A patient in Munich needs an appointment with a neurologist. The family doctor provides a referral, but the next available consultation is months away. The patient turns to Germany’s 116117 booking service, hoping to find an earlier appointment.

Germany wants patients to receive specialist care faster. Yet changes to the statutory health insurance system in 2027 have raised a difficult question: what happens when policymakers reduce the special payments intended to encourage practices to offer appointments?

What is changing in 2027?

Germany’s statutory health insurance system, the Gesetzliche Krankenversicherung (GKV), faces rising expenditure. The federal government has introduced cost-containment measures, including changes to outpatient remuneration.

Under the 2019 Appointment Service and Supply Act (Terminservice- und Versorgungsgesetz, TSVG), certain appointments arranged through appointment service centres or family doctors qualified for special remuneration. The KBV has warned that removing these incentives could reduce practice revenue and make it harder to offer appointments through central services.

That warning needs context. Reduced reimbursement is not the same as cancelled appointments. Some practices may keep their existing schedules; others may change how many new patients they accept. The actual effect on waiting times must be measured after implementation.

Why financial incentives matter

A specialist practice has limited consultation hours. It must allocate those hours between follow-up care and new referrals. Extra payments can encourage a practice to make capacity available for particular referral routes. Removing those payments changes its financial calculation, but does not automatically remove the appointment itself.

The 2027 outpatient reimbursement benchmark is also set to rise by 2.2%. That broader increase should not be confused with the fate of individual appointment incentives. A rise in the benchmark does not necessarily replace a withdrawn bonus for a particular referral.

Does private insurance make a difference?

Germany has separate remuneration arrangements for statutory (GKV) and private (PKV) insurance. Insurance status can affect appointment availability in some specialist practices. Medical urgency and local specialist capacity also matter.

Changing to private insurance is not a quick fix. Eligibility, long-term premiums and restrictions on returning to GKV deserve careful consideration.

How international residents can use 116117

For a newcomer without an established family doctor, the appointment system can be confusing. The official 116117 appointment portal and hotline help statutory patients find participating practices.

For many specialist appointments arranged through the service, patients need a referral (Überweisung) with a mediation code (Vermittlungscode). Exceptions include appointments with family doctors, ophthalmologists and gynaecologists. These booking rules should not be confused with the requirements for making a direct appointment with a specialist.

Ask your family doctor whether the symptoms require an urgent referral. Contact your insurer as well: some statutory funds provide appointment assistance. Searching beyond your immediate neighbourhood may reveal additional options.

116117 also provides guidance for urgent but non-life-threatening medical needs outside normal practice hours. Call 112 for a life-threatening emergency.

Will waiting times rise?

Doctors’ representatives warn that the withdrawal of special remuneration may make appointments harder to obtain. That is a forecast, not yet a demonstrated nationwide outcome for 2027.

Germany needs comparable figures for appointment availability and waiting times before and after the changes, broken down by specialty and region. Otherwise, policymakers will struggle to tell whether central booking improvements have increased access or merely redistributed scarce appointments.

The question for patients is straightforward: when they need a specialist, will they receive an appointment within a medically reasonable time? The success of the reform should be judged by that result, not by savings alone.

Sources and further reading

National Association of Statutory Health Insurance Physicians (KBV); Federal Ministry of Health; 116117 patient service.