Does the health insurance pay?

Cost of treatment

Pilonidal Sinus-OP-costs
First class treatment for all

Pit Picking and Pilonidal Sinus Laser OP: Treatment costs

We are approved by all statutory and private health insurance companies!

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

Germany

Statutory Health Insurance

Examination and operations for sinus pilonidalis
  • 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 exclusive care contracts in accordance with integrated care (IGV) with a number of statutory health insurance funds, especially BKKs. We can offer patients of these health insurance companies additional inclusive services. For example, the Pilonidal Sinus laser surgery costs are included in the IGV. If there is some lead time before the appointment, you can also apply to your health insurance company for individual approval and thus enjoy these benefits.
  • 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 handling of the liquidation to MEDAS, you can also fill in the consent form in advance.

Patients resident in the European Union

Europe

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

Non Europe

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.

Should the pandemic ever end, you can combine your treatment with a short holiday in the state capital Munich with its attractive shopping facilities, inviting gastronomy, cultural treasures and scenic surroundings.

Accepted means of payment