Leistungen bei einer durch Krankheit erforderlichen Sterilisation Gewährung

The statutory health insurance companies cover the costs of medically necessary sterilization.

The statutory health insurance companies cover the costs of sterilization if the procedure is medically necessary.

In women: If

• pregnancy would endanger their health.

In healthy men:

• If a pregnancy is expected to cause serious damage to the woman and at the same time the procedure of sterilization would be life-threatening for the woman.

In other cases, you bear the costs yourself.

• Electronic health card

The attending physicians decide in which cases there is a medical indication for sterilization.

You can appeal against the decision of the health insurance fund. If the objection is not remedied, you can file a complaint with the competent social court.

• Insured persons are entitled to benefits in the event of sterilisation required by illness.
• The claim exists for both women and men.
• Sterilization required by illness occurs when treatment is necessary to protect personal health. This is the case, for example, in women for whom pregnancy would be harmful to health and another form of contraception is not possible or reliable.
• On the other hand, there is no medical indication if, due to the state of health of one of the parents, there would be a risk of the child becoming ill in the event of pregnancy, since in this case sterilisation is not a curative but a prophylactic measure.
• Sterilizations that are not due to illness and are to be carried out as part of individual life planning cannot be carried out at the expense of the GKV.

Please contact your health insurance company.

Ask your health insurance company if there are already pre-printed applications / forms.