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Fertility treatment: what the health insurance fund pays

Fertility treatment is emotionally and financially demanding. At least the statutory health insurance fund contributes to the costs, and in many federal states there is additional funding.

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If the medical conditions are met, the statutory health insurance fund covers 50 % of the costs for up to three attempts at artificial insemination (§ 27a SGB V). Which method (for example IVF, ICSI) and how many attempts depends on the individual case.
The conditions include, among other things, certain age limits, the use of your own egg and sperm cells and prior counseling. Many federal states and the federal government offer additional subsidies, also for unmarried couples, depending on the funding program.

What you should do now

  1. 1

    1. Clarify the conditions

    Have the medical conditions and the age limits checked by a doctor.

  2. 2

    2. Submit the treatment plan

    Submit the treatment plan to the health insurance fund for approval before starting.

  3. 3

    3. Check additional funding

    Find out about funding programs of your federal state and the federal government.

  4. 4

    4. Object if refused

    If the fund refuses, you can file an objection within one month (§ 84 SGG).

Frequently asked questions

Does the health insurance fund pay for artificial insemination?

If the medical conditions are met, the statutory health insurance fund covers 50 % of the costs for up to three treatment attempts (§ 27a SGB V). The conditions include, among other things, certain age limits, the use of your own egg and sperm cells and prior counseling. You must have the treatment plan approved beforehand.

Is there additional funding?

Yes. Many federal states contribute, together with federal funding, to the remaining costs, in part also for further attempts and, depending on the program, also for unmarried couples. The conditions differ from state to state; find out about the respective funding program early.

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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.