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Essen Approves Patient Co-Pays for Ambulance Calls From January 2026

The step follows a funding standoff with statutory insurers over unpaid deployments without hospital transport.

Overview

  • City councillors backed a new fee plan under which patients will owe about €267 per ambulance deployment and €62 for certain medical transports.
  • Essen will continue invoicing health insurers first, then send patients a bill for the expected gap the city says insurers will leave unpaid.
  • The city’s calculation puts a rescue deployment at €1,020, while insurers argue federal law stops them from covering costs not tied to care of their own members, such as Fehlfahrten.
  • Several other North Rhine–Westphalia municipalities, including Rhein-Sieg-Kreis, are preparing similar steps as the state health ministry says it lacks authority to force insurers to pay.
  • Municipal groups warn bills could deter emergency calls and estimate at least €250 million in annual shortfalls across NRW, and Essen is working on hardship provisions for those unable to pay.