Hospital sends huge bill

57 posts in this topic

9 minutes ago, john g. said:

For me, " emergency " would be unexpected, sudden and with possibly dangerous consequences if not treated quickly.

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Yes I can understand that.  But it must be hard to judge.  A bladder infection?   Chlamydia?  If you get me. Untreated can lead to much nastier things, which could be are much more expensive to treat.

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1 hour ago, john g. said:

My Nicole needed a special check up this week with a special machine. Not covered by TK.

Had to pay privately - 450 euros. 

No questions about the test here, please. Only by PM for those I know through PM on here already if you really need to know.

I am a professional independent insurance broker and authorised advertiser. Contact me.

 

Understood @john g.. Love and positive vibes to you both.

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27 minutes ago, snowingagain said:

Yes I can understand that.  But it must be hard to judge.  A bladder infection?   Chlamydia?  If you get me. Untreated can lead to much nastier things, which could be are much more expensive to treat.

Well, we don't know the circumstances here. Ambulance came etc.

 

But anyway, personal circumstances of the OP ( which we cannot judge ) and for some people the Covid issue has led to financial difficulties and people must take payments towards health insurance seriously. MUCH more important than the latest I-Phone, car or boozing down the pub.

 

( PS: I make an exception for snazzy shirts... total empathy!😂)...

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I have no idea what the circumstances were and I hope the issue gets resolved but I doubt the examples of a bladder infection or chlamydia would be classed as an emergency - unconfortable and unpleasant for sure, but not an emergency.  Equally, attending a medical establishment to facilitate early treatment, which is ultimately to the benefit of the person and the healthcare system generally seems unlikely to fall within the meaning of "emergency".  It could, if there are other factors but of itself, early intervention does not describe an emergency.

 

The German meanings of Notfall include, "Situation, in der dringend Hilfe benötigt wird", and "Lage, Situation, in der etwas Bestimmtes nötig ist, gebraucht oder notwendig wird".  Or in English, emergency would include "a serious, unexpected, and often dangerous situation requiring immediate action".  So, I think the hospital and KK would be looking for the "required" unexpected situation requiring immediate medical intervention of some sort but I may of course be wrong.

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I know I'm being flippant here but I remember reading about a young guy in England on his way to somewhere in his car when the Covid stuff started and travelling was often banned and when stopped by the police and asked why he was travelling answered " it's urgent. I've run out of dope."😂

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2 hours ago, john g. said:

For me, " emergency " would be unexpected, sudden and with possibly dangerous consequences if not treated quickly.

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\Yes, it was that. I confirmed it with the ambulance, the doctor who treated me also. I also told them that I had no insurance except for emergencies, and after a few days, they let me go saying that was exactly the reason why they were letting me go. My housemates put me in the ambulance. The doctor, when I asked her how much I d have to pay said "Nothing" I don t know why they send the bill to me directly and not to TKK.

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6 hours ago, Krieg said:

 

I don't get this part, which kind of insurance do you have?

I owe TKK money so I am covered only for emergecy.

2 hours ago, john g. said:

For me, " emergency " would be unexpected, sudden and with possibly dangerous consequences if not treated quickly.

I am a professional independent insurance broker and authorised advertiser. Contact me.

\Yes, it was that. I confirmed it with the ambulance, the doctor who treated me also. I also told them that I had no insurance except for emergencies, and after a few days, they let me go saying that was exactly the reason why they were letting me go. My housemates put me in the ambulance. The doctor, when I asked her how much I d have to pay said "Nothing" I don t know why they send the bill to me directly and not to TKK.

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1 hour ago, solomongrundy said:

\Yes, it was that. I confirmed it with the ambulance, the doctor who treated me also. I also told them that I had no insurance except for emergencies, and after a few days, they let me go saying that was exactly the reason why they were letting me go. My housemates put me in the ambulance. The doctor, when I asked her how much I d have to pay said "Nothing" I don t know why they send the bill to me directly and not to TKK.

Did the hospital know you are TK-insured? Or did they maybe think you have some foreign insurance?

 

By the way, I know this is not the right thread but a warning to dumb fellow foreigners on here:

if you cause an accident or any way  injure someone accidentally - the insurance company will pay the hospital bills and then... chase after you. Be warned. Get personal liability insurance/ private Haftpflichtversicherung.

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6 hours ago, GaryC said:

I have no idea what the circumstances were and I hope the issue gets resolved but I doubt the examples of a bladder infection or chlamydia would be classed as an emergency - unconfortable and unpleasant for sure, but not an emergency.

 

I beg to differ.  Having twice been in the Notaufnahme with bladder infection & 40 degrees fever followed by just under a week in hospital each time.

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20 hours ago, john g. said:

Did the hospital know you are TK-insured? Or did they maybe think you have some foreign insurance?

 

By the way, I know this is not the right thread but a warning to dumb fellow foreigners on here:

if you cause an accident or any way  injure someone accidentally - the insurance company will pay the hospital bills and then... chase after you. Be warned. Get personal liability insurance/ private Haftpflichtversicherung.

I am a professional independent insurance broker and authorised advertiser. Contact me.

My issue was mental. A long period of unemployment led to a complete nervous breakdown and a sense of paranoia. I don t remember but my girlfriend, who called the ambulance, tells me that I was talking about suicide. She told the ambulance nurse this, and also, I did not have my card with me, but only a letter reminding me of my debt. |\This was what the hospital saw. I told the emergency doctor this, and when they released me, it was because insurance would not cover the recommended stay period. Please, can someone help me, I don t have the funds to cover this?

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Have you called TK yet?

Have you spoken to the Accounts department  at the hospital?

Have you discussed with your family doctor?

These are your next steps.

Not sure if we can help on this. Did you finally get work after your long Student visa time?

 

 Emergency definition   can be difficult to explain sometimes, especially with mental health  issues. Whether a health problem needs immediate medical/surgical intervention, or whether a referral for ongoing issue is the path to take.

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48 minutes ago, RedMidge said:

Have you called TK yet?

Have you spoken to the Accounts department  at the hospital?

Have you discussed with your family doctor?

These are your next steps.

Not sure if we can help on this. Did you finally get work after your long Student visa time?

 

 Emergency definition   can be difficult to explain sometimes, especially with mental health  issues. Whether a health problem needs immediate medical/surgical intervention, or whether a referral for ongoing issue is the path to take.

 

1. yes.

2. No. Email bounces. I send a letter by registered post explaining that their doctors confirmed I was an emergency case. 

3> No. I have never ever fallen sick in Germany. I have an house doctor now but that was because of the hospital s referal on out patient treatment as I could not have the in patient treatment they recommended.

4. No. If you are in Germany the higher you go education-wise the harder it gets. And they complain about immigrants!!!!

 

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@solomongrundy what is your status regarding repaying your debts with TK currently/before that emergency? If you have worked out an agreement/plan to repay your debts with monthly rates on top of your ongoing normal monthly premium payments, then you are actually out of the emergency coverage and back to the full coverage (as long as you keep up with the plan, of course). 
therefore it would be important to know how your debt-resolving is set up with the TK.

 

Regarding as to what consists as an emergency legally, here is a definition by the scientific services of the Federal Parliament which is in line with rulings by the high courts:

 

3.4.2.2. services for the treatment of acute illnesses and painful conditions.
According to § 16 para. 3a sentence 2 half-sentence 1 sentence part 2 case 2 SGB V, the following are also excluded from suspension
services that are necessary for the treatment of acute illnesses and pain conditions ...".
are". Although the wording of this legal text refers to the treatment of acute illnesses
"and" pain conditions, there is - as far as can be seen - agreement on the fact that
beside the presence of an acute illness not additionally the existence of pain conditions is
is necessary161. The word "and" is here to be taken in the meaning of an "or".

 

Your description of your roommate calling ambulance because of a massive actue psychological isse including danger of suicide sounds to me very much like a necessary treatment for an acute illness/condition.

therefore I would strongly advise to contact a "Verbraucherschutz"-office nearby to have them help you making your claims at TK.

 

Cheerio

 

 

 

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1 hour ago, Starshollow said:

@solomongrundy what is your status regarding repaying your debts with TK currently/before that emergency? If you have worked out an agreement/plan to repay your debts with monthly rates on top of your ongoing normal monthly premium payments, then you are actually out of the emergency coverage and back to the full coverage (as long as you keep up with the plan, of course).  

 

A friend of mine had that exact situation with AOK.  He made a payment plan they agreed to and was keeping up with it plus his monthly dues and they still blocked his health card. When he phoned them they said they would continue to block until he's fully paid up. He changed to another kasse to get coverage.

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That is interesting, Leon. I'm surprised the new Kasse didn't do any checks with AOK.

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30 minutes ago, LeonG said:

 

A friend of mine had that exact situation with AOK.  He made a payment plan they agreed to and was keeping up with it plus his monthly dues and they still blocked his health card. When he phoned them they said they would continue to block until he's fully paid up. He changed to another kasse to get coverage.

 

That sounds almost criminal.
Fair enough the card being blocked until he had cleared the debt but to keep taking the monthly dues whilst not offering any coverage except in emergencies is plain wrong.
As long as he stuck to the (agreed by AOK) payment plan and was also paying the monthly dues he should have had full coverage.

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If Solomongrundy is uptodate with payments, TK are legally WRONG.

 

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2 hours ago, LeonG said:

 

A friend of mine had that exact situation with AOK.  He made a payment plan they agreed to and was keeping up with it plus his monthly dues and they still blocked his health card. When he phoned them they said they would continue to block until he's fully paid up. He changed to another kasse to get coverage.

 

That would be absolutely illegal and the law (and the high courts) are absolutely clear on that. But it isn't the first time and won't be the last that one has to explain to some emplyoees at a Krankenkasse the actual laws. The times I had to explain and quote to public health insurance employees that the 18-months waiting time before you can give notice to your public health insurance does not apply when a voluntary member decides to switch to a private health insurance is unbelievable...

Which is why I quoted the above so that other Expats finding themselves in a similar situation know the law and their rights and can insist on it.

 

Cheerio

 

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This is a German text recommended to use to demand that your public health insurance starts offering you free use of your insurance card again if (!) you have reached an agreement about a repayment plan with the public insurance and if (!) you are paying both your normal monthly premiums and the monthly rates for repayment properly.
In which case you have a legal right to be reinstated in your health insurance in full.

Absender, Datum

An die …-Krankenkasse

Recht auf Leistungen trotz Beitragsschulden
Meine Mitgliedsnummer: …

Sehr geehrte Damen und Herren,

wegen Beitragsschulden verweigern Sie mir das Recht auf Krankenbehandlung und wollen nur im Notfall und bei Schmerzen Leistungen bezahlen.

§ 16 Absatz 3a Satz 3 SGB V sagt jedoch wörtlich: „Ist eine wirksame Ratenzahlungsvereinbarung zu Stande gekommen, hat das Mitglied ab diesem Zeitpunkt wieder Anspruch auf Leistungen, solange die Raten vertragsgemäß entrichtet werden.”

Da ich meine Beitragsschulden in regelmäßigen Raten abzahle, habe ich folglich Anspruch auf die normalen Leistungen.

Mit freundlichen Grüßen
Unterschrift

 

Cheerio

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