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

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

InsuranceOperation/DiseaseHelp by Expert OfficeInsured Persons
Technikerfor back, knee, spinal and hip surgeryYes10.663.500
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 surgeryYes3.129.100
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 surgeryYes1.669.400
KnappschaftOrthopedic interventions, cancerNo1.542.900
AOK Rheinland-Pfalz/SaarlandOrthopedic interventions, cancerNo1.202.700
Siemens-BetriebskrankenkasseBack interventions, cancerYes1.061.100
BKK Mobil Oil Knee, hip, back surgeryYes1.002.100
AxaOrthopedic interventions, Rare and chronic diseasesYes798.938
AOK Sachsen-AnhaltOrthopedic interventions, gynecologyYes785.000
DKVmany specialist areas, e.g. orthopedic interventions and cancerNo741.195
Audi BKKKnee, hip, back surgeryYes722.800
Viactiv Krankenkasse not specifiednot specified693.900
HandelskrankenkasseBack surgeryNo678.200
Pronova BKKBack, Hand, Hip, Knee, Foot SurgeryYes660.300

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.