The word “benefit” is used in the insurance industry to refer to any pay-out or service you receive from your insurance provider under the terms of your policy as a result of a specific event or circumstance.
If you fall ill, suffer an injury or otherwise require medical, dental, psychological or other treatment covered under your insurance policy, you will receive insurance benefits.
Your policy determines precisely what these benefits are, the extent of these benefits, and the circumstances in which they will be provided.
Possible health insurance benefits include payments for medical bills, a daily sickness allowance if you are unable to work, and reimbursements for the cost of glasses and contact lenses.
Insurance benefits vary significantly depending on the insurance provider and tariff you select. As the prospective policyholder, it is up to you to select a tariff that offers adequate benefits for your needs in return for premiums that fit your financial circumstances.
The long-term nursing care insurance 'Pflegepflichtversicherung' is a mandatory insurance for everyone who lives in Germany. This insurance will cover you if you require long-term care and need external help.
There are annual limitations, to a maximum of four insurance years for ‘Zahnersatz’/dental replacements (implants, onlays, inlays etc.). Here we are limiting the maximum reimbursement amount, to a certain total, but it is increasing every insurance year. Of course, should you have an accident and require immediate dental treatment/replacement, this limit does not apply. Limitations do also not apply for professional cleanings and regular dental treatments.
In Germany, doctor fees are regulated by GOÄ (Gebührenordnung für Ärtze) and GOZ (Gebührenordnung für Zahnärtze). This is a price range regulation that indicates the cost of a treatment. A normal treatment will be charged with factor 2,3. Anything higher than that up to 3,5 needs an explanation from the doctor on the invoice, explaining the increased effort. Everything higher than 3,5 the doctor needs you to sign the so called “Honorarvereinbarung” before the treatment. We advise you to always let us know if this happens.
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