatient treatment, travel costs are only covered in exceptional cases after prior authorization |
Published on: 29.03.2022 - Last modified on: 08.02.2023
