TK insurance customers in Germany seek quality in treatments abroad

The Wineg-Institute of the Techniker health insurance (TK) has published the fourth annual survey of the TK members about their planned treatments abroad. Most of those getting planned overseas treatment are retirees between 70 and 79 treated in a German-speaking spa resort. The top four destinations are Italy, Poland, Czech Republic and Hungary.

The Wineg-Institute of the Techniker health insurance (TK) has published the fourth annual survey of the TK members about their planned treatments abroad.

Most of those getting planned overseas treatment are retirees between 70 and 79 treated in a German-speaking spa resort. The top four destinations are Italy, Poland, Czech Republic and Hungary.

The three reasons for deciding where to go are: good experience with previous treatment, the combination of treatment and relaxation, plus cost savings.

The results of the survey, concerning the satisfaction with the quality of the facilities and the treating doctors, are very positive. For TK members, access to quality is the main reason for future planned EU treatments abroad

Techniker Krankenkasse (TK) with more than 7 million customers is the largest statutory health insurance fund in Germany. Less than one percent of TK members have ever gone to other European countries for insurer paid treatment; customers are very loyal and rarely if ever switch from one insurer to another.

Techniker Krankenkasse (TK) was a pioneer in enabling its members to seek treatment abroad, and is still one of the very few EU health insurers that allows it. For spas and dentistry, the German customer has to pay a high proportion of the cost out of pocket. For those getting dental treatment abroad, the insurer pays out the same amount, so the balance paid by the customer when the cost is lower, is much less. As the overall cost of treatment is much lower, their own share of the costs is much lower.

But unless the insured customer wants to cover all the costs themselves, they do not have a free choice of country or location. TK and the customer share the costs of treatment only at an accredited health spa, including room and board as well as travel to and from the health spa. TK members can choose a health resort outside Germany, but only one in TK’s network of 26 partners in Italy, Austria, Poland, Czech Republic, Slovakia and Hungary that TK pay on a direct basis. All facilities are inspected on site by TK for their compliance with quality standards. The customer can only get treatment within the EU in a facility within TK’s network

For planned treatment abroad, to get reimbursement after treatment and after they have paid the hospital/clinic themselves; the customer has to supply detailed bills/medical prescriptions-including detailed invoices with names of doctors, treatments and costs listed. TK reimburses those costs that would have resulted from that treatment in Germany, limited to the amount of the bill, minus the additional contribution/co-payments stipulated by German law, and with other approved deductions.

To comply with cross-border insurance law, TK does allow customers to select and pay for any type of treatment that is covered under the insurance and under German healthcare rules. Effectively this means they can go to any EU or EEC country, but the insurer has to pre-approve the treatment and destination, while there are several other pre-approval rules that if not followed means that TK will not repay the bills that the customer pays. The spa treatment is a TK extra so only applies in a TK approved spa.

For any customer that travels to a foreign country for treatment and pays the costs, then they are the direct contractual partner of the foreign care provider. TK rebates the costs but cannot influence the quality or price of the benefits received.

Health insurance is a part of the German social insurance system. All employees are either compulsorily insured or a voluntary member of a statutory health insurance fund. This depends on income level and has no impact on the contribution amount or the benefits they receive. So every German and every foreigner working or living in Germany must have health insurance.