Second medical opinion
Sometimes a second medical opinion provides for more clarity. @Photographee.eu/Adobe Stock

You may get a second opinion before surgery. Either you hire an expert office or you organize the second opinion yourself.

Katja Kutsch (name changed) was surprised when the oncologist of the Thorax Clinic in Heidelberg told her that his therapy suggestion for her lung cancer costs 350 euros. Excuse me? In return she receives his verdict by letter in her mailbox. She thought that she had the right to obtain a second opinion. That is what is written in the German Code of Social Law (§ 27b SGB V Second Opinion).

Yes, that is absolutely her right. The only trouble is that the health insurance doesn’t have to pay for this second medical opinion. At least not for most diseases. Currently, the costs for second opinions are covered by health insurance only for three interventions: removal of the uterus, tonsil operations and shoulder arthroscopy.

Help with Organization

However, there is a big BUT here. You can call a clinic or doctor of your choice, make an appointment and come by with your records. A doctor will advise you free of charge. Because practice and theory sometimes differ. And, of course, it is better to be well informed before making a medical decision. Your health insurance company also recognizes this.

If you do not want to search for a clinic yourself, you can also hire an expert’s office. The employees of the expert offices – some of them also doctors – make sure that the documents are complete. They also go in search of a suitable specialist and are the point of contact if comprehension questions arise regarding the second medical opinion.

The following table lists the twenty-five largest health insurance companies in Germany. It is indicated for which diseases the second opinion is guaranteed to be covered according to the insurance company’s website and whether employees of an expert office will help you to organize the second opinion.

Help with second opinion from insurance company or expert’s office

InsuranceOperation/DiseaseHelp by Expert OfficeInsured Persons
Technikerfor back, knee, spinal and hip surgeryNo10.663.500
Barmerfor back and knee surgeryNo8.969.500
DAK Gesundheitfor orthopedic interventionsYes5.600.000
AOK Bayernfor cancer, knee surgeryNo4.563.000
AOK Baden-Württembergmany specialist areas, e.g. orthopedic interventions and cancerNo4.508.600
AOK Plusfor cancer and orthopedic interventions in jointsNo3.368.000
IKK Classicfor cancer, cardiological interventions and foot, hand, hip, knee, back surgeryNo3.129.100
AOK Rheinland/Hamburgmany specialist areas, e.g. orthopedic interventions and cancerNo3.038.100
AOK Nordwestfor cancer and orthopedic interventionsNo2.900.000
AOK Niedersachsennot specifiednot specified2.858.500
Debekamany specialist areas, e.g. orthopedic interventions, cancer, psychological IllnessesNo2.438.893
AOK NordostOrthopedic interventions, cancer and various other specialist areasNo1.741.800
AOK HessenOrthopedic and cardiological interventions, cancerYes1.702.200
KKH Kaufmännische KrankenkasseENT surgery, heart surgery, cancer, urological interventions and back, hip, knee surgeryNo1.669.400
KnappschaftOrthopedic interventions, cancerNo1.542.900
AOK Rheinland-Pfalz/SaarlandOrthopedic interventions, cancerNo1.202.700
Siemens-BetriebskrankenkasseBack interventions, cancerNo1.061.100
BKK Mobil Oil Knee, hip, back surgeryNo1.002.100
AxaOrthopedic interventions, Rare and chronic diseasesYes798.938
AOK Sachsen-AnhaltOrthopedic interventions, gynecologyNo785.000
DKVmany specialist areas, e.g. orthopedic interventions and cancerNo741.195
Audi BKKKnee, hip, back surgeryNo722.800
Viactiv Krankenkasse not specifiednot specified693.900
HandelskrankenkasseBack surgeryNo678.200
Pronova BKKBack, Hand, Hip, Knee, Foot SurgeryNo660.300