Visits to doctors and costs
Medical care can be provided on an outpatient or inpatient basis. If you become ill, a GP is usually the first person you contact.
GPs are mainly specialists in general medicine or general internal medicine. They are primarily responsible for primary care, i.e. initial treatment and, where relevant, the referral of patients to relevant specialists.
- An appointment must be made to be able to see a doctor in his surgery.
- If you are not able to keep an appointment, you must let the doctor know in good time.
- If you need to see a doctor because of a sudden illness, you can go to the surgery without an appointment. However, you must allow for long waiting times.
When you visit a doctor for the first time during one quarter of a calendar year, you must present your insurance card or a medical certificate from social services. In principle, an additional payment of 10% of the costs will be charged for all services, this amount being at least 5 euros but not exceeding 10 euros.
TIP: However, there are hardship clauses which place financial limits on the amount of your contribution. The annual contribution of insured people may not exceed 2% of their gross income. In the case of chronically ill people, there is a limit of 1% of the gross income (see point about the “chronically ill“).
A person is regarded as chronically ill if:
- the person is receiving permanent medical treatment (at least one visit to a doctor per quarter for the same disease) and is participating in an existing structured treatment programme for the treatment or
- there is a need for level 2 or 3 care or oder
- the degree of disability is at least 60% or there is at least a 60% reduction in the ability to be gainfully employed or
- constant medical care is required as there would otherwise be the risk of a worsening of the disease, a reduction in life expectancy or a permanent diminution in the quality of life in the view of a doctor and
- the chronically ill person regularly underwent statutory health examinations prior to the disease from 1 January 2008 onwards (only applies to people born after 1 April 1972);
- the chronically ill person, who suffers from a kind of cancer for which an examination for the early detection of cancer exists, underwent this examination regularly prior to the disease from 1 January 2008 onwards (this only applies only to women born after 1 April 1987 and men born after 1 April 1962);
- the doctor establishes that the insured person has behaved in a way which is appropriate to the treatment.
Incapacity for work
If you work and you are unable to work because of an illness, you will need a sick certificate from your doctor. This certificate is to be submitted to your employer as well as to your health insurance fund no later than on the third calendar day after the start of the illness.