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Techniker Krankenkasse, 20905 Hamburg

Fachzentrum
Ambulante Leistungen

Tel. 040 - 46 06 62 01 50
Frau
Ying Du Geschäftszeichen
Ziegelstr. 23 Y192952484
10117 Berlin
23. Juli 2021

Ihr Antrag auf empfängnisverhütende Mittel: Leider können wir die Kosten nicht
erstatten

Guten Tag Frau Du,

vielen Dank für Ihre Unterlagen. Leider können wir die Kosten für MAXIM 0,03 mg/2 mg überzo­
gene Tabletten nicht erstatten.

Medikamente, die ausschließlich der Empfängnisverhütung dienen, können die Krankenkassen


nur in einem der folgenden Ausnahmefällen übernehmen:

Die Patientin ist noch keine 22 Jahre alt.

Das Arzneimittel wird zur Behandlung einer Krankheit verordnet und ist hierfür zugelassen.

Eine Schwangerschaft muss vermieden werden, da schwerwiegende Gesundheitsschäden


bei der Mutter oder beim Embryo befürchtet werden.
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Dann erhalten Sie in Ihrer Praxis ein Kassenrezept. Die Apotheke kann dieses direkt mit uns ab­
rechnen. Ist dabei eine ärztliche Leistung erforderlich, wird sie ebenfalls über Ihre Gesundheits­
karte abgerechnet.

Bitte sprechen Sie daher ggf. erneut mit Ihrer Ärztin bzw. mit Ihrem Arzt. Sie bzw. er allein kann
entscheiden, ob MAXIM 0,03 mg/2 mg überzogene Tabletten auf Kassenrezept verordnet wer­
den kann.

Wichtig: Bekommen Sie ein Privatrezept und stellt Ihnen die Praxis die ggf. erforderliche ärztli­
KA608013

che Leistung privat in Rechnung? Das bedeutet, dass die Voraussetzungen für eine Kassenleis­
tung nicht erfüllt sind. Wir können dann die Kosten nicht erstatten.
503597574814

Techniker Krankenkasse, Tel. 040 - 46 06 62 01 50


Telefonservice: Mo.- Do. 8 - 18 Uhr, Fr. 8 - 16 Uhr | tk.de
Vorstand: Dr. Jens Baas (Vorsitzender), Thomas Ballast (stellv. Vorsitzender), Karen Walkenhorst
Vorsitzende des Verwaltungsrats: Dominik Kruchen, Dieter F. Märtens
2 - Ying Du, 23. Juli 2021
Geschäftszeichen: Y192952484

Falls Sie Fragen haben, rufen Sie uns einfach an. Wir sind gern für Sie da.

Freundliche Grüße

Robin Dorn
Kundenberater
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KA608013
503597574814

Techniker Krankenkasse, Tel. 040 - 46 06 62 01 50


Telefonservice: Mo.- Do. 8 - 18 Uhr, Fr. 8 - 16 Uhr | tk.de
Vorstand: Dr. Jens Baas (Vorsitzender), Thomas Ballast (stellv. Vorsitzender), Karen Walkenhorst
Vorsitzende des Verwaltungsrats: Dominik Kruchen, Dieter F. Märtens
Medications, bandages and
dressings
Medications, bandages and dressing are usually covered by
social health insurance funds. However, there are certain
aspects to be aware of.
Medications on prescription SHI prescription form. In addition, one of the following
prerequisites must be met:
We cover the majority of costs for medications, band-
ages and dressings that are prescribed to you by a stat­ The medication is intended for children under 12
utory health insurance (SHI) doctor on a pink SHI pre­ years of age or for adolescents under 18 years old
scription form. You only have to pay the required stat­ who have developmental disorders.
utory prescription charge.
The medication has become part of a standard of
However, there are various medications whose costs care treatment, such as acetylsalicylic acid (aspirin)
we might only cover in special cases or not cover at all. for after-care following a heart attack or stroke.
In general, your doctor’s surgery will prescribe these
medications on a private prescription form. Medical products and devices

Important note: Only your doctor can determine whe­ In addition to medications, we also assume the costs
ther you need a certain medication, bandage or dress­ for certain “medical products”. This applies to many
ing. We are not allowed to approve or authorise pre­ types of synthetic eye drops (“artificial tears”), for ex-
scriptions. ample. The requirement here is that they must be certi­
fied as medical products by the manufacturer and
Why is this medication only prescribed for me as a listed as such in the Arzneimittelrichtlinien [German
private prescription? directives on pharmaceuticals].

There can be several reasons for this: What is off-label use?

Your doctor is not an accredited SHI-doctor. In principle, medications are only approved for certain
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indications. If they are used therapeutically for other


The medication is a non-prescription, but pharmacy- treatment purposes, this is called “off-label use”. In this
only medicine. case, we are generally not allowed to cover any of the
costs and pharmaceutical manufacturers are not liable
The medication belongs to the group of "excluded for any harm arising from using the medication.
medications". These include, for example, medica­
tions for less serious illnesses such as the common
cold or "lifestyle drugs" such as appetite suppress­
ants. We pay more: As an optional, non-statutory bene­
fit, we cover the costs for non-prescription, but
Birth control pills: No charge up to age 22 pharmacy-only medications related to homeo­
pathy, phytotherapy and anthroposophy up to a
Oral contraceptive pills are prescribed for young wo­ maximum amount of 100 EUR. This benefit ap­
men under the age of 22 as an SHI-covered prescrip­ plies per calendar year and to all insurees ages 12
tion. For women aged 22 and up, they are responsible and up. Just send us the private prescription along
for the entire cost of the prescription. Exception: The with the invoice from the pharmacy. Please upload
contraceptive is prescribed for therapeutic or medical the documents in the password-protected "Meine
purposes. TK" ["My TK"] area or via the TK-App at "cost reim­
bursement". Alternatively, we ask you to send us
Over-the-counter (non-prescription) medications the originals by postal mail.

Medications you can buy in a pharmacy without a pre­


scription are called over-the-counter (OTC) medica­ TK-ViA: Overview of your medications
tions and thus do not require a doctor’s prescription.
As a rule, you must pay for OTC medications yourself. Would you like an overview of all the medicines, band­
However, there are exceptions here as well. We will ages, dressings, medical consumables and assistive
cover the costs if the medication is prescribed on an products that have been prescribed for you over the

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past 2 years? Then utilise our "Versicherteninformation tk.de website and enter search code 20216981 and
Arzneimittel" ("TK-ViA") information service, which will search code 20008441.
provide you with this overview. TK-ViA will also provide
you with an overview of your prescription charges and
co-payments. 1
We regret, but this information is currently only available in German.

Find out more

For more information – including about TK-ViA and our


other special services regarding medications – visit our
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