Private supplementary insurance for publicly insured people

A brief overview of the key points

• A wide range of supplementary insurance policies are available to top up the benefits of public health insurance.
• Private supplementary health insurance policies often require you to provide information about your health – and you must always answer them honestly.
• Not all supplementary insurance policies are strictly necessary, of course, such as insurance to cover the cost of new glasses.
• Premiums usually increase with age. You should take this into account when planning for the future.
• If you go abroad, you should certainly take out travel insurance, as you will otherwise have to pay any medical bills out of pocket.

Got public health insurance? Why public insurance cover is often insufficient

Public health insurance providers only cover the costs of treatment provided as part of standard care. In other words, it only pays for medically necessary treatments. Innovative, naturopathic, and cosmetic treatments are often excluded from the scope of cover. Even when it comes to medically necessary treatments, the proportion of costs actually reimbursed can be rather low, particularly if it is considered a premium treatment.

So, in order improve their insurance cover, many public insurance patients opt for supplementary insurance policies. This means that the treatment they receive in specific areas is comparable to that of a private patient – regardless of their income. After all, anyone can take out a supplementary insurance policy, no matter how much they earn.

Other publicly insured patients who do not have supplementary insurance face the prospect of getting treatment in a private practice and covering the costs themselves. There’s another important question, though:

Can privately insured people be treated at a private hospital?

It’s certainly possible. However, without a corresponding insurance policy, you would have to pay all medical bills yourself (in line with the cost reimbursement principle). However, as self-pay options can soon become very expensive, taking out supplementary insurance often pays dividends.

Comparable benefits to privately insured patients: What do private supplementary insurance policies cover?

There are numerous ways to increase your level of insurance cover. Everyone with public health insurance is free to select supplementary health insurance policies that meet their needs. You don’t have to switch to private health insurance entirely – instead, you can take out private cover in areas that are important to you.

Good to know:

There is some confusion, even among native German speakers, surrounding two similar but different German terms.

Zusatzversicherung – usually translated as “supplementary insurance” – is a policy that covers services not covered by public health insurance.

Ergänzungsversicherung – usually translated as “complementary insurance” – is a policy that covers the costs of treatments only partially covered by public health insurance. Many people might use one term when they actually mean the other. And, in some cases, people mix them up or use them interchangeably. Nevertheless, it’s an important distinction and certainly good to know.

What exactly do complementary and supplementary insurance policies cover?

There aren’t supplementary insurance policies to cover everything. But, depending on the type of insurance you take out, you might be able to have the following items and services reimbursed:

• Dental implants
• Treatment abroad
• New glasses
• Treatments from specialists, such as natural health practitioners
• Income support in the case of prolonged illness

How much does supplementary insurance cost?

The cost usually depends on the scope of cover. Some supplementary insurance policies, such as health insurance for foreign travel, are very cheap and start at around €10 per year. Other policies, such as supplementary dental insurance, are more expensive and start at around €30 per month. Make sure to check out the full details of supplementary dental insurance from ottonova.

Dental insurance: Comparisons are key!

Even if you take good care of your teeth, it’s entirely possible that a tooth might fall out at some stage. It might be caused by an accident or a severe case of periodontitis, a condition that affects 11.5 million Germans. Dentists say that dental implants are the best tooth replacement option currently on the market. However, public health insurance providers do not cover the cost of dental implants. Many Germans are aware of this – and decide to take out supplementary dental insurance as a result. Around 16 million people in Germany currently have this type of policy.

What exactly your supplementary dental insurance will cover depends on the terms of your contract. For example, the cheapest tariffs might include full cover for all dental treatments, partial cover for implants, and a set allowance for professional teeth cleaning. A premium tariff, on the other hand, might also cover orthodontic treatment. This is why it’s important to compare policies to find the right cover for you.

Health insurance for foreign travel: Keeping you protected overseas

Health insurance for foreign travel is an absolute must for all extended stays abroad – in fact, it is probably the most important type of supplementary health insurance. If you’re going on a trek through a national park in the United States or planning a safari in Africa, it’s entirely possible that you might need medical care or, in more serious cases, repatriation to Germany. Even just an overnight stay in a private hospital in the United States can set you back several thousand euro. Taking out foreign travel insurance ensures that you’re not stuck handling the costs. Most policies only cost about €10 per year.

What is supplementary hospitalization insurance?

Imagine you’ve been diagnosed with a severe illness, such as cancer. You hear about an innovative treatment you think could help, but it’s still in the trial phase. In most cases, public health insurance won’t cover this type of treatment – but private supplementary hospitalization insurance will. Your supplementary insurance would then cover the additional costs of opting for a novel treatment.

What exactly does supplementary hospitalization insurance cover?

• Treatment by a specialist or chief physician
• Private or semi-private room in hospital
• Option for parents to stay in hospital overnight if their child undergoes treatment
• Free choice of hospital
• Certain alternative, naturopathic treatments

Make sure you’re protected for whatever comes your way. ottonova offers a range of tariffs that provide different levels of cover. Which is the right tariff for you?

How much does supplementary hospitalization insurance cost?

The costs depend on your age and the benefits and services you want to include. With ottonova, for example, a 29-year-old would pay around €14 per month for our standard tariff. Our premium tariff would cost around €43.

Sickness allowance insurance: Better benefits if you’re unable to work

A slipped disk, depression, and many other protracted injuries and illnesses could put you out of action for weeks at a time. Is the daily sickness allowance in public health insurance enough for you to get by? This is a particularly important question if you are self-employed, as you will not receive any support in the public health insurance system. If you are an employee with a salary above the premium assessment ceiling, it’s likely that your income would drop significantly overnight. This is because, in most cases, statutory sick pay is significantly below a person’s net salary. It can then be difficult to cover your regular expenses. Sickness allowance insurance helps to cushion the blow.

Good to know:

Make sure not to confuse two long German words! Krankentagegeldversicherung is sickness allowance insurance – Krankenhaustagegeldversicherung is hospitalization allowance insurance. The latter covers things like TV charges when in hospital – and is quite superfluous.

Supplementary outpatient insurance to access more services at your doctor’s office

Supplementary outpatient insurance certainly sounds promising to begin with. It pays for services that you are likely to use sooner or later in your day-to-day life. These might include:

• New glasses
• Vaccinations not covered by your public insurance provider
• Naturopathic treatments
• Hearing aids
• Check-ups and screenings

However, reimbursements in these policies are usually capped.

Supplementary or complementary insurance: How to find the right insurance for you

Are you looking to take out an additional policy to supplement your public health insurance? Your public insurance provider might have a cooperation agreement with a private provider and offer a combi-contract. This would save you up to 10% – but it’s only worthwhile if the overall plan really meets your needs.

Here are some points to consider when making your selection:

1. What insurance do I need?

Think about the services you currently need and what you are likely to need in future. Not all supplementary insurance policies are suitable or worthwhile for everyone with public health insurance. You can still feel like a private patient even if you only arrange cover for the services that matter to you.

2. Run through different options

Crunch the numbers for different scenarios. How much would it cost to have dental prosthetics fitted without supplementary dental insurance? And how much would it cost with insurance? How high would your premiums be? Could you save money by taking out the policy – or would it be cheaper to pay out of pocket? Do the same for insurance to cover private hospital rooms and other benefits.

Need help making your decision?

Our online premium calculator can help you do the math.

3. Compare tariffs

If you think that complementary insurance would be fundamentally worthwhile for you, make sure to put different tariffs under the microscope. Pay close attention to the reimbursement limits in each policy and whether a policy includes services and benefits you might not need. Don’t just read the general tariff descriptions – make sure to read the general terms and conditions, too.

4. Dealing with tricky health questions

Once you’ve made your decision, you’ll have to undergo a health examination. Be honest and answer all the questions to the best of your knowledge. If you don’t, your insurer might not pay out when you need them to. Each insurance provider asks different questions and some go into more detail than others. Take this into account when making your decision.

5. Note the waiting period

Many policies only allow you to access the benefits of your new supplementary health insurance after three months. In some cases, such as some supplementary dental insurance policies, you will have to wait for up to eight months. This means you can’t take out insurance and then access all the benefits a week later. The waiting period is always set out in the general terms and conditions of your selected supplementary insurance.