responsibility finder
Schleswig-Holstein

Apply to the statutory health insurance fund for reimbursement of abortion costs

Source: Zuständigkeitsfinder Schleswig-Holstein (Linie6PLus)

Service Description

If you want to have an abortion and cannot bear the costs yourself, you can apply for the costs to be covered by statutory health insurance under certain conditions.

If the abortion is performed for criminological or medical reasons, the costs will be covered by the health insurance company and billed by your doctor via the electronic health card (eGK). A prior application for cost coverage is not required. This is the case in the following two constellations:

  • If the termination of the pregnancy is necessary from a medical point of view in order to avert a danger to your life or the risk of serious impairment of your physical or mental health, the health insurance company will cover the costs of the termination. In this case, it is not necessary to apply to the health insurance company for the costs to be covered, as the doctor will make the necessary determination.
  • If the pregnancy is to be terminated because it is the result of a criminal offense (rape), the health insurance company will cover the costs of the abortion if no more than 12 weeks have passed since conception. In this case, it is not necessary to apply to the health insurance fund for the costs to be covered, as the doctor will make the relevant findings.

If the abortion is performed for other reasons, it is illegal but not punishable if the following conditions are met in full:

  • You expressly request the abortion.
  • You provide the doctor with a certificate from a recognized conflict counselling centre stating that you have sought advice from a pregnancy conflict counselling centre at least three days before the procedure.
  • A doctor will perform the abortion.
  • A maximum of 12 weeks have passed since conception.

In this case, the health insurance fund will cover the costs of

  • medical advice on the preservation and termination of the pregnancy,
  • medical treatment with the exception of the abortion and follow-up treatment if there are no complications,
  • the provision of medicines, dressings and remedies and
  • hospital treatment

The costs for the medical procedure of the abortion itself and for medical aftercare are not covered by health insurance.

However, if you have little or no income, in certain cases you can apply to your statutory health insurance fund to have the costs of these services covered. This is the case, for example, if you are considered to be in social need.


Process flow

You can submit the application for cost coverage for abortion by post or - in the case of many statutory health insurance companies - in person at the office. It is usually possible to obtain advice over the phone or at the office on the best way to submit the application. Normally, the procedure is as follows:

  • Fill out the application for cost coverage from your statutory health insurance company.
  • Submit the application together with the required documents to your health insurance company.
  • With most health insurance companies, you can also submit the application directly to the office. The application is usually processed immediately.
  • The health insurance company will check your application and issue you with a cost coverage certificate if the requirements are met.
  • You should give the cost coverage certificate to your doctor together with the certificate confirming that you have received counseling at a conflict counseling center.
  • Your doctor will bill the responsible office for the abortion. You do not have to pay anything.
Requirements

You are entitled to have the costs covered by your statutory health insurance if

  • you have your place of residence or habitual abode in Germany and
  • after examination by the health insurance company, you cannot reasonably be expected to bear the costs of the abortion for financial reasons. You can find out the exact requirements and income limits for this from your health insurance company.

An unreasonable cost burden exists for you in particular if you

  • receive assistance with living expenses ("social assistance") or
  • receive unemployment benefit II;
  • have a disability and receive training support (training support within the framework of the Federal Employment Agency's order on individual support for vocational training or on employment and vocational support for people with disabilities) or
  • a training grant under the Federal Training Assistance Act ("Bafög") or
  • receive benefits under the Asylum Seekers Benefits Act;
  • are accommodated in a home or similar facility and the costs of this are borne by social welfare or youth welfare.
Which documents are required?

As a rule:

  • Proof of your personal income and financial circumstances, e.g. current salary statement or bank statement

Please contact your health insurance company to find out which additional documents are required in addition to proof of your personal income and financial circumstances.

What are the fees?

You do not have to pay anything for the application.

What deadlines do I have to pay attention to?
  • You must apply for the costs to be covered before the abortion.
  • Abortion is only possible up to the end of the 12th week (in the case of a criminological indication as well as in the case of an unlawful but non-punishable abortion).
  • Counseling at a pregnancy conflict counseling center must have taken place at least 3 days before the unlawful but non-punishable abortion.
Processing duration

Processing normally takes about 1 to 2 working days.

Your health insurance company must have the necessary information and any required documents in a complete and meaningful form in order to process and decide quickly.
The health insurance company decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time stated is an average value for all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer. The same applies if documents or records are sent to you or your health insurance company by post.

Legal basis
Appeal
  • Contradiction
  • Action before the social court
Applications / forms
What else should I know?

If you do not have statutory health insurance, you can apply for reimbursement of the costs of an abortion at a statutory health insurance fund at your place of residence or habitual abode.

Author
Forwarding service: Deep link to the original portal

The text was automatically translated based on the German content.

Technically approved by

Federal Ministry of Health

Professionally released on

06.12.2021

Teaser

If you want to have an abortion and cannot bear the costs yourself, you can apply for the costs to be covered by statutory health insurance under certain conditions.

Process flow

You can submit the application for cost coverage for abortion by post or - in the case of many statutory health insurance companies - in person at the office. It is usually possible to obtain advice over the phone or at the office on the best way to submit the application. Normally, the procedure is as follows:

  • Fill out the application for cost coverage from your statutory health insurance company.
  • Submit the application together with the required documents to your health insurance company.
  • With most health insurance companies, you can also submit the application directly to the office. The application is usually processed immediately.
  • The health insurance company will check your application and issue you with a cost coverage certificate if the requirements are met.
  • You should give the cost coverage certificate to your doctor together with the certificate confirming that you have received counseling at a conflict counseling center.
  • Your doctor will bill the responsible office for the abortion. You do not have to pay anything.

Requirements

You are entitled to have the costs covered by your statutory health insurance if

  • you have your place of residence or habitual abode in Germany and
  • after examination by the health insurance company, you cannot reasonably be expected to bear the costs of the abortion for financial reasons. You can find out the exact requirements and income limits for this from your health insurance company.

An unreasonable cost burden exists for you in particular if you

  • receive assistance with living expenses ("social assistance") or
  • receive unemployment benefit II;
  • have a disability and receive training support (training support within the framework of the Federal Employment Agency's order on individual support for vocational training or on employment and vocational support for people with disabilities) or
  • a training grant under the Federal Training Assistance Act ("Bafög") or
  • receive benefits under the Asylum Seekers Benefits Act;
  • are accommodated in a home or similar facility and the costs of this are borne by social welfare or youth welfare.

Which documents are required?

As a rule:

  • Proof of your personal income and financial circumstances, e.g. current salary statement or bank statement

Please contact your health insurance company to find out which additional documents are required in addition to proof of your personal income and financial circumstances.

What are the fees?

You do not have to pay anything for the application.

What deadlines do I have to pay attention to?

  • You must apply for the costs to be covered before the abortion.
  • Abortion is only possible up to the end of the 12th week (in the case of a criminological indication as well as in the case of an unlawful but non-punishable abortion).
  • Counseling at a pregnancy conflict counseling center must have taken place at least 3 days before the unlawful but non-punishable abortion.

Processing duration

Processing normally takes about 1 to 2 working days.

Your health insurance company must have the necessary information and any required documents in a complete and meaningful form in order to process and decide quickly.
The health insurance company decides on applications promptly, whereby the statutory processing period is adhered to in order to protect patients' rights.
Please note that the processing time stated is an average value for all health insurance companies. It may vary in individual cases.
The exact processing time also depends on the complexity of the individual case and may be longer. The same applies if documents or records are sent to you or your health insurance company by post.

Legal basis

Appeal

  • Contradiction
  • Action before the social court

Applications / forms

What else should I know?

If you do not have statutory health insurance, you can apply for reimbursement of the costs of an abortion at a statutory health insurance fund at your place of residence or habitual abode.

Author

Forwarding service: Deep link to the original portal

The text was automatically translated based on the German content.

Technically approved by

Federal Ministry of Health

Professionally released on

06.12.2021

Further information and offers