Questions about benefits

BARMER is committed to offering flexible solutions and innovative forms of care.

Here you’ll find the answers to the most questions about our benefits.

Your first point of contact for medical treatment is your general practitioner. BARMER policyholders can choose a GP from more than 40,000 doctor’s practices in Germany. The GP’s practice also offers, for example, preventive check-ups and vaccinations. In the case of special illnesses, the GP issues referrals to a specialist doctor and coordinates further medical treatment. If you need medical help, BARMER will pay the full cost of the treatment for you – without any time Limit.
If you have to go to hospital, BARMER covers the full cost of general hospital services. For a maximum of 28 days per calendar year, policyholders over 18 years of age pay the hospital a statutory deductible of 10 euros per day. You can choose from more than 2,000 existing contract hospitals nationwide if your GP or specialist doctor has not already specified a suitable hospital for you in the hospital referral. Normally you can go to hospital with the hospital referral from your GP or specialist doctor. No special application procedure is necessary. Call the hospital to arrange a specific admission appointment. Your referring physician or the hospital will inform you if an application procedure is necessary in exceptional cases. Find a hospital to suit you with the BARMER Hospital Navigator.

If your physician prescribes medication, you will be given a prescription. Prescriptions are usually pink in colour, valid for 28 days after the doctor has issued them and can be filled at the pharmacy. In rare cases there are also yellow prescriptions, for example when strong painkillers are prescribed. These prescriptions are only valid for seven days after they have been issued by a physician and can be filled at the pharmacy. Non-refundable prescriptions are green or blue in colour and are valid for an unlimited period of time (green) or three months (blue).

You have to pay an additional amount for medications. This is 10 percent of the cost of the medication, but never more than the medication costs – at least 5 euros, maximum 10 euros. There are medications that cost even more, but your pharmacy will tell you whether there are cheaper alternatives. If you need medication regularly, you can get an exemption from the additional payment. During pregnancy, as a member of BARMER you will also receive additional medication that you would normally have to pay for privately. For individual questions, please call us on 0800 333 00 60.

In Germany, you are required by law to provide proof of health insurance. As an employee, you must give your employer your health insurance details. As a student, you will only be enrolled if you can prove that you have health insurance. So you can rely completely on your BARMER. With us you are excellently insured – we are there for you!

In all EU countries and in some other countries, the European Health Insurance Card (EHIC) helps to ensure the necessary treatment in case of an emergency. You will find this on the back of your electronic health card (eGK). So always take your electronic health card with you when you travel! There are also special foreign health insurance certificates for a few other countries.

Outside Europe, it is essential to take out private travel health insurance, as BARMER cannot provide any cover. However, additional private travel health insurance can be a good idea within Europe as well. For example, high deductibles typical for some countries (e.g. for inpatient hospital treatment), return transport, etc. cannot be charged to BARMER via the EHIC.

Homeopathy:

Homeopathic treatment is becoming more and more significant. BARMER offers its policyholders nationwide a contract with highly qualified doctors working in homeopathy. Explain that you wish to participate in this directly in the doctor’s practice and the homeopath will become your new GP. Your contact at BARMER will be happy to advise you in advance about the terms of the contract.

Acupuncture:
Acupuncture for the treatment of chronic lumbar spine pain and chronic knee joint pain caused by knee osteoarthritis is a BARMER service. BARMER covers the costs of ten acupuncture sessions with a licensed physician for these two diagnoses if the symptoms have persisted for at least six months. In justified exceptional cases, five further sessions are possible. Further acupuncture sessions for the treatment of chronic lumbar spine pain and chronic knee joint pain caused by knee osteoarthritis are covered by BARMER after twelve months. For all other diagnoses, acupuncture must be paid for privately and cannot be reimbursed.
Ayurveda:
Ayurveda treatments are not covered by statutory health insurance.

BARMER offers families particular security. For example, the legally required preventive check-ups for children and teenagers are extended by a further three check-ups. In addition, emotional, social and intellectual development is examined using special questionnaires. In the case of certain chronic or rare diseases, the paediatrician can seek telemedical advice from specialist physicians. There is also the possibility of a one-off amblyopia screening between the 5th and 27th month of life to detect health risk factors in the development of your child’s vision. The screening is carried out by a paediatrician.
We cover all legally required vaccinations in full. Which vaccinations these are is regulated in the Vaccination Directive (Schutzimpfungsrichtlinie). Your GP will be happy to advise you as to which vaccinations should be provided. It is best to present your vaccination card. In addition, BARMER pays the costs for many additional vaccinations. You can find out which these are in your specific case by calling 0800 333 00 60.

BARMER covers many different preventive tests that you can take advantage of. You do not need a referral for the tests, even if you consult a specialist. Simply present your insurance card and you will not be charged anything at all. For example:

• Health check from 35 years of age every two years by a general practitioner or internist.
• Gynaecological early detection of cancer for women aged 20 and over at a specialist in gynaecology and obstetrics. From 30 years of age, the examination also includes an examination of the female breast.
• Skin cancer screening every two years for all policyholders over 35 years of age at a GP or dermatologist. In addition, BARMER will cover a skin check by a dermatologist for all policyholders up to the age of 34. BARMER can inform you about the specific scope of services.

Physiotherapeutic treatments such as massages count as a health remedy (“Heilmittel”). Other health remedies include occupational therapy, voice, speech and language therapy, podiatry therapy for diabetic foot syndrome and nutritional therapy for rare metabolic diseases. BARMER covers the costs for all health remedies prescribed by a panel physician. Policyholders over 18 years of age pay a statutory additional payment of 10 percent of the cost of health remedies and an additional 10 euros per prescription – but no more than the actual costs incurred. The additional payment obligation also exists if the health remedies are provided in the doctor’s practice or during outpatient treatment at the Hospital.
BARMER offers you comprehensive protection when you need to go to the dentist. Children and teenagers between the ages of six and 18 should have dental check-ups twice a year to prevent dental and periodontal diseases. Adults should visit the dentist at least once a year for a preventive check-up, even if they have no acute symptoms. BARMER covers the full costs for the contractual check-ups. Furthermore, it also covers all medically necessary services for conserving treatments, surgical and X-ray services, for the treatment of temporomandibular joint diseases, fractures of the jaw and periodontal diseases. If you need treatment, contact your dentist or orthodontist directly and present your insurance card. He will advise you on the scope of the services required and any additional services to be paid for privately, and will provide you with information about the application procedure.
BARMER covers the costs of medically necessary rehabilitation measures or preventive treatments at health resorts for you. In the case of rehabilitation measures for employed persons, “Deutsche Rentenversicherung” (the German pension insurance fund) is generally the responsible agency and the application for benefits must be submitted there. In certain cases, other social insurance agencies may also be responsible for bearing the costs. Your first point of contact is your attending physician if you are applying for the costs of a treatment at a health resort to be covered. He will advise you on the most suitable course of treatment for you and, if necessary, will also determine which agency is responsible.
Webcode of this page: e000087 Author: Barmer Created on: 06.06.2018 Last update on: 06.12.2018
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