What does a visit to the doctor cost? TeleClinic Wiki

What does a visit to the doctor cost? – Understanding the cost models in Germany

For most people in Germany, the question “What does a visit to the doctor cost?” is easy to answer: “Nothing, it’s covered by health insurance.” However, the German healthcare system is more complex and makes a clear distinction between cost models depending on your insurance status. This guide explains how the costs of a visit to the doctor are made up, when you have to pay yourself and what role health insurance companies play.

The short answer: For most people with statutory health insurance in Germany, there are no direct costs for a regular visit to the doctor, as the treatment is billed directly between the health insurance company and the doctor’s surgery. Privately insured and self-pay patients, on the other hand, receive an invoice that they pay themselves. This applies both in the local practice and with the online doctor via TeleClinic.

Costs for people with statutory health insurance: A visit to the doctor without direct payment

If you are insured under a statutory health insurance scheme, you will not usually have to pay a bill after a consultation. This is because the German system is based on a flat-rate billing model. The statutory health insurance funds have contracts with the Associations of Statutory Health Insurance Physicians, which determine the remuneration for medical services. These contracts regulate which services medical practices can bill per patient and quarter. This means that regardless of how often you visit the practice in a quarter, the doctor receives a fixed flat rate from your health insurance fund.

• You do not pay a practice fee or a fixed amount per visit.
• Costs may be incurred for certain additional services that are not included in the statutory health insurance catalog. These are referred to as individual health services (IGeL).

The system is structured in such a way that you have already created the basis for your medical care through your regular contributions.

What does a visit to the GP cost?

The cost of a GP visit are covered by the flat rate for those with statutory health insurance. There are no direct costs for you as a patient, unless you would like an additional service that is not covered by your health insurance.

Costs for privately insured and self-paying patients: The scale of fees for doctors (GOÄ)

The situation is different for people who are privately insured or who pay for treatment themselves. For them, the scale of fees for doctors (GOÄ) applies. This set of rules lists the costs for almost every medical service, from a simple consultation to physical examinations and complex operations.

The price of a service is determined by a so-called rate of increase. The simple rate is usually multiplied by a factor of 2.3 or 3.5, depending on the effort, difficulty and time involved. A simple consultation therefore costs less than a complex examination using special equipment. Rates outside this framework can also be agreed.

• What does a private doctor cost? Billing is based on the GOÄ, which means that the costs for private patients are often higher than the lump sums received by statutory health insurance physicians.
• Costs of a private medical examination: The price depends heavily on the type of examination. A simple physical examination is charged at 2.3 times the normal rate, while extensive diagnostics allow higher rates.

After their visit to the doctor, private patients receive a detailed invoice, which they initially pay themselves and then submit to their private health insurance company for reimbursement.

How much does a visit to the doctor cost as a self-payer?

If you are a self-payer, for example if you have statutory health insurance and would like private treatment, you will also pay for the medical service in accordance with the GOÄ. Here too, you will be invoiced directly. The costs are identical to those for privately insured persons. Self-pay treatments are not subsequently covered by health insurance.

Online consultation: What does a visit to the doctor in the virtual practice cost?

With the increasing digitalization of the healthcare system, online consultations have established themselves as an alternative to traditional visits to the doctor. The same billing principles apply here as in the local practice.

For you as a patient, especially if you have statutory health insurance, the key question is whether your health insurance will cover the costs. Health insurance companies cover the costs of telemedical treatments via video consultation.

Important note: TeleClinic has cooperations with many health insurance companies, so that you also benefit from free advantages. These include 24/7 availability, even on Sundays and public holidays, as well as additional services such as the photo skin check.

• Sick notes and prescriptions can be issued via app at the doctor’s discretion.
• The costs for an online consultation are comparable to an analog doctor’s visit and can be covered by health insurance.

Frequently asked questions about the cost of a visit to the doctor

• What does a visit to the doctor cost the health insurance company?

  The costs for a visit to the doctor cannot be specified as a lump sum for the statutory health insurance funds. They negotiate a flat-rate reimbursement per patient and quarter with the associations of statutory health insurance physicians. There are also fixed individual reimbursements for certain services. The actual expenditure per insured person therefore depends on the intensity of treatment.

• How much does a visit to the doctor cost without insurance?

  If you do not have health insurance, you will have to pay the costs of the doctor’s visit yourself. Billing is based on the scale of fees for doctors (GOÄ). The costs vary depending on the work involved and the treatment. A simple GP visit with a brief consultation and physical examination, for example, can cost between 25 and 45 euros, while specialized treatments can be significantly more expensive. Health insurance is compulsory in Germany, so these cases are rare.

• How much does a private doctor cost?

  The term “private doctor” describes a doctor who exclusively treats private patients. The costs for treatment are also based on the GOÄ. As private doctors often set their rates at the upper end of the GOÄ, the costs can be higher than those of panel doctors who also treat patients with statutory health insurance.

Conclusion: When does it make sense to see a doctor?

Regardless of the cost issue, it is important to seek medical advice if you have health problems. In Germany, the cost is not an obstacle for most people. Whether you opt for a visit to a local practice or an online consultation: Doctors will help you find the right diagnosis and treatment.