From: The role of consumer choice in out-of-pocket spending on health
Service | Coverage and required co-payments | requirement | incentive |
---|---|---|---|
medicines | |||
    prescribed medicines | co-insurance of 5-10€ per package (10% up to reference price) + difference between actual and reference price | moderate | moderate |
    non-prescribed medicines | no coverage | high | moderate |
medical goods and equipment | |||
    prescribed medical goods | co-insurance of 10%, max. 10€ per month | moderate | moderate |
    non-prescribed medical goods | no coverage | high | moderate |
    medical equipment and medical aids | basic options covered with 10% co-insurance, maximum 10€ per month | high | high |
dental care | |||
    dental care services | free if necessary and effective, additional services not covered | none | moderate |
    materials for crowns and dentures | partial reimbursement, co-payments can be several hundred Euros even for standard care (Regelversorgung), hardship provisions for poor households can be granted | high | high |
ambulatory care | |||
    ambulatory medical services | free if deemed necessary and effective (then fully covered by SHI) | none | moderate |
    admission fee | user charge of 10€ per 3 months from 2004–2012 | moderate | none |
    referred services | free if prescribed, no coverage otherwise | none | moderate |
inpatient care | daily fee of 10€ for a maximum 28 days per year, additional services (e.g. single bed rooms) not covered | moderate | moderate |