Privately insured people in Germany are generally reimbursed for video and telephone consultations, because doctors bill them under the Gebührenordnung für Ärzte (GOÄ). What you actually get back depends on your tariff terms and a correct invoice. The joint billing recommendations describe how certain telemedical services can be billed. At Myhealthcarebroker, we review tariff wording for you in English.
TL;DR:
- Search the written tariff for video and telephone consultations, care after treatment, telemonitoring, digital prescriptions, exclusions, approval rules, and claim deadlines.
- Doctors bill remote visits under the GOÄ, but your insurer reimburses according to your tariff; some insurers also offer direct billing through partners.
- Submit an itemized invoice with the date, service, and any GOÄ codes, then follow your tariff’s submission channel and deadline and retain supporting documents.
- A doctor decides whether remote care is clinically appropriate; video psychotherapy and chronic condition monitoring may carry separate duration or approval rules.
- The private insurers’ association says privately insured patients face no percentage cap on video consultations, while public insurance caps them.
Table of Contents
- Which telemedicine services do private tariffs usually cover?
- How does billing and reimbursement work under GOÄ?
- What should you look for in your tariff wording?
- How do you claim telemedicine costs step by step?
- Where does coverage get more conditional?
- Why does clear tariff wording matter more than the brand name?
- How can Myhealthcarebroker help you check telemedicine coverage?
- FAQ
- Sources
Which telemedicine services do private tariffs usually cover?
Your tariff documents rarely use the word "telemedicine" on its own. They list individual digital services, and these are the ones to look for:
- Video consultations: a live video call with a doctor, often through the practice's own certified video system.
- Telephone consultations: a billed phone appointment, useful for follow-ups and results.
- Digital follow-up care: check-ins after treatment, usually arranged through the practice or an app.
- E-prescriptions: a prescription sent to your phone or insurance app and redeemed at a pharmacy, as PKV guidance on digital medicine describes.
- Electronic sick notes: available when the doctor legitimately issues one after a remote consultation.
- Telemonitoring and DiGA: remote tracking for chronic conditions and prescribed health apps, where your tariff allows them.
Private insurers have reimbursed telephone and video treatment from early on. Check your tariff documents to see how digital services are described. A practical example: you book a slot through a telemedicine app, speak to a partner doctor, and may receive a prescription digitally. What follows is the part that decides your refund: the bill.
How does billing and reimbursement work under GOÄ?
Private doctors bill under the GOÄ, a fee schedule with numbered items. Consultation items such as GOÄ Ziffer 1 can be used for remote consultations where appropriate. This flexibility is one reason private insurance supported digital health innovation earlier and more broadly than the public system, according to a peer-reviewed discussion.
To keep billing consistent, the Bundesärztekammer, the Bundespsychotherapeutenkammer and the private insurers agreed joint billing recommendations that standardize how telemonitoring and certain telemedical services are charged.
The typical flow looks like this:
- The doctor issues an invoice based on GOÄ.
- You submit it to your insurer by paper, email or portal.
- The insurer reimburses according to your tariff.
- Some insurers work with telemedicine partners who bill directly.
Privately insured patients can use video consultations without a percentage cap, according to the private insurers' association. Public insurance, by contrast, has capped video consultations, so private patients start from a more generous position.
What should you look for in your tariff wording?
Open your tariff conditions (the AVB) and scan for specific phrases rather than the general word "digital":
- "Video consultation" and "telephone consultation"
- "Telemonitoring" and "digital follow-up care"
- "E-prescription" and any explicit mention of digital services
- Claim time limits and the required invoice format
- Partner integrations for direct billing
- Prior approval requirements for particular telemonitoring services
Digital benefits can vary between tariffs, so confirm any exclusions in the written tariff documentation. Confirm any exclusion in the written tariff documentation, never from a sales summary. If you are still choosing a plan, our overview of private health insurance in Germany explains how tariff classes differ.
Pro Tip: Search your tariff PDF for "Telemedizin", "Videosprechstunde" and "digital" before your first remote appointment, and save the matching pages with your policy number.
How do you claim telemedicine costs step by step?
- Get an itemized invoice. It should state the date, the service and the GOÄ codes where used. Mention your insurer and policy details when booking, as DKV advises for its online doctor service.
- Check your submission rules. Find the time limit and the accepted channel (portal, email or post) in your tariff.
- Attach supporting documents. Add the prescription, DiGA receipt or referral if relevant, and keep copies of everything.
- Track the claim. Answer insurer queries quickly. If anything is unclear or delayed, we can step in and help you resolve it.
Submitting promptly can help keep the paperwork fresh and avoid disputes over missing details.
Where does coverage get more conditional?
The treating physician decides whether a remote consultation is clinically appropriate. If the doctor wants to see you in person, the billing and next steps change accordingly. DKV notes that its partner doctors make this call case by case.
Psychotherapy by video and telemonitoring for chronic conditions follow their own joint recommendations. The FAQ on joint billing recommendations explains that such sessions can be provided and billed, but details like minimum durations and approval processes depend on your tariff. Our guide to psychotherapy and private health insurance covers the mental health side. Beihilfe-eligible insured persons should also expect some administrative rules to differ.
Why does clear tariff wording matter more than the brand name?
The most common question I hear is whether a video visit is refunded like an in-person one. The honest answer sits in a few clauses that most people never open. A short tariff review catches vague wording before you need the benefit, and it saves you from learning about a limit after the invoice arrives. If that sounds useful, ask us for a review.
— Marco
How can Myhealthcarebroker help you check telemedicine coverage?
We are an independent consultancy, not tied to a single insurer. We compare tariffs across providers, run eligibility checks, advise you in clear English and support you through the application and later claims. For telemedicine, we check how your tariff handles GOÄ billing, which digital clauses apply, and whether your insurer has partner integrations, and we help you assemble the claim documents. Our healthcare concierge service is there when you want hands-on help.
Ready for a tariff check? Request your free quote and we will review your telemedicine options with you.
This article is general information, not a substitute for advice from a qualified doctor. Consult a qualified healthcare professional about your own circumstances before acting on anything here.
FAQ
Who offers the best telemedicine provider in Germany?
There is no single best provider, because the right choice depends on your tariff and insurer. Check whether your insurer works with a telemedicine partner for direct billing, then compare how quickly you can get appointments and e-prescriptions.
How much does telemedicine cost?
Doctors bill remote consultations under GOÄ, so the cost depends on the service and the fee factor applied.
Which insurers offer telemedicine?
Many private insurers have reimbursed telephone and video treatment from early on. Because wording differs by tariff, read your own conditions or ask us to compare providers.
What tariffs exist in private health insurance?
Tariffs range from basic or standard-style plans to comprehensive premium plans. Digital benefits can vary between tariff classes, so check the written conditions of any plan you consider.
Sources
- Pmc
- Online-Arzt: Schnelle medizinische Betreuung & digitale Rezepte jederzeit verfügbar | DKV
- Digitale Medizin in der PKV