Guide for those with statutory health insurance (GKV)

In addition to a doctor’s referral, you will need written confirmation of coverage from your health insurance provider in advance. Our experienced admissions management team will be happy to assist you with all the necessary steps and formalities.

Private clinic with statutory health insurance – how cost coverage works

Even for patients with statutory health insurance, there is generally the possibility of your statutory health insurance provider contributing to the costs of your stay in a private clinic. The decision usually depends on the diagnosis, the course of treatment to date, and the medical necessity of inpatient treatment.

Statutory health insurance providers generally cover the costs that would have been incurred for equivalent treatment in a public hospital in your area. Any differences in cost are borne by the patient. These depend on the room category, individual additional services, and any surcharges.

If you have private supplementary insurance, this may cover additional services or significantly reduce your co-payment. Daily sickness allowance insurance can also help to minimize any remaining costs. We would be happy to advise you personally on this.

Apply for coverage by your statutory health insurance provider

To apply for coverage by your statutory health insurance provider, you will need a hospital referral from your treating specialist with a diagnosis according to ICD-10. Some health insurance providers also require a cost estimate from the private clinic of your choice. We can provide you with this estimate on request by telephone or via our contact form.

As soon as your health insurance provider has confirmed coverage in writing, you can send us the referral and approval. You will then be admitted to our private clinic as soon as possible.

Admission to a private clinic with statutory health insurance – step by step to approval

To ensure that your statutory health insurance covers the costs before your stay, we recommend the following procedure:

1. Your attending specialist issues a referral for inpatient treatment with a diagnosis according to ICD-10.
2. In addition, a specialist report should be enclosed, stating which outpatient treatment attempts have already been made and why inpatient therapy is medically necessary.
3. If you have already started outpatient psychotherapy, a short statement from your psychotherapist recommending inpatient treatment may be helpful.
4. You yourself write an informal letter to your health insurance company requesting a case-by-case review and reimbursement of costs for the desired treatment at the Limes Schlossklinik Fürstenhof. In it, describe your motivation, e.g., the need for intensive, disorder-specific therapy.

We would be happy to provide you with an individual cost estimate for your health insurance company in advance. This will enable them to make a quick decision on your request.