Does the health insurance pay?
Cost of Treatment
We have a full approval also of the statutory health insurance companies!
Pilonidal Sinus Surgery - Does the health insurance pay?
We often receive inquiries about whether pit picking costs and laser treatment are covered by health insurance.
The good news is: No, we are not a private practice only. All of our patients benefit from the proven advantages of minimally invasive therapy. However, the billing modalities differ according to residence and insurance status.
Patients resident in the Federal Republic of Germany
Statutory Health Insurance
- We have the full approval of all statutory health insurance companies for examination and outpatient surgery. This means that only supplementary treatments that are not included in the benefits catalogue (EBM) are individual services. Our Pit Picking technique is a fistula removal and therefore a statutory health insurance benefit.
- We have concluded care contracts with a number of statutory health insurance funds, especially BKKs, in accordance with integrated care (IGV). Patients insured with these contractual health insurers can also make use of other proctological services, such as laser treatment for anal fissure and hemorrhoids, without having to pay a co-payment.
- You do not need a referral. However, please remember to bring your current insurance card to the appointment.
Laser epilation (permanent hair removal)
For laser hair removal to prevent recurrences, we offer particularly favourable conditions and package prices for patients with statutory insurance and medical indications. Compare our price-performance ratio with other providers!
Reimbursement of costs by the statutory health insurance is not possible according to the current legal situation: "Socio-medical assessment of the facts: Epilation by means of laser or IPL BIitzlampe in the claimed indication is to be assigned to the "new" examination and treatment methods (NUB) (A "new" method is defined as services that are not included in the EBM or Bema or that are included as services in the EBM or Bema, but whose indication or method of provision has undergone significant changes or extensions). As a NUB, a treatment in the outpatient sector would only be a benefit of the statutory health insurance if it had been included in the range of services of the SHI system by a positive vote of the Joint Federal Committee (G-BA) in accordance with Section 135 (1) SGB V (reservation of authorisation). The Federal Joint Committee has not yet issued a positive recommendation on this method - which can basically be carried out on an outpatient basis - in the claimed indication according to § 135 (1) SGB V. Thus, the requested method is not a health insurance benefit. There is no situation similar to an emergency, neither in the sense of a life-threatening, regularly fatal disease if left untreated (Federal Constitutional Court: "Nikolaus decision" of 06.12.2005 - 1 BvR 347/98 and decision of 10.11.2015 - 1 BvR 2056/12), nor a "comparable disease in terms of value" (§ 2 para. 1a SGB V). A favourable socio-medical assessment is currently also not possible in individual cases." (Opinion of the Medical Service of the Health Insurance in the individual case assessment).
Private health insurance
- You will receive an invoice according to the official scale of charges GOÄ, depending on the expenditure with justification up to 3.5 times the increase rate.
- You can find our registration form for private patients on our download page.
- We have entrusted the processing of the liquidation to bfs+ Health Finance, and you can also fill out the consent form in advance.
Patients resident in the European Union
The costs can be covered by your statutory health insurance in the case of EU patients, but this is somewhat complicated.
You need an approval from your health insurance company, the S2 certificate. You can then use this form to apply for a treatment certificate from a German statutory health insurance company (e.g. AOK, Techniker Krankenkasse).
If this ID is available at the time of treatment, we can bill the insurance company directly for the operation, just as we would for a patient insured in Germany.
Alternatively, it is possible to pay for the treatment and apply for reimbursement afterwards. In this case, there is a risk that the claim will be rejected in whole or in part.
Patients resident outside the European Union
We also offer attractive rates for our high-quality special services, which are often cheaper than the fees in your home country. Payment is possible in cash or by credit card.
This way you can combine your treatment with a short vacation in the state capital Munich with attractive shopping opportunities, inviting gastronomy, cultural treasures and scenic surroundings.
Accepted means of payment
You will always receive an invoice from us after the treatment according to the rules of the official scale of fees for doctors GOÄ. You can pay this in cash and with common credit and debit cards. Patients with their main residence in Germany will receive an invoice by mail from bfs+ to their registration address.