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German Cities Halt Planned Ambulance Fees as Funding Fight Deepens

Officials point to an early‑2026 federal rescue‑care reform that would end the transport requirement for reimbursement.

Overview

  • Essen suspended planned patient co-pays of up to €267 per emergency run and €62 per patient transport after an urgent decision.
  • Gladbeck approved a revised fee statute from 1 January 2026 yet told residents they will not receive bills while responses from cost carriers are pending.
  • Bavaria stated it has no plans to introduce patient charges for rescue transports and says its financing model differs from North Rhine-Westphalia.
  • Health insurers dispute paying for deployments without hospital transport—about 25–30% of calls—and for undercoverage, creating municipal shortfalls estimated at about €250 million in NRW.
  • A federal emergency-care reform is slated to reach the cabinet in early 2026 and is expected to decouple reimbursement from whether a patient is transported.