7 – Co payments for health insurance services

Fact sheet no. 7

The law requires co-payment for certain services of the health schemes from the insured person:

Health scheme serviceCo payment amount
Medicines, dressing materials, aids, travel costs, socio therapy, domestic help10% of the price, a minimum of 5 €, a maximum of € 10.
Not more than the actual cost.
Remedies (e.g. physiotherapy, speech therapy)10% of the cost and the cost of the home visit, plus 10 € for each prescription
Home nursing care10% of the cost limited to 28 days per calendar year, plus € 10 for each prescription
Incontinence material10% of costs, a maximum of 10 € for the whole month's supply
Hospital treatment10 € per day for up to 28 days per calendar year
In patient prevention and rehabilitation measures and cures10 € per day
Exception: Follow-up treatment is to be considered as hospital treatment.
DenturesDue to the fixed subsidies and considering the bonus, co-payment is variable

Insured persons up to age 18 are exempt from co-payment (except: travelling expenses)

Co payment limits

For every calendar year all insured persons from the age of 18 years makes a co-payment in the amount of 2%, chronically ill 1% of their annual gross income.

When determining the personal co-payment  limit all gross revenue of the insured person and their household family members must be taken into consideration.

If the co-payments  exceed these co-payment  limits, you can be exempted on request, either through an advance for the coming year, or by proof of the payments already made in the current year.

The applicant receives at the end of the calendar year a temporary exemption card and is not      required      upon      its      submission      to      make      any      further      payments.