- Medical treatment
- Electronic Health Card and EHIC
- Family insurance
- Preventive health care and early diagnosis
- Cures and medical devices
- Hospital treatment
- Sick pay
- Health insurance for foreign students
- Pregnancy and maternity benefits
- Preventive check-ups
- What to do in case of illness
- Dental treatment and dental prosthesis
If you need to see a physician, dentist or therapist, you have free choice of your doctor. The only prerequisite: The doctor has to be a panel doctor of the statutory health insurance funds. The majority of physicians in private practice are panel doctors. It is a good idea to schedule an appointment with the doctor in advance. Just present your Health Card at the doctor’s office. Your doctor will then settle the costs of your treatment with IKK Südwest.
The health insurance fund does not only pay for the medical treatment but also for the medicines prescribed by the physician. Prescription drugs can be bought only in pharmacies in Germany. The costs for the medicines are paid by IKK Südwest. You have to make a co-payment on a case-by-case basis. Usually, co-payments amount to 10 percent of the costs – a minimum of EUR 5.00, a maximum of EUR 10.00. Some medicines are exempt from co-payments. Please ask your doctor for further information.
Electronic Health Card and EHIC
With the Electronic Health Card, you can identify yourself as an insured person and member of a health insurance fund. For us to be able to issue a Health Card to you, we need a photograph of you. As soon as you visit a doctor or dentist or go to the hospital, please present your Health Card. The easiest way to send the photo to us is an upload on our Web site. The back of the Health Card contains the European Health Insurance Card (EHIC). With the EHIC, you will receive all medically necessary services during trips abroad that cannot wait until you return to Germany.
The prerequisite is that your destination is a country of the European Union or a country with which a social insurance agreement is in place, such as Turkey, Switzerland, Macedonia, Serbia and Tunisia.
If your wife or husband is earning little money or nothing at all, she or he is co-insured in the health insurance free of charge. This also applies to your children. To be co-insured, they have to live in Germany. Whether your child can be co-insured also depends on the child’s age. If you want to co-insure your spouse or your children, we kindly request you fill out the application for family insurance.
Preventive health care and early diagnosis
We bear the costs of regular preventive health care – from the examination of a newborn baby on its first day to check-ups for teenagers. This also applies to the U10, U11 and J2 examinations, whose costs we bear in addition to the statutory benefits.
We pay an annual cancer screening test for women over 20 and for men over 45. For every person over “35”, we pay for the health check-up every second year. Beyond the statutory benefits, we bear the costs for an annual skin cancer screening starting at the age of 19.
Cures and medical devices
A doctor may prescribe a cure or medical device for you, e.g. a massage, physiotherapy, a wheelchair or a hearing aid. The costs are borne by IKK Südwest. You only have to make co-payments. With respect to medical devices, co-payments amount to 10% of the price, with a minimum of EUR 5.00 and a maximum of EUR 10.00. With regard to cures, the co-payment amounts to 10% of the costs and EUR 10.00 per prescription.
Prevention is better than curing. That’s why IKK Südwest also pays the costs for many vaccinations. Below you can view which vaccinations you are entitled to for yourself and your child:
- Haemophilus influenzae type b (Hib)
- Hepatitis B, if no other payer is competent for it or if the age of 18 has not yet been reached.
- Vaccination against early summer meningoencephalitis (FAME)
- Vaccination against cervical cancer without age limit (human viruses)
- Whooping cough (pertussis)
- Poliomyelitis (polio)
- Travel vaccinations (reimbursement of the full cost of recommended travel vaccinations)
- Influenza. Reimbursement of costs in full also for non-risk patients.
- Chicken pox (varicella)
- Lockjaw (tetanus)
Should you have any questions about cost coverage, settlement via your Health Card or about the reimbursement of costs, please don’t hesitate to contact us.
This also applies to travel vaccinations as prevention against diseases, some of which are very dangerous:
- Yellow fever
- Hepatitis A and B
- Japanese encephalitis
- Malaria prophylaxis
- Rabies and typhoid
Please speak with your doctor about which vaccinations are necessary and useful.
When you are insured with IKK Südwest, you can also get treatment at the hospital. The costs of treatment are settled between the hospital and the health insurance. If you are over 18, you must make a legally-prescribed, own contribution of EUR 10.00 per day for your stay in the hospital. But only for a maximum of 28 days. You pay your own contribution directly to the hospital.
If you are unable to work due to an illness, your employer as a rule has to continue to pay your wages for six weeks. From your doctor, you will receive a certificate regarding your inability to work. Please send the certificate immediately to your employer and the health insurance fund. Our mailing address is: IKK Südwest, P.O. Box, 66098 Saarbrücken. Please inform your employer without delay when you are ill and cannot go to work. If you are sick for longer than six weeks, your health insurance will pay you sick pay for a certain period of time.
Health insurance for foreign students
When you begin studying at a German university, it is mandatory for you to have health insurance. This means you have to insure yourself with a statutory health insurance fund. The prerequisite for this is that you still have not completed the 14th semester or are not older than 30 years of age as well as the enrolment in a state or state-recognised university. In the event that you are entitled to benefits in kind due to insurance regulations of your home country, this duty to obtain health insurance does not apply. For detailed advice, please contact us at: 0800/0 119 119.
Pregnancy and maternity benefits
When you are pregnant, you are entitled to 12 to 13 examination appointments with a gynaecologist or a midwife. Pregnant employees can take paid maternity leave six weeks before the birth of their child. During this time as well as up to eight weeks after birth, you do not have to work. During maternity leave, you receive maternity benefits of up to EUR 13.00 per calendar day from IKK Südwest. The employer raises these payments up to the amount of the net wage.
In the event that you have an accident on the way to work or at work, your health insurance is not automatically responsible for payment of treatment. Please inform the doctor or the hospital that the accident occurred on the way to work or at work. Please also inform your employer, since the accident has to be documented. In the case of other accidents (e.g. traffic accident, sports-related injuries, assault, etc.), IKK Südwest will bear the costs of treatment. Please inform us about the accident by telephone or e-mail in each and every case.
The sooner a disease is detected, the better it can be treated. We pay an annual cancer screening test for women over 20 and for men over 45. For every person over “35”, we pay for the health check-up every second year. We pay for at least one dental screening per year. Beyond that, IKK Südwest bears the costs for an annual skin cancer screening starting at age 19.
What to do in case of illness
If you have become sick or have an accident and you need to be treated by a doctor or in a hospital, IKK Südwest bears the costs of treatment. You have to pay only your own statutory contribution.
If you are over 18, you have to make co-payments for a number of benefits, e.g. for drugs, cures and medical devices or for hospital stays. If you or a family member make co-payments for prescription drugs or treatments, it makes sense to collect all invoices. Because you have to make co-payments only up to a specific maximum amount, which depends on your income.
Dental treatment and dental prosthesis
If you need dental treatment, we bear the costs. Please present your Health Card at the dentist’s office.You can have missing teeth replaced by dental prostheses (crown, bridge, full prosthesis). The dentist will create a treatment and cost plan. This plan has to be submitted to us together with the “bonus book” prior to the commencement of the treatment. We will calculate the fixed allowance we will pay. Upon conclusion of the treatment, the dentist will subtract the fixed allowance from the total bill. You then pay your own contribution.