Health insurance companies: Appointments must be based on medical necessity

Berlin. Germany's health insurance companies support requests for an appointment to see a doctor regardless of insurance status.

“It is long overdue that appointments should only be made based on medical necessity,” said the deputy chairwoman of the National Association of Statutory Health Insurance Funds, Stefanie Stoff-Ahnis, to the German Press Agency in Berlin.

“The fact that this problem has now reached its full extent in politics is a good signal for 75 million people with statutory health insurance,” said the top representative of statutory health insurance (GKV).

Politicians from the CSU and SPD are also pushing for steps to be taken against long waiting times for a doctor's appointment for those with statutory health insurance. Klaus Holetschek, CSU parliamentary group leader in the Bavarian state parliament, told the “Bild” newspaper: “It should be considered whether online portals for making appointments are no longer allowed to ask whether a patient is legally or privately insured.” SPD health politician Christos Pantazis also spoke out in favor of introducing an “appointment guarantee”.

Stoff-Ahnis said that the question about the type of health insurance is in fact “an instrument of discrimination” against those with statutory health insurance. “It is absurd and incompatible with my understanding of justice if sick people do not receive doctor’s appointments in the order of medical necessity, but rather according to their insurance status.”

The fund official referred to the model of a primary care system. In the future, appointments could be made in a more targeted manner and, above all, based on medical needs, she said. The coalition also wants to launch such a system. The aim is for patients to be better guided through the healthcare system through certain medical practices as the first point of contact.