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HEALTH INSURANCE

Can privately insured people use e-prescriptions in Germany?

Since January, electronic prescriptions have become mandatory for patients in Germany. But what does that mean for people who are privately insured?

E-prescription service Germany
A patient inserts their health insurance card into a card reader at a German pharmacy. Germany allows people to have both public and private insurance options - with different advantages. But switching can be complicated. Photo: picture alliance/dpa/Reuters/Pool | Annegret Hilse

Germany is moving on apace with its digitalisation – at least when it comes to healthcare. From digital patient records to phone-in sick notes, things are set to be a lot less paper-based in the future.

At the start of the year, Health Minister Karl Lautberbach (SPD) brought in mandatory e-prescriptions for all statutory healthcare users, who can pick up their medication at a pharmacy after a doctor’s visit simply by presenting their health insurance card.

For private patients, however, things are a little different. 

Currently, the government hasn’t fully worked out how it wants e-prescriptions to work for the privately insured, so being able to access this service will depend on a number of things:

  • A health insurance number, or Krankenversichtennummer 
  • The e-prescriptions app ‘Der Gematik’ 
  • A digital health ID, or GesundheitsID, to log into the app 
  • An ‘Online Check-In’ function on your insurance provider’s app 

In order for the practice to issue your digital prescription, you will first need to use the Online Check-In function and present your health insurance number, which can be found on any of your insurance documentation. 

The e-prescription can then be issued to you either via the Der Gematik app or as a print-out with a special code for the pharmacy. 

After redeeming your prescription, you will also receive a Kostenbeleg, or receipt, via the app or as a print-out. This can be transferred to your health insurer’s own app directly or uploaded manually as a PDF in order to reclaim the costs of the medication. 

The major difference between people with private and public insurance is that those with public, or statutory, insurance will be able to use their electronic health insurance card (eGK) at the GP’s when the prescription is issued and can also redeem their prescriptions at pharmacies using the eGK.

Privately insured people, on the other hand, will need to rely on the Online Check-In system and the use of an e-prescriptions app on their phone. 

READ ALSO: The new rules on digital prescriptions in Germany

Will this work at every GP’s surgery? 

This is another important caveat: being able to access an e-prescription will depend on whether the surgery in question has updated their software yet.

Given the legal changes that came into force on January 1st, you would expect most doctors to have modernised their systems, but in some cases there may be delays and limitations – especially for the privately insured. 

READ ALSO: How Germany wants to roll out e-prescriptions and digital patient records

To find out whether your healthcare provider is in the process – and what restrictions may still be in place – speak to them directly either before or during your appointment. 

What if I want someone else to pick up my prescription for me? 

In this case, you can still use an e-prescription, but you will need a print-out of the unique code for the pharmacy.

Of course, since e-prescriptions aren’t (yet) mandatory for private patients, you can also just opt to get your prescription the old-fashioned way and pass it on to a friend to pick it up for you – after letting the pharmacy know. 

Member comments

  1. I am a U.S. person with permanent residency in Germany and privately insured with a USA insurance provider. I have serious doubts that my insurance provider will have an “Online Check-In App” or any digital contact with the German Krankenversicherung system. Wondering if there will be a way for non-Krankenversicherung folks to pay cash for prescription medications???

  2. I am a U.S. person with permanent residency in Germany and privately insured with a USA insurance provider. I have serious doubts that my insurance provider will have an “Online Check-In App” or any digital contact with the German Krankenversicherung system. Wondering if there will be a way for non-Krankenversicherung folks to pay cash for prescription medications???

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HEALTH

How to find available therapists in Germany

It’s no secret that mental health care can be particularly tricky to access in Germany. Here are some helpful tips for anyone who is struggling to book an appointment for therapy.

How to find available therapists in Germany

The process to find psychotherapy in Germany’s urban centres is arduous – licensed therapists often have impossibly long wait times, and private practices don’t accept public health insurance.

A major reason that public insurance funded mental health care is hard to find in Germany comes down to regulations. Specifically the ‘coverage plan’ (Bedarfsplanung) that basically limits the number of licences available for publicly insured therapists in a region.

Germany’s maddening bureaucracy probably won’t be fixed any time soon. So residents in need of therapy will need to find a way through the system as it is.

So here are a few helpful tips for finding therapists, as well as how publicly insured patients can have private practice therapy costs reimbursed.

Look for therapists enrolled at academies

You’ll probably have a better chance getting an appointment with therapists who are currently in training, because not everyone knows that this option exists.

You can search for “Akademie für Psychotherapie”, to find one in your location. The Berliner Akademie für Psychotherapie, is one in the capital city, for example.

If you arrange an appointment this way, you can expect to be connected with a grad student therapist in training who needs to complete their supervised practice hours. In this case, you would see your therapist as usual, and they will be going through your session with an experienced therapist afterward.

The main advantages to seeking a therapist in training is that it may be cheaper and you can probably more readily find an appointment. A potential disadvantage is that the therapist you’ll be seeing is less experienced. 

But according to a Stockholm University study, student therapists who receive regular feedback from supervisors may be just as effective as licensed therapists at treating patients.

How to get reimbursed for going to a private practice

As mentioned above, therapists covered by public health insurance are few and far between, especially in many urban centres, and therefore regularly come with long wait times. But for those willing to do battle with the bureaucracy, there is an option to have your costs reimbursed for seeing a private practice therapist.

Specifically, public insurance providers are obligated to provide full reimbursement of costs in the event of a “supply emergency”. 

Waiting times of more than three months are considered unreasonable. So generally, patients can claim a supply emergency if they have contacted several therapists, and none of them offered available appointments within that time frame.

But you’ll want to make sure that your process is properly documented so that you won’t be stuck with the out-of-pocket costs.

First, you’ll need to document your need for psychotherapy. To get this, make an appointment for a psychotherapeutic consultation with a practice in your area, and be sure to collect a written recommendation for treatment (a PTV 11 form). 

If you don’t know where to start with this, look to the Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung) for a database of therapists. You can also call 116 117 or use the 116 117 App.

After you’ve got your PTV 11 certificate, you’ll need to document your futile search for a licensed therapist. To do this, contact at least three to five therapists that have public health insurance approval. Keep a list of the names of therapists you contacted, as well as dates and times of contact and how long the waiting list for treatment is. 

Additionally, you should try to arrange treatment through the aforementioned Association of Statutory Health Insurance Physicians, and receive confirmation if it’s not possible. So you’ll need to call 116 117, or use the 116 117 App again. But this time go through the process to have them try to find you placement with a therapist. This should take a maximum of four weeks, but rarely happens.

Finally, if you have documented all of the above and have still not found a readily available therapist, then you can seek out a private practice. You’ll need to enroll as a self-paying patient initially, but then you can submit an application for an outpatient reimbursement (Kostenerstattungsverfahren) along with the previously collected certificates and proof of your search. Private practice therapists are usually familiar with this process, and may be able to help you with the application as well.

READ ALSO: What are the main reasons internationals in Germany turn to therapy?

Free phone consultations for students

Students in Berlin can also take advantage of a free 50-minute conversation with a therapist through StudierendenWERK.

For students elsewhere, it’s worth checking what kind of mental health support services your school offers. Many German universities offer mental health support to some extent, and if school counsellors can’t provide the care that you need, they may be able to offer helpful information about where such services are available in your area.

READ ALSO: Here’s how you can get mental health help in English in Germany

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