Overview

• KBV chief Andreas Gassen proposes a yearly fee for insured people who want to see specialists without a GP referral or digital triage, citing expected costs of about €200 to €350.
• Gassen argues the proceeds should fund fully paid additional specialist appointments outside current budget caps, noting many services are now reimbursed only in part.
• The governing coalition is pursuing a binding GP-first model, and Health Minister Nina Warken has said fees for direct specialist treatment will be discussed at government level.
• Pressure for change is fueled by long waits and staff shortages, with a TK/Forsa survey finding 58% of respondents say specialist appointments take far too long and practices reporting a lack of medical assistants.
• Critics warn the fee could entrench unequal access and unnecessary GP visits, as insurers face large deficits reported at roughly €6.7 billion in 2024 and a Union deputy has separately floated a €200 penalty per un-referred specialist visit.