People with cancer must pay for egg or sperm freezing

LSG Darmstadt: Health insurance may not give a voluntary subsidy
(Jur). The statutory health insurance companies may not pay members suffering from cancer the freezing of egg or sperm cells. The so-called cryopreservation is a non-statutory benefit, which may not be subsidized as a voluntary "statute performance", as the Hessian State Social Court (LSG) in Darmstadt in a ruling published on Wednesday, 18 May 2016, ruled (Az .: L 1 KR 357/14 KL).

In addition to the statutory benefits, the health insurance companies are also allowed to introduce voluntary so-called statutory benefits since the beginning of 2012. This should strengthen the competition and the customer orientation of the funds.

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Based on this, the plaintive company health insurance fund (BKK) wanted to introduce cryopreservation as a statutory benefit. Because chemotherapy for cancer can reduce fertility, insured persons with proven cancer should receive a grant of up to € 1,200 to freeze their egg or sperm cells.

The Federal Insurance Office has not approved the corresponding amendment to the Articles of Association - rightly so, as the LSG decided.

The reason explained by the Darmstadt judges, also statutes should relate only to statutory benefits. Many health insurances grant artificial insemination a higher subsidy than the statutory half.

However, the cryopreservation is not an "additional", but a non-statutory "other" performance. This may therefore be "subsidized by virtue of the constitutional right".

Basically, the law itself determines the benefits of the statutory health insurance. "Insofar as the individual health insurance company is allowed to provide benefits on an exceptional basis, the legislature does not want to issue a license in order to create a law-independent benefit right by statute," states the judgment of 28 April 2016, which has now been published in writing.

With similar reasoning also the Federal Social Court (BSG) had rejected in Kassel a health insurance, which also non-marital couples a grant for the artificial insemination wanted to pay (judgment and JurAgentur message from 18 November 2014, Az .: B 1 A 1/14 R) , mwo / fle