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Medical aids: do you really have to pay extra?

With a hearing aid, insole or wheelchair it is often said: 'The fund only pays part, you pay the rest yourself.' That is not always true. For the necessary provision you are entitled to a variant without a surcharge.

Reach your next steps and the matching ready-made texts in just a few minutes, free of charge:

Check the surcharge

Your chances of getting your money back

The health insurance fund must provide a sufficient, appropriate and necessary provision of medical aids (§ 33 SGB V), and in principle without a surcharge (surcharge-free provision). So there must be at least one suitable model for which you only pay the statutory co-payment.
Only for genuine comfort or luxury extras that go beyond what is medically necessary may you be asked to pay. If you are charged a high surcharge across the board for the standard provision, this is often not permitted.

What you should do now

  1. 1

    1. Demand the surcharge-free variant

    Explicitly ask for a surcharge-free, suitable model.

  2. 2

    2. Clarify the necessity

    Is the standard provision medically sufficient? Then no surcharge is needed.

  3. 3

    3. Follow up with the fund

    If you do not get a suitable surcharge-free aid, turn to your health insurance fund.

  4. 4

    4. Object if refused

    If the fund refuses a sufficient provision, you can file an objection (§ 84 SGG).

Frequently asked questions

Do I always have to pay extra for medical aids?

No. You are entitled to a sufficient and appropriate provision without a surcharge (surcharge-free provision, § 33 SGB V); there must be at least one suitable model for which only the statutory co-payment applies. Surcharges are only permitted for genuine comfort extras that go beyond what is medically necessary.

What can I do if only expensive models are offered?

Explicitly demand a surcharge-free aid suitable for your needs. If you do not get one, turn to your health insurance fund and insist on the surcharge-free provision. If the fund refuses a sufficient provision, you can file an objection within one month (§ 84 SGG).

Take action now

We put together the ready-made texts and the right places to contact for you.

General information for self-help, not legal advice (RDG). In case of a high loss or uncertainty: contact a consumer advice center or a lawyer.