Private Doctor (“Wahlarzt”)
A “Wahlarzt” like a private doctor does not have a contract with his or her health insurance. The term “Wahlarzt” comes from the right of the patients to choose their doctor freely. The payment will be made directly with the patient after the appointment. Your child will be treated as a private patient and he or she will receive an invoice. You may send all medical invoices – after payment – to your insurance with a request for reimbursement. Pursuant to social security regulations, you will receive an average of 80% of those costs your health insurance would have to pay if you had consulted an in-network provider. Health insurances settle their invoices every quarter. The amount of the prorated reimbursement is determined by the services performed and is relatively high for standard examinations and less time-consuming consultations. However, the prorated reimbursement can be relatively low for extensive consultations, though many insurance companies cover the majority or all of the costs. Your insurer will provide you with the information and the forms necessary for the refund. Prescriptions from a private doctor are just as redeemable in the pharmacy as those issued by an in-network physician.