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
The same applies to all orthopedic and oncological operations: you have to hope that health insurance supports you. Many insurances do that by now. In some cases, there are even cooperation agreements with expert offices which support patients during the process. And of course it is better to be well informed before making a medical decision. Your health insurance company will also understand this.
If you do not want to go looking for a clinic yourself, you can also hire an expert office. The employees of the expert offices – who are often doctors as well – make sure that the documents are complete. They also look for a suitable specialist and they are your contact person when you have problems understanding the second medical report.
The following table lists the twenty-five biggest health insurances in Germany. It is indicated which diseases are covered for a second opinion and whether you can obtain help from an expert office.
Second Opinion is Free of Charge for these Diseases
|Insurance||Operation/Disease||Help by Expert Office||Insured Persons|
|Techniker||for back, knee, spinal and hip surgery||Yes||10.663.500|
|Barmer||for back and knee surgery||No||8.969.500|
|DAK Gesundheit||for orthopedic interventions||Yes||5.600.000|
|AOK Bayern||for cancer, knee surgery||No||4.563.000|
|AOK Baden-Württemberg||many specialist areas, e.g. orthopedic interventions and cancer||No||4.508.600|
|AOK Plus||for cancer and orthopedic interventions in joints||No||3.368.000|
|IKK Classic||for cancer, cardiological interventions and foot, hand, hip, knee, back surgery||Yes||3.129.100|
|AOK Rheinland/Hamburg||many specialist areas, e.g. orthopedic interventions and cancer||No||3.038.100|
|AOK Nordwest||for cancer and orthopedic interventions||No||2.900.000|
|AOK Niedersachsen||not specified||not specified||2.858.500|
|Debeka||many specialist areas, e.g. orthopedic interventions, cancer, psychological Illnesses||No||2.438.893|
|AOK Nordost||Orthopedic interventions, cancer and various other specialist areas||No||1.741.800|
|AOK Hessen||Orthopedic and cardiological interventions, cancer||Yes||1.702.200|
|KKH Kaufmännische Krankenkasse||ENT surgery, heart surgery, cancer, urological interventions and back, hip, knee surgery||Yes||1.669.400|
|Knappschaft||Orthopedic interventions, cancer||No||1.542.900|
|AOK Rheinland-Pfalz/Saarland||Orthopedic interventions, cancer||No||1.202.700|
|Siemens-Betriebskrankenkasse||Back interventions, cancer||Yes||1.061.100|
|BKK Mobil Oil||Knee, hip, back surgery||Yes||1.002.100|
|Axa||Orthopedic interventions, Rare and chronic diseases||Yes||798.938|
|AOK Sachsen-Anhalt||Orthopedic interventions, gynecology||Yes||785.000|
|DKV||many specialist areas, e.g. orthopedic interventions and cancer||No||741.195|
|Audi BKK||Knee, hip, back surgery||Yes||722.800|
|Viactiv Krankenkasse||not specified||not specified||693.900|
|Pronova BKK||Back, Hand, Hip, Knee, Foot Surgery||Yes||660.300|
This list has been researched in October 2020. If you know of further offers of the listed insurances or have a question, do not hesitate to contact us.