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Stomach reduction with German statutory health insurance

Where the medical indication is in line with guidelines, there is a chance that your German health insurer will cover the costs of a stomach reduction. Here you can read which requirements apply and why you do not have to submit an application with us.

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GermanyNetherlandsMedically reviewed byDr. med. Oliver ScheffelSpecialist in general and bariatric surgeryLast updated:

Explained in detail

Stomach reduction via German statutory health insurance in detail

When your German health insurer may pay, how the route without a prior application works and what remains private – chapter by chapter.

The Weight Doctors® way

Stomach reduction via German statutory health insurance without a prior application

At Weight Doctors there is no complicated application process. You do not submit an application to your German health insurer, do not lodge an objection and do not wait for approval. You contact us, we check your medical indication and organise your complete MMK programme including the date of your operation. Billing with your health insurer takes place directly after the operation – so you can concentrate fully on your journey.

Your journey up to here has probably not been an easy one: health problems, feeling uncomfortable in your own skin, the constant confrontation with the term obesity and other people’s looks in everyday life. Many attempts to lose weight may have been unsuccessful and frustrating. The first step is the decision, the second is the conversation with us.

Perhaps you have heard about other people’s experiences with a stomach reduction and want to know when the German health insurer covers the costs. Here you can inform yourself specifically – also if you want to support a relative in this decision.

A stomach reduction can help to change eating habits permanently and to avoid the dreaded yo-yo effect. Which procedure suits you – whether gastric sleeve, gastric bypass or a stomach reduction without surgery – you choose together with our doctors.

A Weight Doctors® member of staff welcomes a patient to her consultation
Two paths to stomach reduction on German health insurance

Usual pathwith an advance application to the German health insurer

Weight Doctors®Without advance application

ConsultationInitial consultation and indication
MMKSix months of nutrition, exercise and psychology
ApplicationApplication for cost coverage with all documents to the German health insurer
Expert reportReview by the Medical Service
DecisionWaiting for the decision – appeal if rejected
SurgeryProcedure after approval
ConsultationWe check your medical indication: BMI, related conditions, previous attempts to lose weight.
MMKSix months of nutrition, exercise and psychology – we organise all the appointments. With a primary indication, it is not required.
Final checkBefore surgery, we check all the requirements for you. You do not have to speak to your German health insurer.No advance application
SurgeryYour procedure – billing with your German health insurer follows directly after surgery.

* For patients with German statutory health insurance: if the medical indication is established in line with the DGAV guidelines, reimbursement may be possible.

This is how it works at Weight Doctors

To surgery in 4 steps

From the first consultation to the operation, we organise everything for you. Together with our doctors you choose the suitable procedure, and your surgery date is set as binding straight away. Your personal Weight Doctors® 360° coach accompanies you throughout the entire process – from the first day into aftercare.

Your stay via German statutory health insurance is at the Weight Doctors® Nationalklinik in Wertheim, where statutory health insurance patients are treated to a private-practice standard. For pre- and aftercare you choose freely among our locations. This is what the route looks like:

The Weight Doctors® Nationalklinik in Wertheim with the purple W on the façade
  1. Step 1ConsultationIn the no-obligation initial consultation we check your medical indication: BMI, related conditions, previous attempts to lose weight.
  2. Step 2MMKSix months of nutrition, exercise and psychology – we organise all the appointments. With a primary indication, it is not required.
  3. Step 3Final checkBefore surgery, we check all the requirements for you. You do not have to speak to your German health insurer.
  4. Step 4SurgeryThe procedure on the planned date – billing with your German health insurer follows directly after the operation.
  5. afterwardsAftercareYour 360° coach and the Weight Doctors® App with Weight Doctors® Mira continue to support you.
Requirements

When the German health insurer may cover the costs

For many people with obesity or severe excess weight, a stomach reduction is an important step towards a healthier life. Where the medical indication is in line with guidelines, there is a chance of cost coverage by German health insurance – for weight-loss surgery with Weight Doctors BARIATRICS® as well as for the endoscopic Weight Doctors SLEEVE®. The BMI (body mass index) plays the decisive role here; you can work out your value with the BMI calculator.

  • Primary indicationBMI ≥ 50 or BMI ≥ 35 with type 2 diabetes where all treatment options are exhausted – immediate surgery without a waiting period is possible.
  • Medical indicationBMI ≥ 40 or BMI ≥ 35 with recognised related conditions – surgery follows after the 6-month MMK.

As a rule, the German statutory health insurers require grade III obesity, i.e. a BMI over 40. If certain related conditions are demonstrably present, grade II obesity with a BMI over 35 may already be sufficient.

In addition: you are at least 18 years old (there is no fixed upper age limit), you are not pregnant and none is imminently planned, and you are mentally stable enough for the procedure. The German Society for General and Visceral Surgery (DGAV) recognises these obesity-associated related conditions:

Metabolic disorders
  • Type 2 diabetes mellitus
  • Lipid metabolism disorders (dyslipidaemia)
  • non-alcoholic fatty liver disease (NASH/NAFLD)
Cardiovascular disease
  • High blood pressure (arterial hypertension)
  • coronary heart disease
Respiratory conditions
  • Sleep apnoea syndrome (OSAS)
  • Obesity hypoventilation syndrome
  • Asthma
Orthopaedic conditions
  • Osteoarthritis (immobilising joint diseases)
  • Joint problems (knee, hip)
Other recognised conditions
  • Gastro-oesophageal reflux disease (GERD/heartburn)
  • PCOS (polycystic ovary syndrome) and impaired fertility
  • Urinary incontinence
  • chronic venous insufficiency
  • Pseudotumor cerebri (intracranial hypertension)

One of these related conditions together with a BMI ≥ 35 may already be sufficient for cost coverage. Without medical necessity, German health insurers do not as a rule cover the costs; statutory health insurers often prescribe conservative treatment beforehand. The decision is always made case by case – with the MMK we document the medical necessity and all evidence for you.

  1. BMI from 35with a related condition: possible via German statutory health insurance
  2. BMI from 40Medical indication, surgery after MMK
  3. BMI from 50Primary indication: immediate surgery possible
BMI scale according to the WHOCalculate your BMI
Your structured 6-month roadmap

The MMK programme

The multimodal programme (MMK) is a preparation programme recommended by the German Obesity Society (DAG) and, where there is a medical indication, a prerequisite for cost coverage. The MMK itself is not a health insurance service. At Weight Doctors we organise all appointments for you – you do not need to worry about anything, and the programme automatically documents all necessary evidence.

The programme includes thorough patient information and all preliminary examinations. Which procedure makes most sense for you – a gastric bypass or a sleeve gastrectomy (gastric sleeve), in which a narrow stomach tube markedly reduces food intake – we discuss together with you and in line with your wishes.

We also offer psychological support: obesity and its consequences are often emotionally distressing and go along with entrenched patterns of behaviour; depression and anxiety disorders are also not uncommon. We start where you are right now and shape your path together. The 5 pillars of the programme:

Two Weight Doctors® employees with purple kettlebells at the stand on open day
  1. Nutrition counselling (5 sessions)Professional nutrition advice from certified specialists, documentation of eating habits, digital support with the Weight Doctors® App and preparation for nutrition after the operation.
  2. Activity logIndividually adapted exercise programme, documentation of physical activity and increasing fitness for better results from surgery.
  3. Psychological assessmentExclusion of eating disorders and wasting diseases, ensuring mental stability, mental preparation for the changes and support with behavioural change.
  4. Gastroscopy (stomach endoscopy)Review of stomach health and exclusion of contraindications – carried out shortly before the procedure.
  5. Full blood countComprehensive laboratory tests, identification of deficiencies and the basis for later aftercare.

“After years in a traditional obesity centre, the difference is enormous: at Weight Doctors, patients are not simply sent to different places during the MMK programme. We organise and accompany everything – from nutrition advice and exercise therapy to the psychological assessment. The patient has a personal coach and the Weight Doctors App as a constant companion. No one is alone with the process any more. That is true 360-degree care.”

Dr. med. Oliver Scheffel, specialist in general and bariatric surgery
Statutory or private

What the German health insurer pays – and what you pay privately

You have surely already thought about the possible costs of a stomach reduction. With several thousand euros involved, it is understandable that you want certainty in planning. Where the indication is in line with guidelines, the German health insurer covers the procedure itself. You pay privately for the MMK+ programme, in which support before and after the operation is bundled with the Weight Doctors® MEMBERSHIP all-in, and for the gastroscopy.

Privately insured people have, in our experience, simpler conditions and can additionally choose, for example, a gastric balloon or GLP-⁠1 pharmacotherapy; depending on the scope of cover of the insurance, support may be even more intensive. Without German health insurance, you use all services as a self-payer – for example Weight Doctors BARIATRICS® from €2,500 or Weight Doctors SLEEVE® from €5,500, with financing via medipay possible. You can find all prices under Costs & prices.

What statutory health insurance pays*

  • Surgery by a specialist
  • Anaesthesia
  • Materials and medication in the clinic
  • Double room at the Nationalklinik
  • Informed consent discussion
  • Aftercare in the clinic
  • No follow-up cost insurance needed

* For patients with German statutory health insurance: if the medical indication is established in line with the DGAV guidelines, reimbursement may be possible.

What you pay privately

  • Private medical pre- and post-treatment examinations

MMK+ programme

multimodal programme including Weight Doctors® MEMBERSHIP all-in

  • App with Weight Doctors® Mira, body scales and 3D Bodyscan
  • Specialists around the clock
  • Personal coach
  • Telemedicine and e-prescription
  • Communication with the German health insurer
  • Free choice of clinic for preliminary examination and aftercare
Gentle procedures

Afraid of a “major” procedure?

Many people underestimate how much has changed in stomach reduction. Operations are carried out minimally invasively using keyhole technique through a few small punctures; there is no large abdominal incision. We choose the procedure for you together – besides gastric sleeve surgery and gastric bypass there are other options such as the gastric balloon.

With Weight Doctors SLEEVE® using pose® 3.0 Double Helix, even outpatient treatment is possible: endoscopically through the mouth, without an incision and without visible scars. With a primary indication, immediate surgery without a waiting period is possible.

We support you holistically before and after the procedure – from the 6-month MMK programme, for which we organise all appointments, through psychological support to aftercare with your personal 360° coach. You will feel this help from the very first consultation. This often makes stomach reduction much less burdensome than many people first think.

Transparent stomach model with a gastric balloon
  • GermanyNetherlandsDr. ScheffelSpecialist in general and bariatric surgery
  • GermanyAustriaProf. MillerSpecialist in general and visceral surgery
  • GermanyPD Dr. WichmannSpecialist in visceral surgery & expert in endobariatrics
  • GermanyNetherlandsDr. JennerSpecialist in visceral surgery / specialised visceral surgery

All specialists

Case law and studies

A landmark ruling and the evidence from studies

In 2022 the Federal Social Court ruled (case number B 1 KR 19/21 R) that bariatric operations such as stomach reductions are eligible for cost coverage where medically necessary and where there are insufficient alternatives. In its reasoning, the court made clear that not all possible treatment options have to be exhausted before a stomach reduction. What is decisive is that the operation is clearly superior to other alternatives.

A study from Sweden suggests that in obesity a stomach reduction can not only reduce body weight markedly but also offer long-term health benefits: the risk of heart attacks and strokes was 30% lower compared with a control group. The data also show that the procedure can effectively regulate food intake and thus help to avoid a yo-yo effect.

For German health insurers, a stomach reduction is therefore not only medically sensible but also economical: related conditions can be prevented or improved, which can reduce follow-up costs in the long term. Results vary from person to person.

Sources: clinicaltrials.gov, study NCT01479452 · Federal Social Court, judgment B 1 KR 19/21 R of 22 June 2022

Consultation at many locations

You can get your consultation on stomach reduction via German statutory health insurance on site, by video or by phone. For consultation, pre- and aftercare we are here for you at these locations – enter your postcode or choose your city. More about us is shown by the Weight Doctors videos.

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Films

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    The Weight Doctors® Experience: all-round care, AI-supported, 360 degrees

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    Stomach reduction: a patient reports on her experiences
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* For patients with German statutory health insurance: if the medical indication is established in line with the DGAV guidelines, reimbursement may be possible.

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