Demander la prise en charge de l'interruption de grossesse par l'assurance maladie obligatoire
Votre chemin vers l'application
Vous faites la demande de prise en charge auprès de votre caisse d'assurance maladie obligatoire.
Le navigateur des caisses du GKV-Spitzenverband vous mène au portail de vos caisses d'assurance maladie obligatoires. Vous y apprendrez comment faire votre demande.
Si vous avez des questions ou si vous souhaitez obtenir des conseils, veuillez vous adresser à votre caisse d'assurance maladie obligatoire.
If you are applying for additional coverage in cases where there is no medical or criminological indication:
- Proof of your personal income and financial circumstances, such as a current pay stub or bank statement
Please check with your health insurance provider to find out what additional documents are required in addition to proof of your personal income and financial circumstances.
You do not have to pay anything for the application.
Explication simple
If the abortion is performed for criminal or medical reasons, the costs are covered by your health insurance and billed by your doctor via the electronic health card (eGK). A prior application for cost coverage is not required. This applies in the following two situations:
- If, from a medical standpoint, the termination of pregnancy is necessary to avert a danger to your life or the risk of serious impairment to your physical or mental health, the health insurance provider will cover the costs of the termination. In this case, it is not necessary to apply to the health insurance provider for coverage, as the doctor makes the necessary determination.
- If the pregnancy is to be terminated because it is the result of a crime against sexual autonomy—for example, in the case of rape—the health insurance provider will cover the costs of the abortion if no more than 12 weeks have passed since conception. In this case, it is not necessary to apply to the health insurance provider for coverage, as the doctor will make the necessary determinations.
If the termination of pregnancy is performed for other reasons, it is unlawful but not a criminal offense provided the following conditions are fully met:
- You must provide the doctor with a certificate from a recognized pregnancy conflict counseling center proving that you received counseling at such a center at least 3 days before the procedure.
- A doctor performs the termination.
- No more than 12 weeks have passed since conception.
In this case, the health insurance provider covers the costs for:
- medical counseling regarding continuing or terminating the pregnancy,
- medical treatment, with the exception of the termination itself and follow-up care in cases without complications,
- the provision of medications, bandages, and medical supplies, as well as
- hospital treatment
The costs for the medical procedure to terminate the pregnancy itself, as well as for post-procedure medical care in cases without complications, are not covered by health insurance.
However, if you have no income or a low income, you may, in certain cases, apply to your statutory health insurance provider to have the costs of these services covered. This is the case, for example, if you are considered to be in need of social assistance.
Quelles sont les exigences à respecter ?
If there is no medical or criminal justification, you are entitled to full coverage of the costs of the abortion if
- you are a resident of Germany or have your habitual residence there, and
- following a review by your health insurance provider, it is not reasonable to expect you to cover the costs of the abortion for financial reasons. You can find out the exact requirements and income limits for this from your health insurance provider.
In particular, the financial burden is considered unreasonable for you if you
- receive subsistence assistance (“social assistance”) or
- basic income support;
- have a disability and receive training assistance (training assistance under the Federal Employment Agency’s regulation on individual support for vocational training or on employment and vocational support for people with disabilities) or
- receive training assistance under the Federal Training Assistance Act (BAföG) or
- benefits under the Asylum Seekers Benefits Act;
- are housed in a residential home or a similar facility, and the costs for this are covered by social assistance or youth welfare services.
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