Fertility treatment costs and health insurance coverage

State support

We know that finances can play a huge role in deciding upon fertility treatment. Luckily, in Germany, couples looking to go down this route may be eligible for state support, as well as possible partial coverage of the costs by statutory or private health insurance.

Rules will differ across states, as will the financial compensation offered. Find more information on state support here.

Statutory health insurance

Although a law was passed on 1 April 2004 stipulating that those with statutory health insurance have to bear 50% of the costs of infertility treatment themselves, more and more statutory health insurance companies are now granting higher or even full cost coverage if certain criteria are met. The health insurance funds regulate such additional cost coverage in their statutes. The conditions for additional cost coverage and the amount of additional cost coverage are also regulated there.

Couples who are not married can also be reimbursed on a pro-rata basis. It is therefore best to ask your health insurance company individually for information on which costs your health insurance company will cover. Please also ask your health insurance company about the conditions and the amount of the additional costs covered.

We will be happy to advise you in a personal conversation about which costs you can claim from your health insurance.

Prerequisites for cost coverage with statutory health insurance

Before treatment begins, you must have a cost and treatment plan approved by your health insurance company. This will be issued to you by your doctor at the fertility centre after checking the criteria listed below. The statutory health insurance fund is only obliged to pay benefits if the following conditions are met:

• The patients must be married to each other

  
  

• The wife and husband must have reached the age of 25 before the start of therapy. The wife must not have reached the age of 40 at the start of therapy, the husband must not have reached the age of 50

  
  

• The wife must have immune protection against rubella and both spouses must have a negative HIV test

  
  

• The couple must have previously been advised by a doctor who does not perform the procedures themselves, about the medical, psychological and social aspects of artificial insemination

  
  

• In the case of ICSI treatment, two current spermiograms (at least twelve weeks apart) must be available which meet the ICSI criteria. The sperm is assessed according to the valid WHO guidelines

  
  

• Neither the wife nor the husband may be sterilised.

If you as a couple do not fulfil the above-mentioned requirements, only private billing of the fertility treatment is possible.

Private health insurance

Private billing applies if the couple is privately insured or one of the partners is privately insured and the childlessness is caused by him/her.

In the case of private billing, we will conclude an individual fee contract with you. Reimbursement of the costs by your private health insurance or other reimbursement agencies (e.g. allowance, etc.) may not be guaranteed, or not to the full extent.

Before you start treatment, we will inform you about the costs. You will receive a detailed cost estimate from us in advance according to the "Gebührenordnung für Ärzte (GOÄ)".

Private billing for services is also necessary in the following cases:

• The couple does not meet the requirements for cost coverage by the statutory health insurance.

  
  

• The benefits of the statutory insurance have been exhausted.

  
  

• Measures are carried out that are not part of the benefits of statutory health insurance.

Additional benefit of the health insurance funds

Many health insurance companies cover the costs of your own contribution under certain conditions.

Under the following link you can find out which health insurance company covers which costs: www.krankenkasseninfo.de

The statutes of the health insurance funds often differ. Please contact your health insurance company for more information.

Treatment scenarios costs for private payers

The fertility treatment for each of our patients is tailored to their needs and their situation. Treatment costs are discussed with the couple before treatment begins.

We have put together some example scenarios to illustrate the price range of the treatments we offer and to help you find your bearings. We can discuss your individual situation in a personal consultation. Talk to us!

The co-payment for the couple, excluding medication and additional services, is around 2.400,00 EUR per cycle. The individual co-payment depends on the co-payment rate of the health insurance (depending on the health insurance up to 100%).