IGeL: What are individual health services, how useful are they, what do they cost??
IGeL is the abbreviation for "Individual health services". These include medical, dental or even psychotherapeutic Services that patients have to pay for themselves, because the statutory health insurances do not usually cover them.
Examples for this are:
– special preventive examinations during pregnancy – certain eye examinations – cosmetic operations
The physicians offer these examinations during consultations. However, the services go beyond the normal scope of medically necessary care and must therefore be paid for by the patient.
A good example of this is Cosmetic surgery, such as z. B. Nose operations or hallux valgus operations. These are only covered by statutory health insurance in very rare cases. For this to be eligible, there must be medical reports proving that the patient is significantly limited by pain or psychological stress and cannot lead a normal life.
Which IgEL are there?
Basically, two types of IGeL are distinguished:
Services that are not actually medically necessary, but which make perfect sense from an individual point of view:
Medical certificates and services: These would be, for example, a certificate to declare a travel withdrawal, or individual sports medical examinations such as a medically controlled fitness test.
Medical-cosmetic services: Examples are cosmetic surgery or the removal of tattoos.
Psychotherapeutic services: These include, for example, couples therapy or light therapy for depressive symptoms.
Services that are carried out without a well-founded suspicion of illness using innovative methods.
This means that patients want to be examined at their own request. Here are three examples:
– A
Ultrasound examination of the breast or ovaries In the gynecologist's office for early cancer detection. – The screening for glaucoma at the ophthalmologist's office. Special laboratory tests, without symptoms of a disease being present.
These IGeL are most frequently used
– Intraocular prere measurement
One of the most frequently offered and accepted services is intraocular prere measurement for the early detection of glaucoma.
Ultrasound examinations for the early detection of ovarian cancer or of the abdominal cavity are also frequently used.
The PSA test to determine the prostate-specific antigen in the blood is used for early detection of prostate cancer. The costs for the test are not covered by the statutory health insurances.
Who decides what is IGeL?
The Joint Federal Committee, a committee of physicians and representatives of the health insurance funds, decides which medical services are included in the catalog of the statutory health insurance funds. For this purpose, scientific studies are evaluated and costs, benefits and possible harm are weighed up.
If services are evaluated as "negative" – that is, they are not medically necessary, not economical or possible risks for postoperative damage outweigh – then they may not become a health insurance benefit. However, they are permitted as IGeL services.
A Accurate and up-to-date overview of all existing IGeL offers there is no. However, interested parties can enter the desired service in a search field on the IGeL Monitor website, z. B. "Acupuncture in pregnancy", and then receive all the important information on the procedure and costs. Further links to studies as well as a classification of how effective or possibly harmful the treatment is can also be found there.
Important: Not all existing IGeL services are listed, but only the following:
– Services that are also offered in medical practices of established physicians and not only by alternative practitioners. – Services that are frequently offered. – Services that are particularly frequently requested by patients.
IGeL can become a health insurance benefit, if there is a well-founded suspicion of a disease. This is first decided by the attending physician. In unclear cases, health insurers can also have an independent expert opinion prepared.
Beware of unnecessary examinations
From time to time it happens that IGeL are advertised, although they are not necessary or useful are.
Inform yourself in advance .
Therefore, patients should inform themselves carefully before they make use of such a service. The German Medical Association has created an information page on this topic, which includes a checklist with ten different questions. Here are two examples:
Do I feel from my doctor understandable on the benefits and possible risks or side effects of IGeL consult?
– Was I informed that I would receive a second opinion can obtain?
. and dare to ask questions
If you answer "no" to some of the questions, you should be alert. Because according to the resolution on the "handling of individual health services" of the 109. German Doctors' Conference is about Promotional advertising prohibited. False expectations regarding the success of a treatment must also not be raised.
The IGeL treatment contract
For each IGeL is a treatment contract and one final invoice required by law.
Our tip: Contact your health insurance company to find out if they actually do not pay for the service. Because as soon as you have paid the bill, the health insurance company will no longer reimburse you for the costs.
Which health insurance company covers the costs for IGeL?
The statutory health insurance funds cover the costs of preventive examinations at certain fixed intervals. If the doctor recommends further examinations, for example in case of suspicious findings, these are also covered.
If you additional examinations If you have a medical examination and checks, such as the PSA test, carried out, you will usually have to bear the costs for this yourself.
In this case, it may be worthwhile to take out private supplementary insurance, such as the R+V supplementary insurance for visual aids + preventive care. Depending on the tariff you choose, we will reimburse you up to 400 euros within two calendar years for additional preventive examinations.