Leistungen bei einer durch Krankheit erforderlichen Sterilisation Gewährung

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

Statutory health insurance companies cover the cost of sterilisation if the procedure is medically necessary.

For women: If

• pregnancy would endanger her health.

For healthy men:

• If a pregnancy is expected to cause serious harm to the woman and at the same time the sterilization procedure 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 sterilisation.

None

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

• Insured persons are entitled to benefits in the event of sterilisation necessitated by illness.
• The entitlement applies to both women and men.
• Sterilisation necessitated by illness is deemed to have occurred if the treatment is necessary to protect personal health. This is the case, for example, for women for whom pregnancy would be harmful to their health and another form of contraception is not possible or not reliable.
• On the other hand, there is no medical indication if, due to the health condition of one of the parents, an illness of the child would have to be feared in the event of pregnancy, since in this case sterilisation is not a curative but a prophylactic measure.
• Sterilisations that are not due to illness and are to be carried out within the framework of individual life planning cannot be borne by the SHI.

The responsibility lies with the respective health insurance company.