The Reimbursement Principle
Private health insurance (private Krankenversicherung, PKV) in Germany works differently from statutory cover. Instead of the provider billing your insurer directly, you generally receive a bill, pay it, and claim the cost back from your insurer. This "cost-reimbursement" model (Kostenerstattungsprinzip) gives you a direct relationship with your doctor as a private patient — and means good admin habits get you repaid quickly.
The flow: treatment → you receive an invoice → you submit it to your insurer → the insurer reimburses you (and you settle the provider). Many insurers let you submit before you have paid, so the reimbursement funds the bill.
What You Need to Submit
A clean claim usually includes:
- The itemised invoice (Rechnung) from your doctor, dentist or therapist, billed under the correct fee schedule (GOÄ/GOZ)
- The prescription for medication or remedies, plus the pharmacy receipt
- A treatment/cost plan (Heil- und Kostenplan) for major dental work, ideally pre-approved
- Your policy number and the patient's details
How to Submit
| Method | Notes |
|---|---|
| Insurer app | Fastest — photograph the invoice and upload; quickest reimbursement |
| Online portal | Upload scans; good audit trail |
| Post | Still accepted; slower; keep copies |
Most modern insurers offer an app that lets you photograph invoices and submit them in seconds, with reimbursement often arriving within days. Using the app is the single biggest thing you can do to speed up repayment.
Timelines and the Deductible
Reimbursement typically arrives within one to three weeks, faster via app. Remember that your deductible (Selbstbeteiligung) is applied across the year: early claims may be partly absorbed by your excess until it is met, after which you are reimbursed in full per your tariff. Keep a simple running total so you know where you stand against your deductible.
Common Mistakes to Avoid
- Submitting a non-itemised invoice — insurers need the GOÄ/GOZ breakdown
- Forgetting the prescription for medication or remedies
- Starting major dental work without pre-approval — submit the Heil- und Kostenplan first
- Letting invoices pile up — submit promptly so reimbursement aligns with payment deadlines
- Not keeping copies — always retain a copy until reimbursement is confirmed
Make It a Habit
The reimbursement model sounds like extra work, but with an insurer app and a little discipline it is quick and gives you full transparency over your healthcare costs. Submit promptly, keep clean records, and pre-approve big-ticket treatment, and PKV claims become a smooth, predictable routine rather than a chore.
Frequently Asked Questions
Compare PKV Tariffs for Your Situation
Our independent advisors help expats and professionals find the right private health insurance — personalised to your age, health, and budget.
Get My Free Quote