Fertility treatment costs and health insurance coverage at TFP Kinderwunsch Düsseldorf

Treatment scenarios for private payers

Each course of treatment is unique to the patient. All steps, complete with implicated costs, will be discussed and agreed upon during consultations prior to the treatment starting.

Here are some sample scenarios to help to give you a ball-park figure of the price range of treatments available.

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 (which, depending on the health insurance, is up to 100%).

State support

The financial aspect often plays an important role in moving forward with fertility treatment. In Germany, couples looking to go down this route to concieve a child can apply for state support, as well as possibly taking advantage of statutory or private health insurance support.

Conditions and offers vary between states. Find more information on state support here.

Statutory health insurance

Despite a 2004 law which stated otherwise, more and more statutory health insurances in Germany are offering 50-100% funding for fertility treatment.

Pop in and ask us for any advice, or get in touch with your health insurance provider directly to see what criteria they have.

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 an 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 himself, about the medical, psychological and social aspects of artificial insemination.

• In the case of ICSI treatment, 2 current spermiograms (at least 12 weeks apart) must be available which meet the ICSI criteria. The sperm is assessed in accordance with 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 ("causation principle").

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.

Knappschaftsversicherung (Miner's insurance)

Miner's insurance, or 'the Knappschaft', will cover up to 500 EUR of the co-payment for each attempt. This applies for up to three treatment cycles, all treatment measures and for up to eight spontaneous cycle inseminations.

However, there are certain conditoins that must be met. These are:

• Both spouses must be insured with Knappschaftsversicherung

• Both parties must also be 25 or over

• However, the women must be under 40 and the man under 50

• The egg and sperm cells of the spouses must be used

Find out more here: www.krankenkasseninfo.de

Additional health insurance coverage benefits

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.