Insémination artificielle - Demande de prise en charge des coûts
Votre chemin vers l'application
Vous devez faire la demande de prise en charge auprès de votre caisse d'assurance maladie obligatoire. De nombreuses caisses proposent une procédure en ligne à cet effet.
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 sur la demande, veuillez vous adresser à votre caisse d'assurance maladie obligatoire.
Si vous avez des questions sur le traitement de la stérilité, les centres de consultation en matière de grossesse peuvent vous aider. Vous trouverez un localisateur de centres de conseil sur la page Planification familiale de l'Institut fédéral de la santé publique.
- 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.
Explication simple
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.
Quelles sont les exigences à respecter ?
- 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.
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