Health insurance companies: higher co-payments for medicines

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Health insurance companies: Increasingly higher co-payments for medicines

Statutory health insurance patients had to pay more in total for medicinal products in 2010 than in 2009, according to the Federal Association of Pharmacists, referring to the data's own analysis.

Insured persons of the statutory health insurance companies had to pay significantly more for prescription drugs last year than in the previous year. In 2010, patients paid a total of around 1.8 billion euros for medication. That is around 71 million euros more than in 2009, according to the German Pharmacists' Association (DAV). The association was able to evaluate the data because the pharmacies are legally obliged to transmit the additional payments received to the statutory health insurance companies.

Co-payments have increased slightly for several years
Co-payments for medicinal products for people with statutory health insurance have been increasing for years. In 2007, health insurance patients in Germany had to make additional payments of 1.625 billion euros. In 2008 it was almost 1.7 billion euros (1.675). In 2009, insured persons paid around 1.696 billion euros and in 2010 1.767 billion euros. The main reason for the increase in the past year may have been the reduction of numerous fixed amounts and additional payment exemption limits by the statutory health insurance (GKV) as of September 1, 2010. In addition, the prices for pharmaceuticals rose slightly on average.

On average, each insured person paid GKV EUR 2.40 per pack of medication. In the three years before (2007, 2008 and 2009) it was 10 cents less than the average of € 2.30 per drug. Every till patient has to pay 10 percent of the regular sales price for prescription medication. The minimum limit is five euros, the maximum limit for additional payments is 10 euros per pack. However, the additional payment may never be higher than the actual sales price.

Discounts and exemptions from co-payments for drugs
Legislation stipulates that exemptions from the co-payment for medicinal products apply in certain circumstances. Every child and adolescent is exempt without exceeding the age of 18. If an insured person has to spend more than two percent of their gross annual income on pharmaceuticals, the exposure limit has been exceeded. The insured person can then apply for exemption from the additional payment from his health insurance company. If the person affected is chronically ill, the exposure limit is one percent.

If the drug price is 30 percent lower than the fixed amount, the drug can be included in the list of exemptions. Here too, a corresponding application must be made to the responsible health insurance company. Depending on the health insurance provider, discounts for drugs can also be negotiated. The respective health insurers will provide more information. (sb)

Read on this topic:
Medicines: Health insurers will soon pay more
Medicines: drug prices rise

Image: Viktor Mildenberger /

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Video: Understanding Your Health Insurance Costs. Consumer Reports


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