Special insurance cases

Please note that if the calculated start of pregnancy is before the date the contract was finalised (signed), the health insurance policy will not cover the costs of pregnancy, including prenatal care, childbirth and aftercare.

Please contact your health insurance as soon as already while planning a pregnancy or obtain alternative supplementary insurance if the costs are not covered.

A chronic disease is one that has lasted a long time or one that cannot be cured.

In case of chronic illness, it is very important to fully inform your private insurance company about it before you sign your insurance contract, as part of the health check. Otherwise, the insurance company can refuse to pay the benefit, increase the insurance premium and/or even cancel the insurance contract.

Existing chronic illnesses have no impact on your statutory health insurance.

Emotional distress is not something we 'have to deal with alone.’ Mental illnesses, however, require treatment and support. It is not always easy to distinguish between the two situations. In case of doubt, it is always advisable to seek professional help promptly.

Depending on urgency and need, there are various service providers that you can visit. Below you will find a brief explanation of the terms used, as well as information on the billing of costs incurred.

Psychosocial counselling centres and social psychiatric services are, for example, family, women's, education, life or addiction counselling centres. The social psychiatric institutions also belong to this group.

These institutions are the easily accessible services for people seeking help in short-term crises and problems. They usually do not offer treatment programs there, but the specialists in the institutions can often advise and provide emotional support to those seeking help until a treatment program can be found.

The services of psychosocial counselling centres and social psychiatric services are often financed or subsidised by their providers, so that the counselling services can be used cheaply or free of charge. These costs are typically not covered by health insurance.

Psychological psychotherapists are licensed psychologists who have completed additional training as psychotherapists. They are able to identify psychological disorders through targeted conversations and treat them using various methods and therapy approaches (e.g. behavioural therapy, deep psychological or analytical psychotherapy).

This therapy is covered under statutory health insurance. Whether these costs are also covered by the private health insurance depends on the insurance contract. It is advisable to consult the health insurance company before starting therapy and to ensure that the costs are covered.

Medical psychotherapists are licensed physicians with psychotherapeutic or psychiatric specialist training or additional training in psychotherapy. In contrast to psychological psychotherapists, they address physical and biological causes of illness and can also prescribe medication.

Treatment is covered by statutory health insurance. Whether the costs incurred are also covered by the private health insurance depends on the insurance contract. It is advisable to consult the health insurance company before starting treatment and to ensure that the costs are covered.

In addition to licensed doctors and psychotherapists, psychotherapists offer their services who carry out their activities according to the Heilpraktikergesetz. As a rule, they have not completed any medical or psychological studies, but have completed further training as alternative practitioners.

The training and examination curricula are not legally defined, so that they differ considerably in quality and scope. Due to a lack of standards and quality assurance mechanisms, a very careful examination of qualifications and expertise is recommended when choosing a non-medical practitioner.

Psychotherapists who work according to the Heilpraktikergesetz are not allowed to treat severe mental illnesses. They are obliged to refer patients suffering from such illnesses to licensed doctors or psychological psychotherapists.

Psychotherapists who work according to the Heilpraktikergesetz (Heilpraktikergesetz - Heilpraktiker Act) usually offer help and advice in the event of crises of meaning and life, marriage or relationship problems or questions about personal or professional development (coaching).

Psychotherapists who work according to the Heilpraktikergesetz (Heilpraktikergesetz - Heilpraktiker Act) cannot bill their services to the statutory health insurance. The treatment must be paid for by the patient directly. Some private health insurance companies cover the costs; this also depends on the insurance contract and requires clarification with the health insurance company.