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Patients with German statutory health insurance
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Patients with German statutory health insurance

Costs for GKV patients

Normally, the diagnosis (exceptions) and treatment (exceptions) for in-network patients are free of charge, provided that no artificial insemination is performed. This includes, for example, the sole hormonal stimulation to prepare for in-vitro fertilization (IVF) procedures (VZO procedures for optimal results), or diagnostic methods such as abdominal ultrasound (laparoscopy) or HSSG (contrast-enhanced ultrasound).

Artificial insemination

Since January 1, 2004 (health reform), there are binding requirements for insured patients regarding the reimbursement of the costs of artificial insemination methods.

The basic requirement is the approval of the treatment center by the health authority of the respective federal state. *

If artificial insemination (insemination, IVF etc ICSI.) is planned, a cost-sharing application must first be submitted to the health insurance company.

The health insurance companies contribute 50 each % to the costs for

  • up to eight inseminations without stimulation (possibly with Clomifene),
  • up to three insemination cycles with hormonal stimulation (Gonal F, Puregon, Menogon)
  • drei IVF- or three ICSI-cycles

Requirements are:

  • The couple must be married to each other.
  • The woman must be at least 25 years old and a maximum of 39 years old.
  • The husband must be no older than 49 years of age.
  • IVF and ICSI

approx. €1,100 to €2,200 (depending on the amount of medication)

What costs are to be expected per cycle?

  • At the Insemination without stimulation Cycles (if applicable, including Clomiphene stimulation) incur costs totaling 60 to 120 € (depending on the amount of medication used).
  • At the Insemination in the stimulated cycle Depending on the amount of medication used, costs can range from 150 to 500 €. However, in some cases the costs can be significantly higher if the hormonal stimulation is dosed higher or if stimulation has to be continued for a longer period of time.
  • At the IVF In the usual case, conventional IVF procedures cost about €1,500 per patient.
  • At the ICSI In the usual case, conventional ICSI procedures cost about €1,700 per patient.

The prices listed correspond to the 50%th patient self-payment per cycle.

Additional benefits that are excluded from reimbursement:

  • HALO sperm test (160,- EUR)
  • Cryoconservation of fertilized eggs (approx. 400,- Euro)
  • Rental for a storage period of 6 months (125,-Euro)
  • Cryo cycles with the aim of transferring previously frozen fertilized eggs (approx. 450,00 to 600,00 EUR), plus medication costs of approx. 100 to 500 EUR
  • Assisted Hatching (laser hatching aid), approx. 170,- Euro
  • Polycystic disease diagnosis, between 900,- and 1,600,- EUR

* The approval for the admission of the treatment center in accordance with § 27a is in place.

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Patients with German statutory health insurance

GKV insured persons (legal health insurance) must obtain reimbursement of the costs before the start of the artificial insemination procedures. Usually, this period is 1 year.

Patients with private health insurance

PKV policyholders are not required to obtain a cost reimbursement before treatment begins; however, it is advisable to at least do so for cost-intensive treatments such as IVF and ICSI.

Self-paying patients

Self-payers are GKV or PKV patients for whom cost coverage by the statutory health insurance is not available, or private patients without the possibility of cost coverage through their private health insurance.

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