Health
Through private health insurance patients are able to afford the latest treatments, accommodation in specialist establishments, as well as the free choice of physicians and hospitals etc. Private health insurance is thus tailored to specific personal needs, and your insurance agent will gladly assist you in achieving this! You can also choose from among the following policy options:
- Temporary disability insurance (Krankengeldversicherung)
- Daily benefit insurance (Krankenhaus-Taggeldversicherung)
- Care allowance insurance (Pflegegeldversicherung)
- Travel health insurance (Reisekrankenversicherung)
- Hospital expense insurance (Spitalskostenversicherung)
- Outpatient treatment insurance (Versicherung der Kosten ambulanter ärztlicher Betreuung)
- Dental treatment and prosthodontics insurance (Versicherung der Kosten von konservierender Zahnbehandlung und Zahnersatz)
Insurance Cover
Insurance cover begins upon payment of the first premium and the mailing of the policy document. In addition, any waiting periods stipulated in the contract must also have expired.
As a matter of principle, insurance cover will not be offered
- during the prescribed waiting periods
- if incorrect or incomplete information has been submitted concerning previous diseases or illnesses
- in the event of arrears in premium payment following a dunning period
- for cosmetic treatments
- for withdrawal treatments
- for diseases or accidents caused intentionally
However, you may agree upon customized contract terms with your insurance company.
Freedom to Choose Physicians and Hospitals
With private health insurance, the choice of both doctor and hospital is at one’s own discretion. However, prior to embarking on any treatment, you should make sure that your insurance will cover the anticipated costs, and that the hospital of your choice has a partnership agreement with your insurer.
Attention: Insurance companies do not recognize all medical facilities as hospitals (exclusions may encompass, for example, certain specialist hospitals, sanitariums and convalescent homes, as well as rehabilitation centers and homes for the elderly).
Waiting Periods
Normally, insurance cover commences as soon as you have been sent the policy and paid the first premium. With private health insurance, however, certain prescribed waiting periods also need to be observed. This waiting period is generally three months, but does not apply in instances of
- acute infectious disease
- accident
- family members being admitted to existing contracts.
For certain treatments, the prescribed waiting period may actually exceed three months; namely:
- for physiotherapy, dental or orthodontic treatment, as well as prosthodontics, the waiting period can be up to eight months;
- for childbirth, up to nine months; and
- up to three years for care-insurance contracts.
Attention: special waiting periods may be specifically prescribed as regards the reoccurrence of previous diseases.
Automatic Adjustment
Your health insurance guarantees the latest in medical treatment together with a free choice of physician and hospital. In order to keep up with developments in medicine and consequent rising costs, benefits and premiums are adjusted automatically. However, you are at liberty to refuse any such adjustment, but you must inform your insurance company to this effect in writing within four weeks of any notification.
Useful advice: Ask for information as to the consequences of an automatic adjustment, as there may be significant differences between the insurance benefits and actual costs.
Refund of Contributions
Every year, your insurance company will draw up a balance for your policy. Any surplus is collected into a fund from which premiums may be refunded. Depending on the insurance company, a surplus will be either paid out or credited to your premium account.
Terminating a Private Health Insurance Policy
As a matter of principle, health insurance contracts are signed for an indefinite period of time. A policy holder may terminate their contract at the end of an insurance year. Should you wish to terminate the policy, you must observe a prescribed notice period. The actual length of the notice period may vary from company to company, but as a rule, it is between one and three months.
Attention: Your insurance company may also terminate the contract:
- if incorrect or incomplete information was submitted concerning previous diseases or disorders
- in the event of arrears in premium payment following a dunning period
- in instances of insurance fraud.
You will find more information on this in our publication entitled Versicherungsleitfaden (available only in German).
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