Services
Costs and coverage
Before you decide on an additional service, we discuss what it involves and the expected cost. Whether your insurer covers it depends on the particular service and your insurance terms. Booking an appointment does not in itself mean agreeing to self-funded treatment.
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Understanding
A closer look
If a medically appropriate option in your situation is not covered by German statutory health insurance, we tell you about this additional self-funded service. You decide for yourself whether you wish to use it. You do not have to decide during the appointment. Arranging an appointment alone does not mean agreeing to additional services that carry a charge.
Why the exact scope of services matters
A cost estimate needs to make clear which services are included, such as an examination, treatment, imaging guidance or a follow-up. We explain the planned scope. If the treatment plan changes, the cost information needs to reflect that.
If you have German statutory health insurance
Whether a service can be provided under German statutory health insurance depends on the relevant requirements and the specific billing arrangements. This does not mean that every medically recommended measure is covered, nor that every additional investigation must be paid for privately.
If you have German statutory health insurance and pay for a service that your insurer does not cover, we provide a cost estimate in advance. We explain the scope of the service and the expected costs. We provide the service only after you have confirmed the self-funding agreement in writing. Please ask if it is unclear which components are covered and which are not.
Further information
DXA bone density scanning at our practice
DXA, also called DEXA, is offered at OrthoCoast as a self-funded service. Our practice is not authorised to bill German statutory health insurers for this examination. This concerns billing at our practice and is not a general statement about whether DXA can be covered by statutory health insurance.
Before the examination, we explain its planned scope and expected costs. Please also clarify which medical interpretation and discussion of the findings are included. Other parts of osteology care are considered separately; this DXA arrangement does not automatically make them self-funded services.
If you have private insurance or Beihilfe
Even with private insurance or German civil-service healthcare assistance (Beihilfe), reimbursement is not determined by the treatment name alone. The applicable contract and reimbursement terms may differ. A medical recommendation is therefore not a binding commitment from the organisation paying for your care.
If you want to clarify reimbursement in advance, the planned service should be described precisely enough. Ask which documents your insurer or reimbursement body needs. Please agree with us what information our practice can provide in your particular case.
What matters for your decision
Considering a self-funded service
An additional service is considered because it may address a specific medical question, not because you pay for it yourself. We explain the goal, the evidence for possible benefit, relevant risks and alternatives. Where study results are inconsistent, uncertainty is expressly part of that discussion. A higher price is not evidence of a better effect.
Please ask if the benefit, practical demands or costs are still unclear. You may take the information home and decide later. Whether to use a recommended self-funded service remains your decision. The cost estimate gives you a concrete basis for making it.
Discussing your individual costs clearly
The costs depend on the services actually planned and the circumstances of your treatment. Information on a website can offer guidance but does not replace individual information relating to the specific scope of care. It should be clear which services a cost quotation covers for your enquiry.
Further billing arrangements and, where applicable, use of the German medical fee schedule (Gebührenordnung für Ärzte) are explained for each service. A general flat fee for every patient or a promise of reimbursement in advance would not adequately reflect individual circumstances.
Considering costs and medical urgency separately
For urgent symptoms, medical help comes first. You will find the appropriate route on ‘Acute symptoms and medical emergencies’. We are happy to discuss questions about additional services and costs with you.
For routine appointments, clarify your enquiry through patient services. If we have already discussed and recommended a treatment, you can decide to proceed later and use the agreed route. A new consultation solely to arrange the appointment is not required. Please contact us beforehand if your symptoms have changed. For an additional service, we also discuss the associated costs afresh.
Frequently asked questions
Does requesting an appointment already constitute a cost agreement?
No. Requesting an appointment or choosing an appointment type does not replace a self-funding agreement. If you have German statutory health insurance and pay for the service yourself, you receive a cost estimate in advance and sign before the service is provided.
As a patient with German statutory health insurance, must I pay for every OrthoCoast service myself?
A self-funded service such as DXA does not imply any such general rule. Billing arrangements are clarified for each service.
Can I assume my costs will be reimbursed because someone else’s were?
No. The scope of services, medical circumstances and insurance terms may differ. Clarify your own situation based on the specific service planned.
Why is there no general price list here yet?
A cost quotation must match a clearly described scope of services. You will receive the relevant information for your planned treatment before making a decision.
Do I have to agree to a self-funded service immediately?
No. We explain the possible benefit, limitations, alternatives and expected costs. You can consider the information in your own time and decide later. Before the service is provided, the cost estimate must be available and you must have signed to confirm that you wish to receive the treatment and agree to pay the costs.
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