{"id":5754,"date":"2014-06-26T15:49:40","date_gmt":"2014-06-26T13:49:40","guid":{"rendered":"https:\/\/www.kinderwunschzentrum-hamburg.de\/financial-and-legal\/what-does-the-health-insurance-cover\/"},"modified":"2026-10-02T15:59:30","modified_gmt":"2026-10-02T13:59:30","slug":"what-does-the-health-insurance-cover","status":"publish","type":"page","link":"http:\/\/www.kinderwunschzentrum-hamburg.de\/en\/your-wish-to-have-children\/wissenswertes\/financial-and-legal\/what-does-the-health-insurance-cover\/","title":{"rendered":"WHAT DOES THE HEALTH INSURANCE COVER?"},"content":{"rendered":"<h2>Coverage for fertility treatment depends on the type of insurance you have. If you have any questions, we will of course be happy to help you. <\/h2>\n<p>All costs that arise as part of the <strong>diagnosis<\/strong> in order to get to the bottom of the cause of the unfulfilled desire to have children are usually covered by both statutory and private health insurance companies. This also applies to medications to adjust the hormonal balance and for hormonal stimulation if no artificial insemination follows (insemination, IVF or ICSI). <\/p>\n<p>In the case of artificial insemination, statutory health insurance companies generally pay 50 percent for a treatment cycle, some even up to 100 percent. Since the scope of services offered by health insurance companies is sometimes very different and changes frequently, please feel free to contact us. We will work with you to determine which costs your health insurance company will cover.  <\/p>\n<h1>WHAT DOES THE HEALTH INSURANCE COVER?<\/h1>\n<h2>For couples who are insured by statutory health insurance (GKV), the health insurance company usually covers 50 percent of the costs for medical treatment and medication for a treatment cycle.<br \/><\/h2>\n<p>For example, if in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is planned, the woman&#8217;s insurance will reimburse the costs incurred for her treatment on a pro rata basis, and the man&#8217;s insurance will reimburse the amounts incurred for his therapeutic measures on a pro rata basis.<\/p>\n<h2>In order for statutory health insurance companies to cover your costs proportionately, the following requirements must be met:<\/h2>\n<p>The couple wishing to have children must be married to each other.<\/p>\n<p>\u2022 Both partners must be at least 25 years old, with the woman not being older than 40 years and the man not being older than 50 years (the decisive factor is the age on the first day of the cycle, on the first day of stimulation or on the first day of the so-called downregulation).<\/p>\n<p>\u2022 Only eggs and sperm from spouses may be used.<\/p>\n<p>\u2022 A treatment plan approved by the health insurance company must be available.<\/p>\n<p>\u2022 Proof of a consultation with a gynecologist who does not supervise the fertility treatment himself and who refers the couple wishing to have children to a doctor or an officially approved practice with approval for artificial insemination.<\/p>\n<h2>The number of treatment cycles that statutory health insurance covers on a pro-rata basis is limited and applies to:<\/h2>\n<p>8 insemination cycles without hormonal stimulation<\/p>\n<p>\u2022 3 insemination cycles with hormonal stimulation<\/p>\n<p>\u2022 3 cycles of treatment with in vitro fertilization or 3 cycles of treatment with intracytoplasmic sperm injection<\/p>\n<h2>Important: the approval of the treatment plans<\/h2>\n<p>Your doctor will create a detailed treatment plan for both partners. This contains: the causes of unwanted childlessness, the treatment measures and the estimated total costs of the therapy, 50 percent of which are the couple&#8217;s own contribution. Please keep in mind that your treating doctor can only make a rough estimate of the expected costs.  <\/p>\n<h3><em>You submit the treatment plans to your health insurance companies for review and approval. Treatment can begin as soon as all requirements are met and the treatment plans approved by the health insurance companies are available. After the birth of a child, you are again entitled to pro-rata reimbursement of costs for further fertility therapy cycles.  <\/em><\/h3>\n<h1>COST ASSUMPTION FOR PRIVATELY INSURED COUPLES<\/h1>\n<h2>If both partners are privately insured, the treatment will be billed privately based on the fee schedule for doctors (GO\u00c4). To do this, we will conclude an individual fee contract with you. <\/h2>\n<p>The following applies to private health insurance companies (PKV): If amounts for fertility therapy are reimbursed, then this is based on the so-called \u201cpolluter pays\u201d principle. This means that the private health insurance of the partner who caused the unwanted childlessness covers the costs. Before you start fertility treatment, we will clarify together to what extent your private health insurance company will reimburse the necessary therapeutic measures. For this purpose, we create a detailed treatment and cost plan in accordance with the fee schedule for doctors.   <\/p>\n<h3><em>Whether and to what extent costs are actually covered depends on the respective PKV and the scope of services specified in the insurance contract as well as on the type of insurance of both partners (are both in the PKV or is one partner in the statutory insurance). <\/em><\/h3>\n<h1>PRIVATE BILLING<\/h1>\n<h2>In certain cases, statutory health insurance does not cover the proportionate costs of your fertility treatment. The services are then billed privately. This applies if:  <\/h2>\n<p>the couple wishing to have children does not meet the requirements for costs to be covered by statutory health insurance, for example if the age limit is exceeded or if the couple is unmarried.<\/p>\n<p>\u2022 Coverage of benefits by statutory health insurance has been exhausted, for example after three unsuccessful attempts using in-vitro fertilization.<\/p>\n<p>\u2022 Treatment measures are carried out that are not covered by statutory health insurance, such as laser-assisted hatching aid or cryopreservation of germ cells.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Coverage for fertility treatment depends on the type of insurance you have. If you have any questions, we will of course be happy to help you. All costs that arise as part of the diagnosis in order to get to the bottom of the cause of the unfulfilled desire to have children are usually covered [&hellip;]<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":5571,"menu_order":3,"comment_status":"open","ping_status":"open","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-5754","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>WHAT DOES THE HEALTH INSURANCE COVER? - Kinderwunschzentrum Hamburg Fleetinsel | Hamburg, Kinderwunsch, k\u00fcnstliche Befruchtung, ICSI, Endometriose, Reproduktionsmedizin, IVF, Insemination, Kinderlosigkeit, Fertilisation, Wunschkind, kinderwunschzentrum, babywunsch, Refertilisierung, Spermabank, fertilitycenter<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"http:\/\/www.kinderwunschzentrum-hamburg.de\/en\/your-wish-to-have-children\/wissenswertes\/financial-and-legal\/what-does-the-health-insurance-cover\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"WHAT DOES THE HEALTH INSURANCE COVER? - Kinderwunschzentrum Hamburg Fleetinsel | Hamburg, Kinderwunsch, k\u00fcnstliche Befruchtung, ICSI, Endometriose, Reproduktionsmedizin, IVF, Insemination, Kinderlosigkeit, Fertilisation, Wunschkind, kinderwunschzentrum, babywunsch, Refertilisierung, Spermabank, fertilitycenter\" \/>\n<meta property=\"og:description\" content=\"Coverage for fertility treatment depends on the type of insurance you have. 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