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Reimbursement of meningococcal vaccinations | Meningitis moves


In 2019, 256 people in Germany developed meningococci. A relatively small number and most of us tend to assume that severe strokes of fate will not hit us but rather others. But what if we or our children become one of these victims?

Meningococcal disease occurs predominantly in infancy and toddlerhood and is unfortunately often not over after a few days with fever, malaise, coughing and runny nose. This disease can become life-threatening within a very short time and the initial symptoms are usually so unspecific that a timely diagnosis is not always possible. In 2/3 of the cases it can lead to meningitis (inflammation of the meninges) and in 1/3 of the cases to sepsis (blood poisoning).

The consequences of meningococcal disease can be serious, including scars or the loss of limbs due to amputations, which can mean several operations even in childhood. About 10 percent of those affected die despite intensive medical treatment.

In Germany, children can be protected from meningococcal groups A, B, C, W and Y with vaccinations. The vaccination against group C was included in the vaccination calendar by the Standing Vaccination Commission (STIKO) in 2006 and is recommended for all children aged 12 months. There are also two meningococcal vaccinations available.

The STIKO already recommends vaccination against group B for high-risk patients: indoors and as a travel vaccination, but it has not yet been included in the standard vaccination calendar. The ACWY vaccination is a combination vaccination recommended by the STIKO for high-risk patients or when traveling to a meningococcal risk area.

You can find more information about meningococcal diseases and the various possible vaccinations in an older post by me here on the blog, on the page of www.meningitis-bewegt.de and of course directly from your pediatrician.

Reimbursement of meningococcal vaccinations

Vaccinations that are not in the standard STIKO vaccination calendar are only reimbursed on a voluntary basis by some health insurance companies and are a private service. However, many health insurance companies now allow partial reimbursement, and some even cover the costs of the meningococcal vaccinations that may also be possible. You can find out how your health insurance company is reimbursed on the website www.meningitis-bewegt.de.

A while ago I was able to ask Wiebke Kottenkamp from the health insurance company BKK VBU in an Instagram live video about reimbursement that I received from followers and blog readers in advance. You can find the live video on Instagram as IG-TV, I have summarized your questions and answers here.

Your questions and the answers from Wiebke Kottenkamp from the BKK VBU

Which vaccinations are generally reimbursed by health insurance companies?

In Germany there is a legal right to all standard vaccinations recommended by the Standing Vaccination Commission (STIKO) at the Robert Koch Institute (RKI). These are, for example, vaccinations against tetanus, rubella or hepatitis B as well as all vaccinations for children and adolescents. The BKK VBU covers the full costs of advice, vaccination and vaccine for all statutory protective vaccinations and vaccinations recommended by a doctor.

Does the BKK VBU also reimburse the possible meningococcal vaccinations?

Yes, we, the BKK VBU, will cover the costs for all meningococcal vaccinations if the pediatrician advises them. The STIKO recommends meningococcal C vaccination as standard for all children aged 12 months, so all health insurances assume the costs for this vaccination as a compulsory service. That is why the majority of children are vaccinated against group C pathogens.

But this vaccination cannot protect against other meningococcal groups. The vaccinations against the other groups of pathogens are voluntary additional services of the health insurance companies. So they can decide to reimburse the costs, but do not have to. The BKK VBU has decided that we will also reimburse ALL vaccinations recommended by a doctor!

How can I get a reimbursement from my health insurance company?

It is very important to first ask the health insurance company. Just like the BKK VBU, other health insurance companies also reimburse vaccinations that go beyond the standard catalog of the Standing Vaccination Commission and are declared as a voluntary additional service. It is also helpful that you ask whether the costs are covered in full or on a pro-rata basis and whether there is a maximum amount. The BKK VBU takes over z. B. 100% of the cost of all medically recommended vaccinations without a maximum amount.

How does a refund work?

Unfortunately, the costs for voluntary additional services cannot be billed directly to the chip card. With a private prescription from the pediatrician, the vaccine must first be bought independently at the pharmacy. For the vaccination itself, the pediatrician will issue an invoice, which is initially paid in advance by the patient or parents. This invoice is submitted to the health insurance company together with the private prescription and the pharmacy receipt. At the BKK VBU and many other health insurances, this is now very easy via the respective app of the fund. The BKK VBU then transfers the full amount to the member’s account.

There are also application forms on the Internet that you can use as a template to request reimbursement from your own health insurance company. You can find them on the website of www.meningitis-bewegt.de, among other places.

What are the options if I cannot interpret the cost of the vaccine?

If the financial situation does not allow parents to pay in advance for the costs of the additional meningococcal vaccinations, there is the possibility of a declaration of resignation. This is presented at the pharmacy and authorizes the pharmacist to settle the costs directly with the health insurance company. It is important to clarify this with the health insurance company beforehand.

Why does the BKK VBU reimburse all additional possible vaccinations?

It is important to us, the BKK VBU, to make it easier for our members to access as many preventive services as possible. We want to give everyone their individual path.

If the parents want the meningococcal vaccinations that are also possible and the doctors recommend this vaccination, then money shouldn’t fail. That is why the BKK VBU has decided to do exactly this as part of the voluntary additional services: We bear the costs of all vaccinations recommended by the treating physicians. That is why we reimburse the costs in full and without limitation to a certain amount.

How many insured persons take advantage of the offer of reimbursement for the meningococcal vaccinations that are also possible?

The meningococcal B vaccination is the vaccination that is most often reimbursed by the BKK VBU. This shows that vaccinations are also important to our members and that they are happy to accept our offer!

Why is the BKK · VBU so proactive in getting the meningococcal B vaccination reimbursed?

Most meningococcal diseases in Germany are caused by group B pathogens (with 60%), followed by group Y, C, W, A and others. Vaccination against meningococcal group C has been compulsory for all health insurers for many years, but there is still no general recommendation for group B, which is why it is paid on a voluntary basis by the health insurances. We take a critical view of this, as meningococcal diseases are rare, but can become life-threatening within a few hours. Vaccinations can offer the best possible protection here.

What else do you offer parents to protect their children from diseases / meningococcal diseases in the best possible way?

I can only urgently advise all parents (also as a mother) to attend the preventive medical check-ups from the birth of the child. Here you can get rid of all questions and get advice from pediatricians as part of the U-examinations as to which vaccinations make sense for children at what age.

The decision for or against a vaccination is individual and is made by the parents for their children. In order for them to be able to make the right decision, it is important that they and we obtain sufficient and correct information beforehand. In addition to talking to the pediatrician, the @meningitisbewegt_de campaign also provides information.

It is important to the BKK VBU that the decision made does not fail because of the costs.

* This post contains advertising and was created in cooperation with Meningitis moved., An initiative of GlaxoSmithKline.

NP-DE-MNX-WCNT-210014; 03/21



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