If you are on statutory health insurance and need a specialist next year, you may soon hear this: a regular appointment in February, or a self-pay slot the day after tomorrow. Andreas Gassen, head of the National Association of Statutory Health Insurance Physicians (KBV), told the RND newspaper network he fully expects such offers. Status: 14 November 2026.
What exactly did Gassen say?
“I assume there will be private-consultation offers, because every appointment is paid for there,” he said. Insured patients would be treated like private patients but “have to pay the costs out of their own pocket as self-payers”. Only that, he argued, could fund extra work beyond the budget. And: “Once the budget is used up, patients will have to accept that they may only get an appointment at their preferred practice next quarter.”
The backdrop is the GKV Contribution Rate Stabilisation Act (Beitragssatzstabilisierungsgesetz), passed by the Bundestag and Bundesrat on 10 July 2026. It aims to relieve the statutory insurers by almost €19 billion in 2027 and keep supplementary contributions from rising. According to the KBV, about €3 billion will be saved in outpatient care alone. Gassen says ENT, orthopaedics, cardiology, radiology and rheumatology are hit hardest, with some specialties losing 25 per cent of revenue, which he called “an existential cut”. The Federal Health Ministry says the goal is to tie spending growth to the economy rather than cut across the board.
Is this even allowed?
Views differ. Consumer advocates are clear: doctors contracted to the statutory system may not offer insured patients faster appointments for money, nor offer them only self-pay slots. Patients who pay do not commit an offence, but are advised not to agree. The Verbraucherzentrale has sent a formal warning to the booking platform Doctolib for showing self-pay slots to statutory patients; the case is in court. Gassen, by contrast, speaks of a “private consultation”, an offer outside the statutory system. That boundary is likely to keep courts busy.
How widespread this already is, nobody knows, as no statistics exist. Reports describe Berlin dermatology practices where regular statutory slots open only in February 2027 while a self-pay slot is free two days later, and a radiology practice in North Rhine-Westphalia that treats statutory patients only until 1 p.m. Green health spokesman Janosch Dahmen warns: “Statutory medicine risks becoming a short consultation.” Stefanie Stoff-Ahnis, deputy chair of the GKV-Spitzenverband, calls the situation “completely unacceptable”.
Gassen himself sketches a compromise: a quota of urgent appointments agreed with the insurers, but on the principle “whoever orders, pays”. If practices guarantee appointments, insurers must guarantee payment, even when patients do not turn up.
What can patients do now?
First, do not accept self-pay offers for services covered by insurance. Consumer advocates advise reporting them to the regional Association of Statutory Health Insurance Physicians or the state medical chamber, and, failing that, to the state health ministry. Second, in urgent cases call the appointment service on 116117, which is meant to arrange a specialist appointment generally within four weeks. Third, keep appointments or cancel early; the KBV names no-shows as a lever against waiting times. Fourth, note that policymakers are discussing a GP-first model, but nothing has been decided.
Our assessment: shortages are likely to be felt first in the specialties named and in big cities such as Munich, where practices find more privately insured patients. Whether self-pay slots become mainstream depends on whether regulators and courts draw lines early. That is not certain; reliable figures will only emerge once the 2027 budgets take effect.
Sources: Federal Health Ministry, KBV, Tagesspiegel/RND, web.de, Apotheken Umschau
