Electrolysis refund Germany
Table of contents:
Insurance Belgium
So far, there are no reimbursement possibilities for electrolysis in Belgium.
Insurance abroad
Are you a trans woman wanting surgery at 2pass Clinic, but you do not live in Belgium? Sometimes you can get your treatment paid in full or in part by your health insurance with a European S2 form. However, not every insurance company deals with it the same way.
The S2 form, formerly known as E112, has been designed by the European Union for healthcare abroad. You can get it from your insurance company if you want to have an FFS or any other treatment at 2pass Clinic, but only if you do not live in Belgium yourself. Whether or not your insurance pays for the operation is not fixed. It varies per insurance company.
Please contact your insurance to receive your own S2 application form, then make sure to send it to us. The doctor will make sure you receive all the required documents.
Insurer decides
Whether the insurer assumes the costs (partially), depends on the type of treatment, but also on the company’s policy. Some treatments are considered purely cosmetic and are not reimbursed. Other interventions may be assessed as medically necessary. Ask the insurance company in advance what they normally pay back and what they don't. This prevents disappointment.
If the insurer agrees to the S2 application, the patient must submit the form to the clinic. The practitioner decides whether the costs are claimed directly from the insurer, or whether the patient receives the invoice and has to pay in advance. In the latter case, the patient can forward the bill to the insurer and request a refund. This should include a medical report from the attending physician.
Succesful refund examples
So far, refunds for electrolysis have only successfully been obtained by patients from Germany. You can find more information here on insurance refunds in Germany.
Even though patients from other countries have not reported any success regarding refunds, we suggest everyone contacts their insurance company even when the situation looks hopeless. Hopefully, when a significant amount of (trans) women keep contacting them about it, they will come to realize the system needs to change.
Germany
German citizens can try to get a reimbursement via two regulations:
Via the S2 application (formerly known as E-112):
The S2 form is actually only necessary if we, as a private clinic, would bill the Belgian basic health insurance funds directly for the services provided to German patients. First, you would need approval from your German health insurer, of course.
- You submit the S2 to your German health insurer.
- Your German health insurer approves the service abroad.
- Then you submit the approved cover - approved by the German health insurer (written on the S2) - to the competent authority in Belgium (this would be the "Mutualiteit" of your choice), submit the S2 in Belgium and have it approved here.
- Then you submit your paper to 2pass Clinic and then we can take further steps to bill the Belgian health insurance system. In that case, you as a patient would have nothing to do with the financial procedures.
Unfortunately, given that it is not a standard reimbursement in Belgium and approval depends widely on the insurer, we opt for the second regulation.
Claim reimbursement afterwards in Germany:
- After treatment or surgery, you submit the invoice to your German health insurance company, which refunds the service (after presentation of the confirmation of costs and the invoice/receipt). Some German health insurance administrations might say you need an S2 application, but that is only the case of you would opt for the 1st regulation listed above.
- Try to get a medical assessment that indicates it is a medical treatment needed in preparation for Facial Feminization Surgery or Sex Reassignment surgery, especially when the treatment cannot be provided in Germany.
E.g. In 2019, the German Federal Social Court (Bundessozialgericht) ruled that a public health insurance company must pay for transgender customers to have their beard hair removed, even if it is done by a beautician.
- Patient who received a refund for her electrolysis treatment at 2pass Clinic
- Patient who received a refund for her electrolysis treatment at 2pass Clinic
Still, things might go differently in reality
Insurance companies often mix op both regulations. Because of this, the counselling center in Mannheim offers the following information:
- First, an application is made to the German health insurance for a cost allowance. Reason: Nowhere in Germany is intensive feminizing needle epilation with analgesia offered that is similarly effective, appropriate and economical. In any case, you should enclose a medical letter, justifying the indication and form of therapy.
If the health insurance company has approved it, then start treatment in Belgium.
After completion of the first treatment unit, you can start billing. - If the health insurance company refuses, the insurance company should receive a legal letter and an insurance medical letter from a legal representative, in which the application is justified again in detail from a legal and medical point of view (more precisely insurance medicine).
As a rule, the insurance company will then approve the costs at the latest. - Particularly stubborn objectors may only be persuaded in the "contradiction procedure". There is a good chance that your application will be approved. This is because the case law of the Federal Social Court does not really allow anything else. Otherwise, you will have to go to the Social Court, but that would be quite unusual, because the legal situation is very clear.
We really hope things will change for the better. If changes were to occur, please contact us so we can update this info accordingly.
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