Limit on the burden on co-payments in statutory health insurance
Co-payments must be made for medicines, remedies and treatments that are prescribed. However, health insurers do not have to pay more than two percent of their gross annual income. For chronically ill people, the burden limit is one percent of the annual gross income. Gross income includes all income with which insured persons finance their livelihoods - for example: Salary pensions or pensions, Capital interest Rental income The calculation of the debit limit shall take into account the gross annual income of all nationals living in the household. These can be spouses, civil partners under the Civil Partnership Act or children insured with family insurance. For families, the burden limit is reduced by the child allowances and, where appropriate, the allowance for the spouse. In the case of recipients of social assistance, the standard rate of the head of household is the basis for calculating the debit limit, which is why the allowances cannot be estimated. Children and adolescents up to the age of 18 are in principle exempt from co-payments. Exception: Additional payment for travel expenses.
Collect all additional payment documents so that they can prove to the health insurance company that they have reached the debit limit. Upon application, they are exempted from additional contributions from their health insurance fund for the current calendar year. Children and adolescents are always exempt from the co-payment.