[Compilation of Second Opinion Programs in the German Statutory Health Insurance]

According to a new legislation passed in 2016, patients with an indication for elective procedures have the right to obtain a second opinion. The Federal Joint Committee has not yet provided a list of indications that this legislation will cover. Independently of this, the statutory health insurances can, nonetheless, pay for a second opinion. The aim of this article is to give an overview of current second opinion programs delivered by the statutory health insurance schemes.

Websites of all German statutory health insurance schemes (n=117) were searched for second opinion programs and their features in November 2016. All data was extracted by one person and verified by a second person.

In total, 78 second-opinion programs were identified. Half of all statutory health insurance schemes (50%, n=59) provide at least one second-opinion program. The majority of them was in the field of orthopedics (78%, n=61) and oncology (58%, n=45). Multiple replies were possible. In most cases, second-opinion programs were outsourced (58%; n=44), followed by forwarding patients to health service providers contracted with the statutory health insurance scheme (45% n=34). Only in 11% (n=8) was the second opinion delivered by staff of the statutory health insurance scheme. The second opinion was delivered based on submitted documents only (63%; n=48), direct patient-physician contact (43%; n=33), and contact by phone (14%; n=11). The delivery of the second opinion took 7 days in median, while the delivery based on submitted documents only (median 7) was faster than the delivery by direct-physician contact (median 14).

The majority of those living in Germany have the possibility to obtain a second opinion. However, second-opinion programs are very heterogeneous so that patients are confused about their rights to second opinion.