Self-Pay Patient Rights Under IGeL Benefits Explained

In Germany, it's essential for patients to be aware of Individual Health Services (IGeL), which are medical services not covered by statutory health insurance. Here's a breakdown of what you need to know about IGeL.

The authority responsible for the website "igel-monitor.de" is the Medizinischer Dienst Bund (Medical Service Federation), a coordinating body supported by the 15 regional Medical Services in Germany. This organisation promotes professional work and issues guidelines to ensure assessment and advice according to nationwide uniform criteria.

If a doctor's office mentions the term "Individual health service (IGeL)", it refers to a medical service not covered by statutory health insurance. Some examples of non-medically necessary IGeL services include sports medical examinations, tattoo removal, couples therapy, and travel vaccinations.

Before undergoing any IGeL service, it's worth checking with your health insurance company to see if they cover any related costs. Doctors cannot make consent to an IGeL a prerequisite for a medically necessary treatment.

When a doctor recommends an IGeL service, it's your right to ask if the self-payer service is beneficial for you. A contract must be concluded before the treatment, and doctors are required to explain the costs of IGeL services to patients before performing them.

Patients should receive a written cost estimate in advance, listing the costs according to the fee schedule for doctors (GOÄ). It's important to inform oneself as best as possible about IGeL services before deciding.

Some IGeL services, such as hyaluronic acid injections for hip and knee arthritis, may cause more harm than good, according to the Medical Service of the Federal Government. Not all IGeL procedures can be assumed to be effective, as warned by the same authority.

The "igel-monitor.de" portal provides information on various common self-payer services and their potential benefits, but not all information is available. The portal does not systematically record and test all IGeL offers.

A period of reflection is usually allowed for IGeL, except for travel vaccinations which must be given within a certain time frame before travel. Some cancer screening examinations, such as an ultrasound of the ovaries or a PSA test, can fall under the category of IGeL if there is no increased risk of illness.

Asking questions in the doctor's office, such as "What benefit could this method have for me?", "How well is it tested?", "What risks could be associated with it?", "What consequences would a positive or negative test result have for me?", "Would follow-up examinations be necessary?", "What costs would I incur?", and "Why is this service not covered by insurance?" can help in personal assessment of IGeL.

If the above conditions are not met, patients do not have to pay for the IGeL, even if they have received it. The effectiveness of some IGeL services is not guaranteed, so it's crucial to make an informed decision.