ADHD while studying raises practical questions: who pays for the diagnosis, what do medicines cost, and what support does the university offer? The answers depend on whether you are insured statutorily or privately and which service you need. This guide classifies the 2026 costs and keeps health insurance and compensation for disadvantages (Nachteilsausgleich) clearly apart.
Short answer: Diagnosis, medical and psychotherapeutic treatment, and prescribed medicines and aids are part of the statutory treatment benefits under section 27 SGB V (Sozialgesetzbuch V, the German Social Code Book V) where they are medically necessary. You pay the statutory copayment, for medicines 10 percent of the pharmacy price, at least 5 and at most 10 euros (section 61 SGB V). Compensation for disadvantages at university is not regulated by your fund. Last updated: October 2026.
Key points at a glance
- Your statutory fund covers medically necessary diagnostics and treatment, including psychotherapy (section 27 (1) SGB V).
- Prescribed medicines carry a copayment of 10 percent of the pharmacy price, at least 5 and at most 10 euros (section 61 SGB V).
- The annual cap of 2 percent, or 1 percent for chronically ill people in continuous treatment, also applies to ADHD treatment costs (section 62 SGB V).
- Compensation for disadvantages, for example altered examination conditions, is requested from your university.
- In private health insurance, reimbursement of diagnostics, therapy and aids depends on the tariff.
Which services does statutory insurance cover for ADHD?
Under section 27 (1) SGB V, treatment covers everything necessary to recognise an illness, cure it, prevent it from worsening or relieve its symptoms. This includes medical and psychotherapeutic treatment, the supply of medicines, bandages, therapeutic and other aids, and digital health applications.
Whether a specific examination or therapy is necessary is decided on medical grounds. If your fund refuses a service, ask for the refusal in writing and its reasons, so that you can have it reviewed.
What does treatment cost during a degree?
Most costs arise through copayments. The table shows the rules as of October 2026. The Social Code Book V is the binding source.
| Service | Copayment | Legal basis |
|---|---|---|
| Prescribed medicines | 10 percent of the pharmacy price, at least 5 and at most 10 euros per item, never more than the cost of the medicine | Section 61 sentence 1 SGB V |
| Therapeutic services, for example occupational therapy | 10 percent of the costs plus 10 euros per prescription | Section 61 sentence 3 SGB V |
| Aids and appliances | Copayment under section 61 sentence 1; for consumable aids 10 percent of the fund share, up to 15 euros per monthly need | Section 33 (8) SGB V |
Copayments add up within the calendar year. Once you reach the annual cap, you pay no further copayments that year. For ADHD treatment the cap is 2 percent of gross income for living costs, and 1 percent for chronically ill people in continuous treatment (section 62 (1) SGB V).
When does the annual cap apply to ADHD?
Whether ADHD counts as a serious chronic illness for the 1 percent cap is determined by the Federal Joint Committee (G-BA) through its rulings (section 62 (1) sentence 8 SGB V). Your fund checks whether your situation falls under them. Until then, plan with the 2 percent cap.
Assumption: your gross income for living costs is 12,000 euros a year, and you pay 10 euros per pack. The 2 percent cap is then 240 euros. After 24 packs in the calendar year it is reached, and no copayment applies for the rest of the year.
Documentation matters. Collect prescriptions, receipts and copayment statements as you go, so that you can prove the total to your fund.
What support does the university offer?
Compensation for disadvantages is not a claim against your health insurance fund. It can include, for example, extended processing time, a different form of examination or a quieter room. Your university decides on the application under its examination or compensation regulations.
Apply early, because deadlines and evidence requirements are set in advance. Our German guide on accessible studies, compensation for disadvantages and support (in German) gives an overview of the steps.
The two levels need to be kept separate. Compensation for disadvantages does not replace medical treatment and does not settle any cost question. Medical costs run through your health insurance, while organisational adjustments in your studies run through the university. Keeping the two apart avoids confusion with both bodies.
What changes in private health insurance?
In private tariffs, reimbursement follows the benefits you have agreed. Psychotherapy, medicines and aids are treated differently depending on the tariff level. Before signing, check exactly which benefits your tariff provides for these treatments and what deductible (Selbstbeteiligung) applies.
A diagnosis can play a role in a private application. In statutory health insurance, pre-existing conditions are not relevant for admission. If you consider switching, know these differences in advance. An overview of aids in private cover is available in our German guide on aids in private insurance (in German).
How do you prepare for medical appointments and proof?
Good preparation helps in the conversation with your doctor and in clarifying costs. Before the appointment, note which difficulties arise during your studies, since when they have existed and how they affect lectures, examinations or daily life. This information is the basis for judging whether a service is necessary.
- Keep a short log of symptoms, concentration and daily life over a few weeks.
- Collect all existing findings, reports and prescriptions in one folder.
- Ask which diagnostics are medically sensible and necessary, and have the recommendation recorded in the report.
Frequently asked questions
Does the statutory fund pay for the diagnosis?
If the examination is medically necessary, it belongs to treatment under section 27 SGB V. Clarify with your doctor which steps are needed. If your fund refuses a service, ask for a written justification.
Do I have to pay for prescribed medicines myself?
Yes, but only the statutory copayment under section 61 SGB V. It is generally 10 percent of the pharmacy price, at least 5 and at most 10 euros per item. Once you reach the annual cap, the copayment ends for the rest of the calendar year.
What happens if the fund refuses a service?
Ask for the refusal in writing and check it. You can file an objection (Widerspruch) against a refusal notice. The deadline is stated in the notice, so act promptly and support your reasons with medical documents.
Can I get compensation for disadvantages without medical documents?
Your university decides this under its own regulations. It sets which evidence it requires and in what form. Ask the student advisory service or the examination office early which documents you will need.
Does an ADHD diagnosis affect my choice of insurer?
In statutory health insurance, pre-existing conditions play no role in admission. Private insurers check health information in the application and may exclude benefits or charge surcharges. Get advice on the information you must provide before you apply.
What should you do now?
- Clarify with your doctor which diagnostics and treatment are necessary.
- Collect findings, prescriptions and copayment receipts for the current calendar year.
- Apply for compensation for disadvantages with your university in good time before examination dates.
- If you consider switching to private cover, check the benefits for therapy, medicines and aids.
Related reading
- Copayment Exemption and Out-of-Pocket Limit for Students
- Health insurance for students: glossary from A to Z
- Chronically ill during studies: copayment and annual cap
Sources: Section 27 SGB V, statutory treatment (retrieved October 2026, in German), Section 61 SGB V, copayments (retrieved October 2026, in German), Section 62 SGB V, annual cap (retrieved October 2026, in German), Section 33 SGB V, aids (retrieved October 2026, in German).
Last updated: October 2026. This guide is general information, not individual advice.
