There are people with health insurance who use products that, besides the co-payment obligation of between five and ten euros, cause additional costs that have to be paid out of their own pocket. Why this is so, however, is not clear from the report of the umbrella organization of the health insurance funds, which the funds criticize.
Twenty percent of all insured persons who have prescribed a medical aid from one of the product groups of the continuously expanded and updated list of medical aids pay extra for the additional costs, as the additional costs report GKV-Spitzenverband shows.
From the year 2020, 28 million supplies with a volume of nine million euros were analyzed, of which 5.7 million cases had produced additional costs. 746 million euros therefore not only fell under the legal co-payment obligation but were additional costs because the products were more expensive.
Experts of the report thus calculated 132 euros per year on average for a GK-insured person. Depending on the product group, the additional costs plus co-payment can sometimes be much more. This is especially the case with hearing aids/hearing aids, which cost an average of 1,234 euros more. The counterexample is incontinence pads at 32.40 euros.
However, every insured person is free to choose a specific product. The person concerned may not be influenced by home care providers, medical supply stores, and other service providers. A law from 2017 (Heil- und Hilfsmittelversorgungsgesetz) also prohibits that aids free of additional costs are not even offered in the first place. However, co-payments are still allowed. All service providers are also obliged to notify the health insurance funds of any additional costs incurred, which then form the basis of the GKV additional cost report.
Source: www.aerzteblatt.de