German health insurers push for 24‑hour cooling‑off on self‑paid doctor add‑ons

Germany’s statutory health insurance association (GKV) estimates the annual market for individually billed medical services (IGeL) at at least €2.4 billion. These optional procedures – such as hyaluronic‑acid knee injections, ovarian ultrasounds or Botox for excessive sweating – are paid out‑of‑pocket by patients and are promoted by many physicians.

The GKV proposes a mandatory 24‑hour reflection period between a patient’s agreement to an IGeL service and its performance. The aim is to give patients time to review information on the procedure’s efficacy, as the Medical Service’s IGeL‑monitor rates nine out of ten offered services as having unclear benefit or even potential harm.

Gynecologists, ophthalmologists, urologists, dermatologists and orthopaedists are reported as the most frequent providers of these add‑ons. Insurers also call for stronger information duties for doctors and for the services not to be delivered immediately during the same visit, because a later revocation is impossible once the procedure has been performed.