Does insurance cover egg freezing in Germany? What the AOK pays for

This page covers Germany, with short sections on Austria and Switzerland.

Many women ask the AOK whether the cost of freezing eggs is covered. The answer is complex. And often surprising.

Most people first think of elective egg freezing, meaning freezing eggs in advance to have a child later. The AOK does not cover any costs for this. It is different if an illness has to be treated with a therapy that damages germ cells, such as chemotherapy for cancer: the AOK then pays for the cryopreservation, including storage.

Important: The information that freezing eggs is a self-pay service applies only to elective egg freezing. If a therapy that damages germ cells is coming up, you have a legal entitlement to have the health insurance fund cover the cryopreservation. What matters is having the right medical documents.

The AOK clearly distinguishes between medically necessary cryopreservation and elective egg freezing. This distinction decides whether several thousand euros come out of your own pocket. That is why this page explains exactly when the AOK pays, which requirements apply, and how to submit the application correctly.

AOK fertility treatment: what is covered

The AOK covers more services for fertility treatment than many people assume. It draws a strict line between medically necessary measures and elective treatments.

Medically indicated cryopreservation: full coverage

If an illness has to be treated with a therapy that can damage germ cells, the AOK covers the cryopreservation of eggs in full (Section 27a, paragraph 4 of Book V of the German Social Code, Sozialgesetzbuch V, SGB V). According to the guideline of the Federal Joint Committee (Gemeinsamer Bundesausschuss, G-BA), this includes preparation, retrieval, processing, transport, freezing, storage, and later thawing. This service has been billable since July 1, 2021. The AOK pays for storage as long as the entitlement lasts.

For those affected, this is a major relief, because as a self-pay service, stimulation, retrieval, and freezing cost several thousand euros, and annual storage comes on top. What one cycle and storage cost in Germany, Austria, and Switzerland is shown in our overview Egg freezing cost, with prices from clinic price lists. The entitlement applies to women up to their 40th birthday and to men up to their 50th birthday. Unlike with assisted reproduction, there is no minimum age of 25, and you do not need to be married.

Elective egg freezing: no coverage from the AOK

When eggs are frozen as a precaution without medical necessity, the AOK pays nothing. This affects women who:

• Want to put off having a child for professional reasons
• Wish to have a child at 35 or older and want to “secure” their fertility
• Are still unsure about wanting a child
• Do not have a suitable partner

Here you pay all costs yourself: the treatment cycle, medication, and annual storage. Current ranges by country, with sources, are in Egg freezing cost, and our egg freezing guide explains the process.

Assisted reproduction: 50% reimbursement

For conventional fertility treatments, the AOK pays 50% of the approved costs. It covers IVF and ICSI for up to three attempts, as alternatives, not in addition to each other:

Freezing and later transferring embryos or fertilized eggs is not part of the statutory benefit for assisted reproduction. Some health insurance funds contribute to it voluntarily through their bylaws.

The ICSI cost can vary widely depending on the clinic and additional treatments. In large cities such as Munich, prices are often higher than in more rural areas.

Additional AOK benefits

Beyond the statutory 50%, health insurance funds may provide additional benefits for assisted reproduction in their bylaws (Section 11, paragraph 6 SGB V). At the AOK, this depends on the regional AOK concerned; there are no uniform additional AOK benefits. Documented examples for 2026:

AOK PLUS (Saxony, Thuringia):

• An additional 25% of the approved costs, so 75% together with the statutory share
• Under certain conditions, TESE for men and assisted hatching for women over 35

AOK Bayern:

• An additional €500 per married couple and attempt
• Up to €1,500 for one additional attempt per series of attempts

Which additional benefits your AOK covers is stated in its bylaws. It is best to ask before treatment begins. Important: Benefits under the bylaws apply only to services provided to the fund's own insured members.

Requirements for reimbursement from the AOK

Reimbursement from the AOK is tied to clear requirements. The criteria differ considerably depending on the type of treatment.

Medical indication for cryopreservation

For full coverage of egg freezing, an illness must be treated with a therapy that, according to current knowledge, can damage germ cells. According to the G-BA guideline, this includes in particular:

Therapies that damage germ cells:

• Surgical removal of the ovaries
• Radiation therapy with expected damage to the ovaries, for example in the pelvic area
• Medications that can potentially damage fertility, for example certain chemotherapies

Typical reasons:

• Cancers that require such a therapy
• Other illnesses, such as autoimmune diseases, if they are treated with medications that can potentially damage fertility

An illness that, without treatment, reduces fertility does not by itself establish an entitlement. What matters is the planned therapy that damages germ cells. The specialist physician who treats the underlying illness must determine this and certify it.

Personal requirements for fertility treatment

For conventional fertility treatments (Section 27a SGB V), additional requirements apply:

Age limit:

• Woman: from the 25th birthday; the entitlement ends on the 40th birthday
• Man: from the 25th birthday; the entitlement ends on the 50th birthday
• Both partners must meet the limits, specifically at the start of each cycle

Relationship status:

• Married couples: 50% of the approved costs
• Unmarried couples: no entitlement, they pay the costs themselves
• Same-sex married couples: no entitlement, because only the eggs and sperm of the spouses may be used

Medical requirements:

• A physician's determination that the treatment is necessary and has a sufficient chance of success
• Counseling by a physician who does not perform the treatment, with a referral to an approved center
• The HIV status of both partners must be known

Special features in Germany, Austria, and Switzerland

Germany (AOK): The regional AOKs offer different additional benefits. For example, AOK Bayern adds €500 per attempt, and AOK PLUS covers 75% in total.

Austria: The IVF Fund (IVF-Fonds) covers 70% of the costs for IVF, ICSI, and frozen embryo transfer attempts, but only for certain indications: infertility due to blocked fallopian tubes, endometriosis, or polycystic ovaries, as well as male infertility. Elective egg freezing without a medical indication is currently prohibited in Austria. The Constitutional Court (Verfassungsgerichtshof) has repealed the ban, but the repeal takes effect only at the end of March 31, 2027.

Switzerland: Mandatory basic health insurance (Grundversicherung) does not pay for IVF or ICSI, but it does pay for up to three insemination cycles per pregnancy (with deductible and co-insurance). It has covered medically necessary fertility preservation since 2019, for example before cancer therapy with a medium or high risk to fertility, up to the 40th birthday and with storage initially for a maximum of five years.

Understanding exclusion criteria

Certain circumstances rule out reimbursement for assisted reproduction:

Medical exclusions:

• No sufficient chance of success according to a physician's determination
• After two fully completed IVF or ICSI attempts without fertilization, the fund does not pay for another attempt
• After a sterilization, there is generally no entitlement; exceptions only with the fund's approval

Legal and formal factors:

• The couple is not married to each other
• Donor sperm is to be used
• Three unsuccessful, fully completed attempts already (a clinically confirmed pregnancy without a birth is not counted, and after the birth of a child the count starts over)
• Counseling and referral by a physician who does not perform the treatment are missing

Application and approval process at the AOK

The path to coverage follows a structured process. If you know the individual steps, you avoid unnecessary delays.

Application for medically indicated cryopreservation

Step 1: Gathering the documents The basis is a medical certificate from the specialist physician who treats the underlying illness. According to the G-BA guideline, it contains, among other things:

• The underlying illness
• Any previous therapy
• The planned therapy that damages germ cells

The next step, with this certificate, is counseling and information at the fertility clinic.

A typical stumbling block: If the certificate does not state explicitly that the planned chemotherapy is gonadotoxic (germ cell-damaging), this can lead to follow-up questions or a rejection. If this information is submitted later, there is often nothing left standing in the way of coverage.

Step 2: Coordination with the AOK and the clinic Clarify early with your AOK and the fertility clinic which documents they need and whether a written application is required. Typical information includes:

• Personal details and insurance number
• Medical information about the illness and therapy
• Information about the planned cryopreservation
• Cost breakdown from the clinic

Step 3: Submission and processing time Submit everything as early as possible; with cancer therapy, time is often pressing. The health insurance fund must decide on a benefit application promptly (Section 13, paragraph 3a SGB V): within three weeks at the latest, or within five weeks if it obtains an expert opinion from the Medical Service (Medizinischer Dienst).

Treatment plan for fertility treatment

For conventional fertility treatments, a treatment plan is required:

Before the first cycle: The fertility clinic issues the treatment plan, and the AOK must approve it before treatment begins. It includes, among other things:

• The diagnosis and the planned method
• At most three cycles planned in a row (up to eight for insemination in a natural cycle)
• The expected costs, of which the AOK covers 50%

Approval process: The AOK checks whether the legal requirements are met. This is mainly about:

• The age of both partners
• The marriage
• The number of attempts already completed
• The chance of success determined by a physician

A new treatment plan is needed at the latest one year after approval or when the method changes.

Filing an objection after a rejection

If the AOK rejects your application, you have several options:

Objection procedure: Within one month after the rejection notice is issued, you can file an objection (Section 84 of the Social Courts Act, Sozialgerichtsgesetz, SGG). It should contain:

• A statement of why the rejection is not justified
• Additional medical documents
• A statement from your treating physician
• A reference to the legal basis, such as Section 27a SGB V

Social court proceedings: If the objection is rejected, you can file a lawsuit with the social court.

For medically necessary cryopreservation, the legal situation is clear: The entitlement is expressly regulated in Section 27a, paragraph 4 SGB V when a therapy that damages germ cells is coming up.

Special features of the different regional AOKs

AOK Bayern: Pays an additional €500 per married couple and attempt, up to the actual costs of the AOK-insured partner at most, and up to €1,500 for one additional attempt per series of attempts.

AOK PLUS: In Saxony and Thuringia, covers an additional 25%, so 75% of the approved costs in total, and under certain conditions also TESE and assisted hatching.

Other AOKs: For other regional AOKs, it is worth looking at the respective bylaws. You should not plan on benefits that are not listed there.

The regional differences can be considerable. If you move to another federal state, it is therefore worth checking the benefits of the new regional AOK specifically.

AOK vs. other health insurance funds: comparing fertility benefits

For the legally required benefits, all funds are the same. Differences exist only for voluntary benefits under the bylaws. A close comparison is worthwhile before you make a decision.

Scope of benefits for cryopreservation

AOK compared: Cryopreservation before a therapy that damages germ cells is regulated by law. The AOK therefore provides the same here as all other statutory funds:

The age limit of 40 applies to women; for men, the entitlement ends on the 50th birthday.

Fertility treatment: reimbursement in detail

The 50% rule and exceptions: All statutory health insurance funds pay the legally required 50%. There are differences for voluntary additional benefits:

AOK additional benefits:

• AOK PLUS: 75% in total, plus TESE and assisted hatching under certain conditions
• AOK Bayern: plus €500 per attempt, additional attempt up to €1,500
• Other AOKs: depending on the bylaws

Benefits at competing funds: The Techniker Krankenkasse, for example, covers:

• A subsidy of up to €500 toward the out-of-pocket cost for complete IVF or ICSI attempts
• Since 2026, a one-time payment of up to €200 for assisted hatching (women from age 37, under certain conditions) and up to €300 for a TESE
• 50% of the costs for the transfer of surplus cryopreserved eggs from a previous attempt

For Barmer and DAK, the funds' own pages name no benefits beyond the legally required 50%.

Private health insurance vs. AOK

The difference from private health insurance can be considerable:

Private health insurance benefits:

• Elective egg freezing: usually no reimbursement, the tariff is decisive
• IVF/ICSI: coverage under the causation principle, meaning when the cause lies with the insured person; marriage is usually not mandatory
• Cryopreservation and additional treatments: depending on the tariff

AOK vs. private: How high the out-of-pocket cost with private health insurance actually turns out to be depends heavily on the individual tariff. Always check the specific contract terms.

Regional differences: Germany vs. Austria vs. Switzerland

Germany (AOK):

• Medical cryopreservation: 100% coverage including storage
• IVF/ICSI: 50% for up to 3 attempts
• Elective egg freezing: no reimbursement
• Age limit for women: entitlement ends on the 40th birthday

Austria (IVF Fund):

• Medical cryopreservation: permitted if an illness or its treatment seriously endangers fertility; clarify coverage with the health insurance fund in advance
• IVF/ICSI: 70% for up to 4 attempts, for married couples, registered partnerships, and cohabiting couples, only for certain indications
• Elective egg freezing: currently prohibited without a medical indication (repeal of the ban takes effect only after March 31, 2027)
• Age limit for women: under 40 at the start of an attempt

Switzerland (basic health insurance):

• Medical cryopreservation: covered since 2019 before cancer therapies with a high risk, up to the 40th birthday, storage initially for a maximum of 5 years
• IVF/ICSI: no reimbursement from basic health insurance
• Insemination: up to 3 cycles per pregnancy (with deductible and co-insurance)
• Elective egg freezing: no reimbursement

Switching funds for fertility treatment

Strategic switch of funds: Switching health insurance funds before planned fertility treatment can be worthwhile if the new fund offers documented additional benefits.

Important deadlines:

• You are bound to a fund you have chosen for at least 12 months
• After that, you can cancel effective at the end of the calendar month after next
• Special right of cancellation if the fund charges an additional contribution for the first time or raises it
• Optional tariffs can extend the commitment period to between one and three years

Funds with documented additional benefits (as of 2026):

1. Techniker Krankenkasse: subsidy of up to €500 toward the out-of-pocket cost, assisted hatching and TESE, 50% for the transfer of cryopreserved eggs from a previous attempt
2. AOK PLUS: 75% of the approved costs in total (for insured members in Saxony and Thuringia)
3. AOK Bayern: plus €500 per attempt and up to €1,500 for an additional attempt

Example calculation for switching funds: Suppose the approved costs of an IVF for the insured partner are €4,000. With the statutory share of 50%, €2,000 remains as your out-of-pocket cost. If the fund covers 75% in total, like AOK PLUS, the out-of-pocket cost drops to €1,000. The savings would then be €1,000 per attempt. Important: Subsidies apply only to services provided to insured members of the respective fund.

Frequently asked questions

Does the AOK cover the cost of elective egg freezing?

No, the AOK does not cover any costs for elective egg freezing. Freezing eggs as a precaution without medical necessity counts as an elective service and must be paid for entirely out of pocket.

What one cycle of elective egg freezing and annual storage cost, with sources, is in our overview Egg freezing cost.

Exception: If a therapy that damages germ cells is coming up because of an illness, such as chemotherapy for cancer, the AOK covers the cryopreservation. This includes hormone treatment, retrieval, freezing, and storage, for women up to the 40th birthday.

Without a medical indication, it is worth looking at alternative ways to finance it, such as payment in installments or special fertility loans.

What requirements do I have to meet for AOK reimbursement?

The requirements differ considerably depending on the type of treatment:

For medical cryopreservation:

• An illness that has to be treated with a therapy that damages germ cells
• A medical certificate from the specialist physician who treats the underlying illness
• Counseling and information at the fertility clinic
• Women up to the 40th birthday, men up to the 50th birthday; no minimum age of 25, no marriage required

For fertility treatments (IVF/ICSI):

• Age: both partners at least 25, the woman under 40, the man under 50
• Married couple (unmarried couples have no entitlement)
• A physician's determination that the treatment is necessary and has a chance of success
• Counseling by a physician who does not perform the treatment, and a referral
• A treatment plan approved before treatment begins

The age limits apply strictly. Example: If a woman is only 24 years old, the application for coverage of IVF is rejected. After her 25th birthday, the same application can be approved.

How long does the approval process at the AOK take?

The health insurance fund must decide on a benefit application promptly (Section 13, paragraph 3a SGB V):

Standard case (up to 3 weeks):

• Three weeks after the application is received at the latest
• It is usually faster if all documents are complete from the start

With an expert opinion (up to 5 weeks):

• If the fund obtains an expert opinion, for example from the Medical Service, it has up to five weeks
• It must inform you of this

Urgent cases: In time-critical cases, such as a chemotherapy scheduled at short notice, explicitly point out the urgency to the AOK and clarify the procedure by phone.

A practical tip: Always submit the application with all required documents. Every follow-up request costs time.

What does storing frozen eggs cost with the AOK?

The AOK covers the storage costs for frozen eggs differently depending on the indication:

With a medical indication:

• Storage is part of the fund's benefit as long as the entitlement lasts
• For women, the entitlement ends on the 40th birthday; for men, on the 50th
• After that, you pay for further storage yourself

With elective egg freezing:

• Entirely self-pay from the start
• The annual fee is set by the clinic or cryobank; you can find current prices in Egg freezing cost

Example calculation for storage:

• A woman has her eggs frozen at age 30 before chemotherapy
• Until her 40th birthday, the AOK bears the storage cost: €0
• She pays for any further storage after that herself, at the annual fee of her clinic or cryobank

If you have questions about reimbursement from your AOK or are looking for a second opinion on trying to conceive, our Fertility Clinic Finder on Fertilio.de can help. Here you will find qualified experts who can advise you individually and support you with the application. We are also happy to help you find the right fertility clinic, with transparent costs and real reviews from other patients.

Sources

• Trying to conceive: AOK benefits, AOK, 2026
• Section 27a SGB V: Assisted reproduction, Federal Ministry of Justice, as of 2026
• Cryopreservation Guideline (Kryo-RL), Federal Joint Committee (G-BA), 2022
• Guideline on Assisted Reproduction (KB-RL), Federal Joint Committee (G-BA), 2022
• AOK Health Advantage: additional benefits, AOK Bayern, 2026
• Bylaws of AOK PLUS (Section 11h Assisted reproduction), AOK PLUS, 2026
• Assisted reproduction: TK benefits, Techniker Krankenkasse, 2026
• Section 13 SGB V: Reimbursement and decision deadlines, Federal Ministry of Justice, as of 2026
• Section 175 SGB V: Choosing and switching health insurance funds, Federal Ministry of Justice, as of 2026
• Section 84 SGG: Objection deadline, Federal Ministry of Justice, as of 2026
• IVF Fund Act (IVF-Fonds-Gesetz), Federal Legal Information System (Rechtsinformationssystem des Bundes, RIS), as of 2026
• Federal Law Gazette I No. 61/2025: Promulgation of the repeal of Section 2b (1) FMedG, Republic of Austria, 2025
• KLV Annex 1 (as of July 1, 2026), Federal Office of Public Health (BAG), 2026