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Sterilization; information on cost coverage
The statutory health insurance funds cover the costs of medically necessary sterilization.
Responsible for you
Procedure details
Description
Statutory health insurance companies cover the costs of sterilization if the procedure is medically necessary.
For women: If pregnancy would endanger their health.
For healthy men: If pregnancy is expected to cause serious harm to the woman and the sterilization procedure would be life-threatening for the woman.
In other cases, you bear the costs yourself.
Requirements
The attending physicians decide in which cases there is a medical indication for sterilization.
Required documents
-
Electronic health card
Fees
none
Deadlines
none
Special notes
Uninsured persons receive assistance within the framework of social welfare or war victims' welfare in the event of sterilization necessitated by illness, if the procedure is performed by a physician. The assistance includes the same benefits that insured persons receive in the statutory health insurance (except sickness benefit). The income limit of § 85 of the Social Security Code XII applies (basic amount of twice the standard needs level 1 + 70% of the standard needs level 1 for additional family members + expenses for accommodation to a reasonable extent. A more favorable income limit applies in war victims' welfare.
Legal bases
Appeal
You can lodge an appeal against the health insurance company's decision. If the appeal is not upheld, you can take legal action at the competent social court.
Status: 27.09.2024
Editorial responsibility Niedersächsisches Ministerium für Soziales, Gesundheit und Gleichstellung
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