Statutory health insurance holders utilized significantly more funds for higher-value medical aids in 2025. According to a cost report published by the Federal Association of Statutory Health Insurance Funds (GKV-Spitzenverband) and reported by the Funke Media Group newspapers (Saturday editions), these voluntary extra costs amounted to roughly €1.13 billion, representing a nearly nine percent increase over the previous year.
Concurrently, the average out-of-pocket payment per extra-cost case rose to €158.61. This represents a seven percent increase despite a slight decline the year prior. This individual expense rose more sharply than the overall spending by the statutory health insurance funds on medical aids, which increased by five percent to €12.12 billion.
The Spitzenverband analyzed data covering 31.9 million aid provisions in 2025. In 77.7 percent of these cases, insured individuals received their aids without incurring extra costs. However, in approximately 7.1 million cases-22.3 percent of all provisions-they opted for a higher-value supply and paid the surcharge themselves. This proportion of extra-cost cases slightly increased compared to the preceding year, achieving the highest rate since the reporting began in 2019.
Oliver Blatt, the chairman of the GKV-Spitzenverband, told reporters that “All insured persons have the right to care without extra costs.” He clarified that additional payments are only required if insured individuals consciously choose services that exceed what is medically necessary.
Under general rules, the statutory health insurance funds cover the costs of the economically sound standard treatment for medically necessary aids, and insured persons are only required to pay the legally stipulated co-payment. When they choose a higher-value execution-often for comfort or aesthetic reasons-they must bear the resulting extra costs.
Hearing aids were particularly noteworthy. Although these devices accounted for only 5.9 percent of all extra-cost cases, they represented about 62 percent of the total extra costs due to high individual contributions. On average, insured people paid an additional €1,656.99 for this product group, significantly more than any other aid.
Insoles were the product category with the highest share of extra-cost agreements, selected in more than one in two provisions. In total, 96 percent of all extra-cost cases were concentrated within just eight product categories, including insoles, hearing and vision aids, bandages, incontinence aids, and aids for compression therapy.
Because of these trends, the GKV-Spitzenverband is calling for greater transparency regarding the reasons for extra-cost agreements. The association urges service providers to inform the health insurance funds about why insured persons opted for higher-cost care. This information is necessary to determine whether the additional payments stemmed from voluntary desires for services beyond the medically necessary, or whether the insured individuals were simply unaware of their legal entitlement.
