Refund possible
Who can now get money back from their health insurance company
January 9, 2026 – 10:17 amReading time: 2 minutes
Anyone who is prescribed a medication only has to pay co-payments up to a certain limit. But you have to take action yourself to get the refund.
Exemptions from co-payments for medical services only apply for one calendar year. The Baden-Württemberg State Pharmacists Association points this out. So anyone who was exempt from additional payments last year will not automatically be exempt this year. An exemption saved in the pharmacy is also no longer valid. Instead, those with statutory health insurance must take action themselves.
Especially for chronically ill people, it can be worthwhile to apply for an exemption from your health insurance company at the beginning of the year. Because they often have high costs and their co-payment limit is only one percent of their annual gross income. For all other people with statutory health insurance it is two percent.
Anyone who knows at the beginning of the year that he or she will exceed the limit can submit an application now. According to the Federal Association of Consumer Organizations, you then transfer the individual maximum contribution to the cash register at once and are completely exempt from additional payments. However: If these end up being less than the amount paid, there will be no money back.
According to consumer advocates, all other insured people should keep an eye on their expenses for medical services prescribed by a doctor throughout the year. Tip: Collect all receipts for your co-payments for medications, therapies or aids in one place.
You can use the pharmacy co-payment calculator to calculate your individual exposure limit. If this is exceeded, you can download the application for exemption online from many health insurance companies and submit it with the relevant evidence. If the application is approved, you will receive an exemption notice and will no longer have to pay any additional payments for the rest of the year.
By the way: According to the State Pharmacists Association, at the beginning of the new year it is also a good idea to check whether too many additional payments were made last year. Anyone who finds out now that they have exceeded their limit in 2025 can fill out the application for the fund afterwards and get money refunded.
