Private insurance & Beihilfe

Private insurance & Beihilfe

Psychotherapy for privately insured patients and Beihilfe recipients

In many cases, psychotherapy can be reimbursed by private health insurance or Beihilfe (the German civil service health allowance). Which services are covered depends on your individual insurance contract or the applicable Beihilfe rules.

I not only accompany you therapeutically, but can also help make the application and billing process easy to follow. That way you know before treatment begins which steps are needed.

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BILLING & REIMBURSEMENT

How billing works

Treatment is billed according to the German fee schedule for psychotherapists (GOP), which is based on the fee schedule for physicians (GOÄ). Your contract is with my practice, and you receive the invoice directly from me. As a rule, I bill at 2.3 times the base rate. The first consultation is billed the same way: as one unit of psychotherapy including a psychopathological assessment (50 minutes). You will find the individual amounts on the fees page.
As is usual with private insurance, you first pay the invoice yourself and then submit it to your private insurer or Beihilfe office, which reimburses you.

Whether and to what extent costs are covered depends on your individual insurance contract or the Beihilfe rules. As these can differ, it is advisable to clarify coverage with your insurer or Beihilfe office before treatment begins.
If longer-term psychotherapy requires an approval or application process, I will of course guide you through it and provide the necessary documents.

Good to know

The rules of private health insurers and Beihilfe differ in some respects. The following sections give you the key information on both routes and on how an application might proceed.

PRIVATE INSURANCE OR BEIHILFE?

Two routes, one goal

Even though the details may differ, private health insurance and Beihilfe have one thing in common: under certain conditions, the costs of psychotherapy can be covered in full or in part.

Here is an overview of the main differences.

Private insurance

Benefits depend on your individual insurance contract. Depending on your plan, psychotherapy is reimbursed in full or in part. Often a few initial assessment sessions are possible first. If required, an application for coverage is made afterwards.

As contract terms differ, it is advisable to contact your private insurer before treatment begins and clarify what is covered.

Beihilfe

Beihilfe covers part of the treatment costs for those entitled to it and is usually supplemented by private insurance for the remaining costs. Longer-term psychotherapy often requires an approval procedure.

Which documents are needed and how the process works in detail depends on the respective Beihilfe office. I am happy to help you prepare the necessary steps and answer your questions about the procedure.

THE PROCESS

How treatment works

The exact process may vary depending on your private insurer or Beihilfe office. In many cases, however, treatment follows these steps:

01Arrange a first consultation

In the first consultation we get to know each other and discuss your concerns. Together we consider whether psychotherapy makes sense and which method (psychoanalysis or psychodynamic psychotherapy) seems suitable for you.

02Initial assessment sessions

In the first sessions you have the opportunity to find out whether you can imagine working with me. At the same time, this phase serves diagnostic assessment and joint treatment planning.

Schreibtisch mit Bücherregal in der Praxis von Rahel Simmenauer

03Application and approval

If your private insurer or Beihilfe office requires approval, I will help you with the necessary documents. Once approved, regular treatment can begin.

04Beginning psychotherapy

Sessions take place at the rhythm we have agreed. During treatment we regularly review progress and adjust therapy if needed.

Good to know

Yes. As is usual with private insurance, you first pay the invoice yourself and then submit it to your private insurer or Beihilfe office.

That depends on your individual plan. Some plans reimburse the full cost, others only partly or up to a certain limit. I recommend clarifying coverage directly with your insurer before treatment begins.

Initial assessment sessions serve diagnostic clarification and are usually reimbursed regardless of prior approval. Whether this applies to your plan is best clarified in advance with your insurer or Beihilfe office.

It happens. Sometimes documents are simply missing, sometimes an appeal makes sense. It depends on the reasons given and your plan. I am happy to help you understand the decision and communicate with your insurer.

It varies and depends on the respective office. As a rule, you should allow a few weeks. I provide the necessary documents promptly so that the process is not delayed unnecessarily.

The GOÄ/GOP sets a base rate for each service, which is multiplied by a factor depending on the effort involved. Factors between 2.3 and 3.5 are common. Above 2.3, a brief justification is required on the invoice. As a rule, I bill at 2.3 times the base rate; I only charge a higher rate for particularly demanding or complex treatment.

Yes. So that your insurer or Beihilfe office can reimburse the costs, the diagnosis appears on the invoice. If discretion is particularly important to you here, you may also want to look into the option of paying yourself, where no diagnosis is passed on.

Which steps apply to you can be clarified in a first consultation.

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