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Hospital treatment; information on cost coverage

As an insured person, you are entitled to hospital treatment. Treatment is provided on a full inpatient basis if the treatment objective cannot be achieved through partial, pre- or post-inpatient or outpatient treatment, including home nursing care.

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Procedure details

Insured persons are entitled to treatment in an approved hospital. The benefits include, in particular, medical treatment, nursing care, provision of medicines, remedies and aids as well as accommodation and meals. Hospital treatment also includes discharge management to support you in securing further care after discharge from hospital. To this end, hospital doctors can prescribe medication and, for a period of up to seven days, bandages, remedies and aids, home nursing care and determine your incapacity to work.

The principle of "outpatient before inpatient" applies to inpatient hospital treatment. Insured persons are therefore only entitled to full inpatient treatment in an approved hospital if the treatment objective cannot be achieved through partial, pre- or post-inpatient or outpatient treatment, including home nursing care.

  • Required Documents

    If there is no emergency, you need a hospital referral from your attending physician (general practitioner or specialist) to be admitted to a hospital.

You should discuss whether hospital treatment is necessary with the doctor treating you. This can be your family doctor or a specialist. If it is not an emergency, you will need a hospital referral from your treating doctor (GP or specialist) in order to be admitted to hospital. As a rule, you do not need to contact your health insurance company beforehand to be admitted to hospital.

Insured persons who have reached the age of 18 pay 10 euros per calendar day to the hospital from the start of full inpatient hospital treatment within a calendar year for a maximum of 28 days. If insured persons choose a hospital other than the one specified in the medical referral without a compelling reason, they may also be charged all or part of the additional costs.

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If the health insurance company refuses the benefit, an objection can be lodged. If the objection is not upheld, you can appeal to the social court.

Status: 07.11.2025
Editorially responsible for prodecure description: Niedersächsisches Ministerium für Soziales, Gesundheit und Gleichstellung + Zentrale Redaktion BayernPortal im Bayerischen Staatsministerium für Digitales
Source: Federal Portal
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