Vaccinations - What does the health insurance fund pay?

and Florian Tiefenböck, doctor

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

More about the experts

Florian Tiefenböck studied human medicine at the LMU Munich. In March 2014, he joined as a student and has supported the editorial team with medical articles ever since. After receiving his medical license and practical work in internal medicine at the University Hospital Augsburg, he has been a permanent member of the team since December 2019 and, among other things, ensures the medical quality of the tools.

More posts by Florian Tiefenböck All content is checked by medical journalists.

People with statutory health insurance are entitled to a range of free vaccinations. The Federal Joint Committee has determined which these are in a guideline - based on the recommendations of the Standing Vaccination Commission at the Robert Koch Institute in Berlin.

Vaccination Directive

The vaccination guideline defines exactly for which people or situations the vaccination recommendations apply. These are based on the stipulations of the Standing Vaccination Commission (STIKO) of the Robert Koch Institute (RKI).

The experts recommend some vaccinations as the standard vaccination for everyone (e.g. those against measles and tetanus). They only recommend other vaccinations for certain risk groups or for special situations (indicated vaccination).

The health insurance companies only cover the vaccination costs in accordance with the mandatory requirements as set out in the guideline. Insured persons are also entitled to cover the vaccination costs if the immunization is to be made up or the vaccination protection is to be completed (in the case of adolescents no later than 18 years of age).

Which vaccinations does the health insurance fund pay for?

The statutory health insurance companies cover the costs for a number of vaccinations. These include, for example, the basic immunizations for infants and young children:

• diphtheria
• Haemophilus influenzae B (pathogen including epiglottitis)
• Hepatitis B.
• measles
• Meningococcal serogroup C (causing meningitis)
• mumps
• Pertussis (whooping cough)
• Pneumococci (pathogens including pneumonia, otitis media or meningitis)
• Poliomyelitis (short: polio = polio)
• Rotavirus
• rubella
• tetanus
• Varicella (chickenpox)

In addition, the statutory health insurance contributes to the vaccination costs:

• Herpes zoster: Standard vaccination against shingles for all over 60-year-olds
• HPV (Human Papillomavirus): Standard vaccination for ages nine to 14 years
• Influenza: Vaccination against influenza as the annual standard vaccination for everyone over 60 years of age
• Measles, mumps, rubella: Standard vaccination also for all over 18-year-olds born after 1970
• Pneumococci: Standard vaccination also for all over 60-year-olds

The statutory health insurances also pay the costs for necessary booster vaccinations:

• Tetanus, diphtheria, pertussis: For U9 (5-6 years) and once between 9 and 16 years, then every ten years (pertussis only once more here)
• Polio: One-time booster vaccination between 9 and 16 years of age

There are also a number of additional situations in which vaccinations are recommended. Doctors recommend additional vaccinations for certain people at risk, such as women of childbearing potential. For example, they also get pertussis injections every ten years along with tetanus and diphtheria. The flu vaccination is also one of these indicated vaccinations, for example for pregnant women or previously ill people. They too are paid for by the cash registers.

Vaccinations that an employee needs because of their job are usually paid for by the employer. One example is vaccination against hepatitis A for people who work in the healthcare sector. The company also takes care of the vaccinations that the employee receives as a result of an assignment abroad. For people who are particularly at risk of health, such as the chronically ill, the health insurance companies cover the costs.

Special regulations

Some health insurances have voluntarily included further vaccination costs in their range of services, for example the HPV vaccination for women after their 18th birthday or the flu vaccination for those under 60 years of age. Ask your health insurance company which vaccination costs they will pay in addition to those required by law.

Travel vaccinations

Anyone who travels abroad for non-professional reasons (e.g. on vacation) usually has to pay for recommended vaccinations against cholera, hepatitis A and B or typhus out of their own pocket. The statutory health insurance companies are not obliged to cover the costs. However, inquiries do not hurt - some health insurers have voluntarily included individual travel vaccinations in their range of services and usually cover the full costs!

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