Diabetes and reimbursements for medicine expenses

As a rule, insulin products are subject to the higher special reimbursement (100%). In this case, once the annual deductible of 50 euros has been paid, you will pay a purchase- and product-specific deductible of 4.50 € for the product, and the price exceeding this amount will be reimbursed in full. An exception to this is temporary insulin therapy during pregnancy, which is subject to the basic reimbursement (40%). For some insulin products, the reimbursement may be subject to special terms and conditions.

As a rule, other diabetes medicine products than insulin are subject to the lower special reimbursement (65%). All medicinal products meant for the treatment of diabetes are not necessarily reimbursable, or their reimbursability may be subject to special terms and conditions.

Often, a person with diabetes also uses medicinal products to treat high blood pressure and cholesterol. In general, these medicinal products are subject to the basic reimbursement (40%). With regard to the treatment of both blood pressure and cholesterol, there are specific medicinal products which qualify for the lower special reimbursement (65%).

There is a specific limit for the medical products subject to reimbursement, i.e. annual maximum limit on out-of-pocket costs for a calendar year. The initial deductible (50 euros) and the self-paid share of the price of reimbursed prescription products accumulate toward the limit. If the annual limit is exceeded, you are entitled to additional reimbursement payable at the pharmacy when buying medicinal products. Once the limit has been reached, you pay a deductible of EUR 2.50 per purchase and drug for each reimbursable product.