The world of acronyms is huge: terms that are formed from the initial letters of individual words are increasingly appearing. "IGeL" is such an acronym. And in this case, neither the "community of interests of Labyrinth fish", nor the "Institute for Holistic Learning" or any other institution is meant. "IGeL" is the acronym for "Individual Health Services". This means first of all all diagnostic and treatment options that are not covered by the statutory health insurance.
Show hedgehogs or spines?
A total of 79 points from the so-called benefits catalog of the statutory health insurance (GKV) are currently IGeL. These include:
- Travel medical advice and corresponding vaccination advice
- Travel vaccinations
- Fitness examinations, for example, for travel, airworthiness, diving sport
- Sports medical examinations and consultations
- Allergic professional aptitude tests (eg baker, hairdresser)
- Medical-cosmetic services such as removing tattoos
- Aesthetic operations
- Tests to test the compatibility of cosmetics
- Blood group determination on request
- Additional check-ups on request
Many meaningful investigations
With many IGeL achievements can be recognized quickly, why they should not be paid by the health insurance companies, but still make sense. For example, if you want to go on a holiday in the tropics, you should definitely have your "tropical fitness" checked by the doctor. Together with the appropriate vaccinations you can drive so well prepared on vacation, without having to lie on the bag the health insurance. Holiday is private pleasure - and the right holiday preparation is not in the funding task of the health insurance. Also useful are the allergological occupational aptitude tests, which are partly prescribed by the professional associations.
For example, if you want to become a baker, you should get tested for a possible flour dust allergy before starting work; Hairdressers or masons come into contact with chemicals that they may be allergic to. Therefore, a clarification before starting work is important - and this is possible without health insurance participation. Similarly, for example, the glaucoma examination at the ophthalmologist, which is useful for patients over 40 years of age and can prevent future blindness. This disease goes unnoticed without examination and can not be treated adequately in the further stage.
Heal or cash off?
According to a study of the Scientific Institute of the AOK (WIdO) and the Consumer Center NRW, almost a quarter of all insured persons (23.1%) have been offered an individual health service. At the same time, this offer is made clear to a rather high-income and educated patient population, as the study found out.
For the patients, the situation is often as follows: When talking with the doctor, it becomes clear that a faster, or even better clarification by additional tests is possible. These must then be paid for privately. At this point, many patients feel pressured, relying on the expertise and expertise of their doctor.
However, a serious offer from the doctor's office will always give the patient plenty of time to rethink the situation and obtain comprehensive information. If the doctor's offer is based on an acute and specific emergency, the costs would be covered by the health insurance company anyway. The German Medical Association also describes the range of IGeL services as a balancing act between "healing and cash-off", because in their opinion statutory health insurance no longer guarantees the necessary medical care in all areas. At the upcoming German Medical Conference in May 2006 in Madgeburg, a revised list of IGeL services will be presented and discussed.
Create your own transparency
Anyone who is offered an "individual health service" in the doctor's office should accept it as such: an offer which, from the doctor's point of view, is medically necessary in individual cases. If the purpose and meaning of the proposed study are not obvious, it should specifically and emphatically ask for the meaning and purpose of the supplementary studies.
No doctor is allowed to perform and charge an individual individual benefit against the declared will of the patient. No patient may be forced to make an immediate decision during the examination or the interview. Who has doubts about the necessity of the proposed investigations, should in case of doubt, get a second opinion. Your own health insurance is also a good contact person at this point.
First the consent, then the investigation
In principle, additional services that are billed privately must always be recorded in a written agreement before the service is used. The patient must be expressly informed of the costs to be borne by him in this agreement and must declare his consent in writing.
If this consent is not available, the doctor may not invoice. The invoice amount is based on the fee schedule for doctors (GOÄ). Since every calculation is based on a complicated accounting system, the patient should also be able to explain the price of his examination well and inquire in case of doubt at the medical association.
For patients this means:
- Let us explain exactly how you benefit from the investigation and what consequences you have to expect.
- Do not be pressured and take your time to decide.
- If in doubt, get a second opinion.
- Before using your cash register, ask why the cost of this service is not covered.
It is generally forbidden to offer such services on account, which are actually cash benefits. If patients are asked by their doctor with reference to the exhausted budget for private payment, the health insurance and the medical association should be switched on. Some patient counseling offers the social association VdK Germany. In addition one can inform oneself also with the consumer centers.
Stiftung Warentest has also examined the various cancer screening examinations and recorded their findings in the book "Examinations for Early Detection - Cancer - Benefits and Risks". The book can be ordered there directly or through the bookstore. The German Medical Association informs together with the Ärztekammer Nordrhein in a brochure about individual individual services.