Artificial insemination - applying for cost coverage
Your way to the application
You can apply to your statutory health insurance provider to have the costs covered. Many insurance companies offer an online procedure for this.
The Health Insurance Navigator of the National Association of Statutory Health Insurance Funds takes you to the portal of your statutory health insurance fund. There you can find out how to submit your application.
If you have any questions about the application, please contact your statutory health insurance fund.
If you have any questions about fertility treatment, the pregnancy advice centers can help you. On the Family Planning page of the Federal Institute of Public Health, you will find a finder of advice centers.
- Original treatment plan with a copy from the attending physician or fertility center.
Depending on the special case, further documents may be required. Please contact your health insurance company for more information.
You do not have to pay anything for the application.
Simply explained
Before starting treatment, you must submit a treatment plan drawn up by a doctor to the health insurance company for approval. The statutory health insurance companies will cover 50 percent of the costs of the measures approved in the treatment plan.
Treatments on the man's body are covered by the man's health insurance, treatments on the woman's body are covered by the woman's health insurance.
The main requirements are
- You cannot become pregnant naturally.
- From a medical point of view, artificial insemination measures are suitable for bringing about a pregnancy.
- You are married and use your own egg and sperm cells.
- Women must be between 25 and 39 years old; men between 25 and 49 years old.
Your doctor can advise you on the various methods of artificial insemination.
It often takes several attempts at artificial insemination for you to become pregnant. Artificial insemination measures may only be carried out at the expense of the statutory health insurance funds if there is a reasonable chance that the chosen treatment method will result in pregnancy. The Federal Joint Committee stipulates further details in its guidelines on artificial insemination. According to these guidelines, there is no longer a sufficient chance of success for the respective treatment measures if
- in the case of insemination in a spontaneous cycle up to eight times,
- up to three times in the case of insemination following hormonal stimulation,
- up to three times in the case of in vitro fertilization,
- up to twice for intratubal gamete transfer,
- up to three times in the case of intracytoplasmic sperm injection
without a clinically proven pregnancy having occurred.
What requirements must be met?
- Your doctor has diagnosed you with a fertility disorder. This means that you are unable to conceive naturally.
- Your doctor confirms that fertility treatment has a chance of success.
- Both partners are married.
- Only your own egg and sperm cells may be used. The statutory health insurance companies cannot cover artificial insemination with sperm or egg donation from a third party.
- If you are a woman, you must be at least 25 years old and no older than 39.
- If you are a man, you must be at least 25 and no older than 49.
Frequently asked questions and answers
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