Service fees and co-payments
Health insurance covers most healthcare costs, but for some services you will have to pay a service fee or co-payment.
Visit and bed-day fees are additional fees that healthcare providers are entitled to charge for services covered by the Health Insurance Fund.
The co-payment for healthcare services is the amount that you, as an insured person, must pay yourself for certain services. The amount of the co-payment is determined in accordance with the additional conditions set out in the Health Insurance Fund's list of healthcare services.
Good to know!
A visit fee may not be charged for preventive services, such as participating in a screening.
Good to know!
A visit fee may not be charged for preventive services, such as participating in a screening.
Frequently asked questions
When should a service fee be paid and when not?
A service fee may be charged:
- For issuing a document (including a health certificate)
- The fee must be reasonable and, in the case of minors, must not exceed the average cost of issuing the document.
- The healthcare provider who has received the fee must issue the patient with a document certifying receipt of the fee.
- A family doctor may not charge for a certificate required for military service, but must submit an invoice to the national defense department responsible for the conscript's place of residence.
- For issuing an extract from a health card (for example, if you change your family doctor)
A service fee may be charged:
- For issuing a document (including a health certificate)
- The fee must be reasonable and, in the case of minors, must not exceed the average cost of issuing the document.
- The healthcare provider who has received the fee must issue the patient with a document certifying receipt of the fee.
- A family doctor may not charge for a certificate required for military service, but must submit an invoice to the national defense department responsible for the conscript's place of residence.
- For issuing an extract from a health card (for example, if you change your family doctor)
No service fee is required for:
- issuing a certificate of incapacity for work;
- issuing a prescription.
No service fee is required for:
- issuing a certificate of incapacity for work;
- issuing a prescription.
When do I have to pay a visit fee?
A visit fee may be charged
- For a home visit by a doctor, including a family doctor
- For a visit to a specialist (including a dentist), physiotherapist, clinical psychologist, and speech therapist, as well as for visits to the emergency department.
A visit fee may be charged
- For a home visit by a doctor, including a family doctor
- For a visit to a specialist (including a dentist), physiotherapist, clinical psychologist, and speech therapist, as well as for visits to the emergency department.
The visit fee may not be charged
- for a visit to a family doctor;
- for preventive services, such as national screening tests;
The visit fee may not be charged
- for a visit to a family doctor;
- for preventive services, such as national screening tests;
If the patient does not show up at the agreed time for the service or cancels the appointment less than 24 hours before the start of the visit or procedure, the healthcare provider has the right to charge them double the visit fee the next time.
If the patient does not show up at the agreed time for the service or cancels the appointment less than 24 hours before the start of the visit or procedure, the healthcare provider has the right to charge them double the visit fee the next time.
If the patient does not show up at the agreed time for the service or cancels the appointment less than 24 hours before the start of the visit or procedure, the healthcare provider has the right to charge them double the visit fee the next time.
How much can the visit fee be?
The Health Insurance Act sets a maximum limit for such fees. Charging a fee is the right of the service provider, not an obligation – the medical institution may always set a more favorable visit or bed-day fee for you.
The visit fee is
- up to €5 for a visit by a doctor, including a family doctor;
- up to €20 for a visit by a specialist (including a dentist), physiotherapist, clinical psychologist, or speech therapist, and for visits to the emergency department.
The Health Insurance Act sets a maximum limit for such fees. Charging a fee is the right of the service provider, not an obligation – the medical institution may always set a more favorable visit or bed-day fee for you.
The visit fee is
- up to €5 for a visit by a doctor, including a family doctor;
- up to €20 for a visit by a specialist (including a dentist), physiotherapist, clinical psychologist, or speech therapist, and for visits to the emergency department.
The visit fee for a specialist is up to €5 for insured persons who are:
- under 19 years of age;
- pregnant (except in cases where outpatient care is provided in connection with pregnancy or childbirth);
- mothers of children under one year of age;
- persons over 63 years of age;
- recipients of disability or old-age pensions under the National Pension Insurance Act;
- persons with partial or no work capacity as determined under the Work Capacity Support Act;
- unemployed persons within the meaning of the Labor Market Measures Act;
- recipients of subsistence benefits under the Social Welfare Act or their family members, if the person or their family has received subsistence benefits in the month of outpatient specialist care or in the two preceding months.
The visit fee for a specialist is up to €5 for insured persons who are:
- under 19 years of age;
- pregnant (except in cases where outpatient care is provided in connection with pregnancy or childbirth);
- mothers of children under one year of age;
- persons over 63 years of age;
- recipients of disability or old-age pensions under the National Pension Insurance Act;
- persons with partial or no work capacity as determined under the Work Capacity Support Act;
- unemployed persons within the meaning of the Labor Market Measures Act;
- recipients of subsistence benefits under the Social Welfare Act or their family members, if the person or their family has received subsistence benefits in the month of outpatient specialist care or in the two preceding months.
In the case of specialist medical care, no visit fee may be charged:
- for emergency medical care (emergency medical care) if it is immediately followed by hospital treatment;
- if outpatient treatment is provided in connection with pregnancy or childbirth;
- upon referral within the institution to another doctor or a specialist equivalent to a healthcare professional;
- upon referral by a doctor to another doctor of the same specialty (including referral to another medical institution);
- again within 365 days if the doctor or specialist equivalent to a healthcare professional leaves the patient under their own observation or treatment;
- a healthcare specialist (physiotherapist, speech therapist, clinical psychologist) who works at a family doctor center or provides services to patients at a health center on the basis of a cooperation agreement and upon referral by a cooperation partner;
- for participation in a screening program.
In the case of specialist medical care, no visit fee may be charged:
- for emergency medical care (emergency medical care) if it is immediately followed by hospital treatment;
- if outpatient treatment is provided in connection with pregnancy or childbirth;
- upon referral within the institution to another doctor or a specialist equivalent to a healthcare professional;
- upon referral by a doctor to another doctor of the same specialty (including referral to another medical institution);
- again within 365 days if the doctor or specialist equivalent to a healthcare professional leaves the patient under their own observation or treatment;
- a healthcare specialist (physiotherapist, speech therapist, clinical psychologist) who works at a family doctor center or provides services to patients at a health center on the basis of a cooperation agreement and upon referral by a cooperation partner;
- for participation in a screening program.
How much can be charged for a bed day?
Up to €5 per day can be charged for a bed day in a hospital (including inpatient nursing care) for up to 10 days, i.e. a maximum of €50 for one case of illness for the time spent in hospital.
A bed-day fee may not be charged:
- for the duration of intensive care,
- for inpatient specialist care related to pregnancy or childbirth,
- for inpatient specialist care provided to a minor.
Up to €5 per day can be charged for a bed day in a hospital (including inpatient nursing care) for up to 10 days, i.e. a maximum of €50 for one case of illness for the time spent in hospital.
A bed-day fee may not be charged:
- for the duration of intensive care,
- for inpatient specialist care related to pregnancy or childbirth,
- for inpatient specialist care provided to a minor.
How much can the co-payment for healthcare services be?
Co-payment % of the total cost of the service and co-payment amount in euros
- Elective abortion, 30% - 60.29€
- Medical termination of a pregnancy at the request of the patient, 50% - 24.29€
- Bed-day fee for independent inpatient nursing care (formerly nursing care), 10% - 14.20€
- Enteral nutrition solution 1000 kcal (home treatment), 50% - 1.83€
- Oral standard complete nutritional supplement 600 kcal (home treatment), 25% - 1.78€ (no co-payment required in the case of a hereditary metabolic disorder)
- Oral nutritionally complete dietary supplement with customized composition 600 kcal (home treatment), 25% - 9.89€ (no co-payment required in the case of hereditary metabolic disorders)
- Oral nutritional supplement with customized composition to supplement regular food, 600 kcal (home treatment), 25% - 2.23€ (no co-payment required in the case of a hereditary metabolic disorder)
Co-payment % of the total cost of the service and co-payment amount in euros
- Elective abortion, 30% - 60.29€
- Medical termination of a pregnancy at the request of the patient, 50% - 24.29€
- Bed-day fee for independent inpatient nursing care (formerly nursing care), 10% - 14.20€
- Enteral nutrition solution 1000 kcal (home treatment), 50% - 1.83€
- Oral standard complete nutritional supplement 600 kcal (home treatment), 25% - 1.78€ (no co-payment required in the case of a hereditary metabolic disorder)
- Oral nutritionally complete dietary supplement with customized composition 600 kcal (home treatment), 25% - 9.89€ (no co-payment required in the case of hereditary metabolic disorders)
- Oral nutritional supplement with customized composition to supplement regular food, 600 kcal (home treatment), 25% - 2.23€ (no co-payment required in the case of a hereditary metabolic disorder)
Does the Health Insurance Fund cover the cost of a visit to a specialist for insured persons?
No, the Health Insurance Fund does not cover the cost of a visit to a specialist if the appointment is made outside the treatment queue. This is known as "jumping the queue," meaning that the patient waives the services financed by the Health Insurance Fund and pays the full cost of both the visit and the treatment to the medical institution themselves.
No, the Health Insurance Fund does not cover the cost of a visit to a specialist if the appointment is made outside the treatment queue. This is known as "jumping the queue," meaning that the patient waives the services financed by the Health Insurance Fund and pays the full cost of both the visit and the treatment to the medical institution themselves.
How much is the visit fee for a specialist if I do not have health insurance?
If you do not have health insurance, you will have to pay for healthcare services yourself. Each medical institution has its own price list, so you should ask the specific medical institution for the price.
Information about the current visit fee must be available and visible to patients in every medical institution.
If you do not have health insurance, you will have to pay for healthcare services yourself. Each medical institution has its own price list, so you should ask the specific medical institution for the price.
Information about the current visit fee must be available and visible to patients in every medical institution.
Why do I have to pay a visit fee when I go to a specialist, but not when I go to my family doctor?
This encourages people to first seek help from their family doctor for health concerns and only then, if necessary, refer to a specialist.
This encourages people to first seek help from their family doctor for health concerns and only then, if necessary, refer to a specialist.
A mother and child fell ill at the same time and a family doctor was called to their home, who charged a visit fee for both of them, totaling 10 euros (2 x 5 euros). Did the family doctor act correctly?
No, the family doctor did not act correctly. The visit fee for a single home visit may not exceed €5, regardless of the number of insured persons covered by the same home visit.
If the family doctor charged more than the permitted visit fee, please submit the doctor's details and a receipt proving payment together with a statement to the Health Insurance Fund.
No, the family doctor did not act correctly. The visit fee for a single home visit may not exceed €5, regardless of the number of insured persons covered by the same home visit.
If the family doctor charged more than the permitted visit fee, please submit the doctor's details and a receipt proving payment together with a statement to the Health Insurance Fund.