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Belastungsgrenze bei Zuzahlungen in der gesetzlichen Krankenversicherung prüfen lassen

Sachsen-Anhalt 99134035128001, 99134035128001 Typ 2/3

Inhalt

Leistungsschlüssel

99134035128001, 99134035128001

Leistungsbezeichnung

Have the load limit for co-payments checked in the statutory health insurance

Leistungsbezeichnung II

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Leistungstypisierung

Typ 2/3

Begriffe im Kontext

nicht vorhanden

Leistungstyp

Leistungsobjekt mit Verrichtung und Detail

Leistungsgruppierung

Krankenversicherung (134)

Verrichtungskennung

Ermittlung (128)

Verrichtungsdetail

the load limit for co-payments in the statutory health insurance

SDG Informationsbereiche

nicht vorhanden

Lagen Portalverbund

  • Gesundheitsvorsorge (1130100)
  • Sozialabgaben (1060300)

Einheitlicher Ansprechpartner

Nein

Fachlich freigegeben am

24.07.2020

Fachlich freigegeben durch

Lower Saxony Ministry of Social Affairs, Health and Gender Equality

Teaser

Co-payments for medicines, remedies and applications may not exceed two percent of the annual gross income.

Volltext

For medications, remedies and applications that are prescribed, co-payments must be made. However, those with health insurance do not have to pay more than two percent of their annual gross income.

For chronically ill people, the load limit is one percent of the annual gross income.

Gross income includes all income with which insured persons finance their livelihood - for example:

  • Salary
  • pensions or pensions,
  • Interest on capital
  • Rental income

When calculating the load limit, the annual gross income of all members living in the household is taken into account. These can be spouses, life partners under the Civil Partnership Act or children with family insurance.

For families, the burden limit is reduced by the child allowances and, if necessary, the allowance for the spouse.

In the case of recipients of social assistance, the standard rate of the head of household is used as the basis for calculating the load limit, which is why the allowances cannot be estimated.

Children and adolescents up to the age of 18 are generally exempt from co-payments. Exception: Co-payment for travel expenses.

Erforderliche Unterlagen

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Voraussetzungen

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Kosten

Fees may apply. Please contact the competent authority. 

Verfahrensablauf

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Bearbeitungsdauer

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Frist

Deadlines may have to be observed. Please contact the competent authority.

Weiterführende Informationen

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Hinweise

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Rechtsbehelf

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Kurztext

  • Co-payments are due for prescribed medications, remedies and applications
  • The co-payments may not exceed two percent of the annual gross income
  • For the chronically ill, the limit is one percent
  • Children and adolescents up to the age of 18 are exempt from the co-payment
  • In the case of recipients of social assistance, the standard rate of the head of household applies as the basis for calculation

Ansprechpunkt

Contact your health insurance company.

Zuständige Stelle

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Formulare

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