Costs
The costs of basic examinations for those who wish to have a child are covered by the health insurance funds. The same applies to a limited extent to simple forms of therapy such as cycle monitoring. It is more difficult with regard to reimbursement of costs for assisted reproduction procedures. These are insemination treatment and IVF or ICSI therapy. These are paid pro rata by the health insurance funds under certain conditions.
However, if the general requirements for funding by health insurances are not met, treatments might be still possible as self-payment. Conditions should be discussed with our medical staff.
Requirements for cost sharing by the statutory health insurance funds
The couple must be married. Only sperm and eggs from the spouses are used. The age of the woman is between 25 and 40 years, the age of the man between 25 and 50 years. There must be a medically determined infertility and there must be sufficient prospects of success with treatment.
Services covered by statutory health insurance companies
50% of the treatment and medication costs incurred are covered (according to Section 27a SGB V). Individual health insurance funds voluntarily pay a higher share of the costs, but they are not legally obliged to do so.
The following treatments are subsidised:
- 8 treatment cycles of intrauterine insemination treatment without prior ovarian stimulation
- 3 cycles of intrauterine insemination treatment with preparatory ovarian stimulation treatment
- 3 cycles of IVF or ICSI therapy
Services covered by private health insurance companies
The regulations of the private health insurance companies are very different. The prerequisite for assumption of costs or participation in the costs of treatment and medication is that an organic cause for the infertility has been found in the insured person. The so-called "causer pays principle" applies here. This means, for example, that in the case of male infertility, the man's private health insurance covers all the costs of therapy, even if the woman has statutory insurance.
The age limits and the number of treatment attempts vary depending on the insurance contract.