Faulty hospital invoice or co-payment: check and challenge

As a person with statutory insurance, you pay a limited statutory co-payment per day in the hospital, the treatment itself the hospital bills with the fund. Additional invoices only come into play for agreed optional services (for example a single room, senior physician). Demands beyond that you should examine.

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Your chances of getting your money back

The statutory co-payment is 10 euros per hospital day for at most 28 days a year; on reaching the burden limit it lapses. The actual treatment the hospital bills directly with your health fund.

Only expressly agreed optional services may be billed privately. Without a written optional-service agreement, such demands are attackable.

What you should do now

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1. Classify the invoice
Distinguish the statutory co-payment, optional services (agreed) and general treatment (fund billing).
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2. Check the optional-service agreement
For optional services a written agreement has to exist. If it is missing, the demand is attackable.
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3. Use the burden limit
If you are at the annual burden limit, you can be exempted from co-payments, check this with your fund.
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4. Challenge
Challenge faulty or unagreed demands in writing and demand a breakdown.

How to spot the scam

Optional services are billed that you never agreed in writing.
The co-payment is demanded beyond the statutory limits.
The general treatment is billed to you privately.

Frequently asked questions

How high is the co-payment in the hospital?

For those with statutory insurance, 10 euros per day for at most 28 days in the calendar year. On reaching the individual burden limit, the co-payment lapses. The treatment itself the hospital bills with your health fund.

When may the hospital bill me something privately?

Only for expressly and in writing agreed optional services such as a single room or senior physician treatment. Without a valid optional-service agreement, such private invoices are attackable.

How do I fight back against a false invoice?

Challenge it in writing, demand a breakdown and check whether an optional-service agreement exists. On reaching the burden limit, have yourself exempted from co-payments. Do not pay disputed demands prematurely.

Take action now

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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.