This article addresses common queries about referrals for specialist visits. Our other piece on remedies discusses the necessity of referrals prior to consulting a therapist.
If you're covered under our standard short or long-term plan, it's wise to get a referral from a general practitioner (GP) before seeing a specialist. Without one, you'll only receive a 75% reimbursement for specialist fees.
GPs typically charge lower fees compared to specialists. Assessing the necessity or suitability of a specialist treatment by a GP helps insurance providers significantly reduce medical costs.
For example, back pain might necessitate a neurologist rather than an orthopedist. These cost-saving measures result in lower monthly premiums for insured individuals on standard plans compared to premium plans.
Who are general practitioners?
Family doctors (Hausärzte), gynecologists, pediatricians, ophthalmologists and dentists are general practitioners. These doctors can issue you a referral to see a specialist.
What does a referral look like?
The standard and widely used referral format in Germany is shown below; however, referrals from other countries do come in different forms, such as documents or other formats.
Do I need to get a referral every time I see a specialist?
Submitting a referral ensures full reimbursement if you are insured under a standard plan. It's important to note that a referral remains valid for six months from its issuance and can be reused for the same condition or follow-up appointments with the specialist. However, if your follow-up appointment takes place six months after the initial referral, you can contact your general practitioner's office to request a reissued referral with a new date. No appointment is necessary for this, and you can conveniently pick it up at the practice.