Selbstzahler (self-payer) is not a form of health insurance in Germany, but a payment option sometimes used to access medical care more quickly, especially for a first specialist appointment. Patients pay the doctor’s invoice themselves, usually based on the official private fee schedule (GOÄ). This can be useful to obtain a faster diagnosis or initial assessment, after which follow-up care may continue under statutory insurance (GKV).
To avoid being billed privately by default, patients should clearly inform the practice before each follow-up appointment that future visits are to be charged to their Krankenkasse and confirm this again at reception. Patients should explicitly confirm with the practice that future appointments and treatments will be billed to their Krankenkasse. It is essential to note that Selbstzahler costs cannot be reimbursed later, and fees can accumulate quickly; therefore, this option should be used selectively and with clear communication.