( jur).The statutory health insurance funds may not pay for the freezing of egg cells or sperm cells. The so-called cryoconservation is a non-statutory benefit, which can not be subsidized as a voluntary "constitutional performance", as the Hessische Landessozialgericht( LSG) in Darmstadt decided in a judgment published on Wednesday 18 May 2016( Az.: L 1KR 357/14 KL).
Since the beginning of 2012, the health insurance companies have been able to introduce voluntary so-called statutory benefits. This is intended to strengthen the competition and customer orientation of the funds.
Based on this, the complaining company sickness fund( BKK) wanted to introduce the cryopreservation as a statutory power. Because chemotherapy against cancer can eradicate fertility, insured persons with proven cancer should receive an allowance of up to € 1,200 to freeze their egg or sperm cells.
The Federal Insurance Office has not approved the corresponding amendment to the statutes - rightly, as the LSG now decided.
In the reasons stated the Darmstadt judges, also statutory services should refer only to legally provided benefits. Thus, numerous health insurance funds grant a higher than the legally half-rate subsidy for artificial insemination.
The cryopreservation is not an "additional", but a "other" performance not provided by law. This should therefore be "not subsidized by the constitutional law".
In principle, the law itself determines the benefits of statutory health insurance."In so far as the individual health insurance fund itself can exceptionally develop services, the legislature does not want to issue a" Freibrierief "in order to create a law-independent right of performance by means of the statutes," says
the Social Security Court in Kassel also rejected a health insurance fund which wanted to pay non-married couples an allowance for artificial insemination( judgment and JurAgentur report of 18 November 2014, ref.: B 1 A 1/14 R).mwo / fb