Does supplementary insurance pay for IGeL services at the doctor?
In short
Does supplementary insurance pay for IGeL services at the doctor? Partly. Outpatient top-up policies often refund check-ups and screening up to a fixed amount, one published policy up to EUR 200 a year. Anything not listed in the terms you pay yourself. A policy taken out just for IGeL rarely pays off, because the premium usually eats up the budget.
Prices of common IGeL services and premiums of outpatient top-up policies from published figures.
Example
Typical range
Ovarian ultrasound
about EUR 25 to 53
Glaucoma screening by eye examination
about EUR 20 to 40
Skin cancer screening as a self-payer
about EUR 35 to 100
Outpatient top-up policy, age 26 to 39
about EUR 18 to 28 a month
Outpatient top-up policy, age 40 and over
about EUR 22 to 32 a month
Check-up budget in one published policy
up to EUR 200 a year, building up to EUR 1,000
IGeL prices as of July 2025 from the IGeL Report 2024 and consumer research;
premiums as of October 2026 from published tariff examples of one insurer.
The doctor may charge more or less depending on effort.
Your premium depends on age and scope; we obtain the exact quote.
Worked example
Woman, 45, three IGeL services a year
She has an ovarian ultrasound, an eye examination and a blood count, and is considering an outpatient top-up policy for them.
Ovarian ultrasound
EUR 25 to 53
Eye examination for glaucoma screening
EUR 20 to 40
Blood count as a check-up
EUR 40 to 100
IGeL total
EUR 85 to 193 a year
Outpatient policy from age 40, EUR 22.14 a month
EUR 265.68 a year
Even if the policy refunds all three examinations from the check-up budget, the premium is higher. Only with glasses, alternative practitioners or vaccinations on top can the policy pay off.
What IGeL services are
IGeL stands for individuelle Gesundheitsleistungen, individual health services. These are examinations and treatments your statutory health insurer (gesetzliche Krankenkasse) does not pay for, because their benefit is not proven or because there is no medical reason. The doctor bills you privately under the German fee schedule for doctors (GOÄ).
Common examples are an ultrasound of the ovaries for cancer screening, eye pressure measurement for glaucoma, the PSA test or a full blood count without symptoms. If you have actual symptoms or a suspected condition, the same examination is often covered by your Krankenkasse. So always ask first why it is not covered here.
IGeL service
Price at the doctor's
Ovarian ultrasound for cancer screening
about EUR 25 to 53
Eye examination for glaucoma screening
about EUR 20 to 40
Blood count as a check-up
about EUR 40 to 100
PSA test for prostate screening
about EUR 25 to 35
Breast ultrasound for cancer screening
about EUR 26 to 60
Vitamin D test
about EUR 27 to 33
What supplementary insurance pays for
An outpatient top-up policy (ambulante Zusatzversicherung) does not pay for every IGeL automatically, only for what its terms list. A typical feature is an annual amount for check-ups and screening; one published policy offers up to EUR 200 a year, which can build up to EUR 1,000. Some policies only refer to the statutory screening programmes, and then the typical IGeL services are not included.
Check three things: whether the policy explicitly refunds check-ups outside the statutory catalogue, how high the annual budget is, and whether it is shared with glasses or alternative practitioners (Heilpraktiker). A shared pot can be used up by a single pair of glasses.
When it pays off and when it does not
A mid-range outpatient policy costs about EUR 12 to 32 a month in published examples. If you only use two or three IGeL a year, you will often pay more in premiums than you get back. A policy just for IGeL therefore rarely makes sense.
It looks different if you use the policy anyway for glasses, alternative practitioners, travel vaccinations or professional teeth cleaning. Then the check-up budget is an extra you can take along. It is still worth looking at the IGeL ratings of the Medical Service (Medizinischer Dienst): many services have no proven benefit there.
Before the examination: agree in writing
If the doctor knows that nobody is certain to cover the costs, they must tell you the expected costs in text form before treatment. For people with statutory insurance, the doctor also needs your written consent to private treatment and a note that you will bear the costs.
Where written consent was missing, a regional court ruled that the doctor had no claim to a fee at all. Do not sign anything in passing at reception; take time to think and submit the invoice to your top-up insurer afterwards. If your German is limited, ask for the cost information to be explained before you sign.
Step by step
Ask the doctor why your Krankenkasse does not pay for the service.
Get the costs in text form with the GOÄ item numbers.
Check in the policy terms whether check-ups outside the statutory catalogue are refunded.
Check the budget and how much is left this year.
Only then agree in writing and submit the invoice to your insurer.
Checklist
Costs received in text form beforehand
Written consent only after time to think
Invoice under GOÄ with item number and multiplier
Policy explicitly lists check-ups or screening
Annual budget not already used for glasses or alternative practitioners
Common mistakes
Taking out a top-up policy just for IGeL
Signing at reception without knowing the costs
Assuming that every check-up in the policy includes IGeL
Paying for an IGeL when you have symptoms and the Krankenkasse would be responsible
Questions and answers
Frequently asked
Does statutory health insurance pay for IGeL?
No, that is exactly what makes them IGeL.
Some Krankenkassen voluntarily refund individual services as extra benefits (Satzungsleistungen);
ask yours.
Does private health insurance pay for IGeL?
The term does not exist for privately insured people.
Private health insurance (PKV) refunds what is medically necessary and covered by the policy;
check-ups under the statutory programmes are usually included.
Do I have to pay for an IGeL without a written agreement?
According to a ruling by the Regional Court of Mannheim,
the doctor has no claim to a fee without prior written consent.
A verbal agreement is not enough.
Can I submit the invoice afterwards?
Yes, if your policy covers the service and the waiting period is over.
Treatment before the policy started is not covered.
How can I tell which IGeL make sense?
The IGeL-Monitor of the Medical Service rates many services.
None received a clear positive rating there, three were rated tending to positive.
