Overview
- Essen plans patient co-payments from January 2026, estimating about €267 per ambulance trip and €62 for certain patient transports such as dialysis or chemotherapy.
- Statutory insurers point to §60(2) No. 2 SGB V to justify covering only transports to hospital, and they have cut reimbursements by roughly a quarter since September.
- Several districts, including Rhein-Sieg, Mettmann and Ennepe-Ruhr, are preparing or debating similar steps, while Hamm says it will keep negotiating rather than bill patients.
- Municipal leaders and the Städtetag NRW warn of large budget gaps from unreimbursed “Fehlfahrten” and caution that visible bills could deter people from calling 112.
- NRW Health Minister Karl-Josef Laumann plans to mediate as city leaders, including those in Cologne and Essen, press Bund and Land for a swift interim and legislative solution.