Prescription Co-payment: Who Qualifies and What You Get
Learn how prescription co-payments work for public insurance holders in Germany and how to limit your annual costs.
This scheme involves a small shared cost for medication that public insurance holders must pay when filling a prescription.
Who it's for
This scheme is designed specifically for individuals who are covered under public health insurance. If you are a member of a public insurance provider, you are subject to these co-payment rules when obtaining medication.
What you get
The primary benefit of being in the public insurance system is that the insurance provider covers the vast majority of the cost for your prescribed medications. Instead of paying the full price for a drug, you only pay a fixed, capped portion, which makes essential medicine much more affordable for the average citizen.
What it costs you
When you go to the pharmacy to collect your medication, you will be required to pay a small fee. This co-payment typically ranges between €5 and €10 per prescription. This amount is a set contribution toward the cost of the medicine.
The catch to know
While you must pay these fees, there is a safety net in place to prevent high medical costs from becoming a financial burden. If your total spent on these co-payments reaches a certain level, you can be exempted from paying more for the rest of the year. This limit is based on your annual income. If your total costs exceed 2% of your annual income, you can apply to have the remaining costs covered. This concept is known locally as the "Belastungsgrenze," which serves as a cap on your out-of-pocket medical expenses.
How to apply
- Collect and save every receipt from the pharmacy that shows your co-payment for each prescription.
- Monitor your total spending throughout the year to see how close you are to the income-based limit.
- Once you believe you have reached the threshold based on your annual income, contact your public health insurance provider.
- Submit your documentation and proof of income to the insurance provider to request an exemption from further co-payments for the remainder of the year.