Question · Beihilfe reimbursement
How does German Beihilfe work?
Short answer: for "How does German Beihilfe work?", RAB Arztbesuche sends a licensed physician on a private home visit anywhere in Berlin — daily from 6 am to midnight, usually within 60 to 90 minutes.
Beihilfe is the state contribution to medical costs of German civil servants, judges and soldiers — typically 50 to 80 percent of the bill. The remainder is covered by a private supplementary insurance. House calls under GOÄ are usually reimbursed in full.
Medically reviewed by Susanne Reiche · Last reviewed
Short answer
Beihilfe is the state contribution to medical costs of German civil servants, judges and soldiers — typically 50 to 80 percent of the bill. The remainder is covered by a private supplementary insurance. House calls under GOÄ are usually reimbursed in full.
The two-pot Beihilfe principle
Beihilfe is a state welfare benefit in Germany for civil servants (Beamte), judges, soldiers, pensioners and their dependants. It is not a health insurance in the classic sense but a commitment by the public employer to cover a defined share of medical costs. The Beihilfe rate depends on status and family situation: active civil servants typically 50 percent, pensioners 70 percent, spouses without their own income 70 percent, children 80 percent. The Beihilfe office of the employer (federal government, state, agency) reimburses that share. The remainder is covered by a private supplementary insurance — the typical 'Beamten-PKV' with a reduced premium.
For a house call this works as follows: you pay nothing on site, receive the GOÄ invoice from the private billing service and submit it to two places — the Beihilfe office of your employer and your supplementary private insurance. Both process the claim separately, both reimburse proportionally. For an active civil servant with 50 percent Beihilfe and 50 percent PKV, roughly half the bill comes from Beihilfe (often processed in 10 to 25 working days) and the other half from PKV (usually 5 to 15 working days). Together this typically results in full reimbursement — provided the tariff limits fit.
What to watch: Beihilfe and supplementary insurance each have their own tariff limits. Beihilfe usually reimburses GOÄ services up to factor 2.3 without query; higher factors trigger a justification review — occasionally factors are cut back to 2.3 if the medical rationale is deemed insufficient. Equally important: certain services are excluded under Beihilfe rules, but a medically necessary house call is not. If you are unsure how your Beihilfe office treats a particular item, ask before the visit about the relevant administrative regulations — we are happy to give the expected GOÄ codes on the phone.
Example: federal civil servant in Steglitz
A 48-year-old federal civil servant with 50 percent Beihilfe and 50 percent supplementary PKV has a house call for acute bronchitis. The bill is 290 euros under GOÄ with factor 2.3 for medical services and 1.8 for the ECG. He submits the bill first to the Beihilfe office — 145 euros arrive after 14 working days. In parallel he submits it to his PKV — another 145 euros arrive after 7 working days. End result: full reimbursement.
What you need to know about Beihilfe
- Eligible: civil servants (federal/state/local), judges, soldiers, pensioners and dependants.
- Typical rate: 50 % active, 70 % pensioners, 70 % spouse without own income, 80 % children.
- Remainder covered by supplementary private insurance (complementary tariff).
- House call under GOÄ: usually fully reimbursed (Beihilfe + PKV).
- Factor 2.3 generally accepted; higher factors trigger a written-justification check.
- Reimbursement time: Beihilfe 10 – 25 working days; supplementary PKV 5 – 15 days.
- Separate claims: submit invoice to Beihilfe office and PKV individually.
- Private prescriptions may need separate claims — attach the pharmacy receipt.
Emergency? Dial the emergency number
If unconscious, with severe chest pain, breathlessness or heavy bleeding, dial 112 immediately. Our service complements the emergency services — it does not replace them.
Frequently asked questions
Do I need a special form for Beihilfe?
Yes. Each Beihilfe office has its own form (online or PDF) submitted with the original invoice. Many states now accept digital submission.
What if Beihilfe reimburses less than the PKV expects?
PKV reimburses only the contractually agreed share — usually the complement to the Beihilfe rate. If Beihilfe is reduced, the patient may carry the difference. Submit to Beihilfe first, then to PKV; appeal the Beihilfe decision if necessary.
Are house calls recognised under Beihilfe?
Yes, if medically necessary. The Beihilfe regulation explicitly recognises house calls as reimbursable — including private GOÄ visits.