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Health insurance for employed
Your health in the best hands.
From high-performance coverage for the price-conscious, to the best price-coverage ratio and top coverage – our plans cover accommodation in a private or double room, treatment by the head of the department, and high-quality dental prostheses.
Health insurance for employed
Your health in the best hands.
From high-performance coverage for the price-conscious, to the best price-coverage ratio and top coverage – our plans cover accommodation in a private or double room, treatment by the head of the department, and high-quality dental prostheses.
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Premium
Economy |
Business
Class |
Experts' recommendation
Business
Class Pro |
First
Class |
Top performance
First
Class Pro+ |
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Premium
Economy |
Business
Class |
Business
Class Pro |
First
Class |
First
Class Pro+ |
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| Contribution refund | none | none | max. one annual average monthly premium (excluding the statutory surcharge) | none | max. one annual average monthly premium (excluding the statutory surcharge) |
| Deductible |
10% per invoice amount max. €500 deductible per calendar year or 50% per invoice amount max. €1,000 deductible per calendar year |
10% per invoice amount max. €500 deductible per calendar year or 25% per invoice amount max. €1,250 deductible per calendar year |
none |
10% per invoice amount max. €500 deductible per calendar year or 25% per invoice amount max. €1,250 deductible per calendar year |
none |
Outpatient |
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| Outpatient medical treatment | 100% | 100% | 100% | 100% | 100% |
| Direct access to specialist care |
Primary physician principle 100% reimbursement for treatment by your primary physician or use of the ottonova concierge service – otherwise 80% You may directly consult the following medical specialists: Ophthalmologists, dentists, gynecologists, psychotherapists, paediatricians. |
100% | 100% | 100% | 100% |
| Doctors’ fees | up to 3.5-fold | up to 3.5-fold | up to 3.5-fold | up to 5.0-fold | up to 5 times the rate |
| Dressings and medication | 100% | 100% | 100% | 100% | 100% |
| Medication prescribed directly by a medical specialist |
Primary physician principle 100% reimbursement for treatment by your primary physician or use of the ottonova concierge service – otherwise 80% You may directly consult the following medical specialists: Ophthalmologists, dentists, gynecologists, psychotherapists, pediatricians. |
100% | 100% | 100% | 100% |
| Outpatient transportation costs | rescue costs up to €2,500 | rescue costs up to €2,500 | rescue costs up to €2,500 | rescue costs up to €2,500 | rescue costs up to €2,500 |
| Vision (e.g. glasses, contact lenses) | up to €150 in 3 years | up to €300 in 2 years | up to €300 in 2 years | up to €500 in 2 years | up to €500 in 2 years |
| Elective Vision Correction Surgery (i. e. LASIK) | up to €500(per eye)from the 25th month within 24 months, before that up to € 250 per eye |
up to €1,000(per eye) from the 25th month within 24 months, before that up to € 500 per eye |
up to €1,000(per eye) from the 25th month within 24 months, before that up to € 500 per eye |
up to €1,500(per eye) from the 25th month within 24 months, before that up to € 750 per eye |
up to €5,000(both eyes together) in 5 years |
| General reimbursement for medical devices (i. e. hearing aids, wheelchairs) |
100% up to €500 aids from €500 100% after approval, otherwise 75%. Hearing aids: up to €1,500 per hearing aid, with BAHA (hearing implant) up to €4,000 per hearing aid shoe insoles: 2 pairs every 2 insurance years Custom orthopedic shoes: 4 pairs every 2 insurance years, minus €100 per pair |
100% up to €500 aids from €500 100% after approval, otherwise 75%. Hearing aids: up to €1,500 per hearing aid, with BAHA (hearing implant) up to €4,000 per hearing aid shoe insoles: 2 pairs every 2 insurance years Custom orthopedic shoes: 4 pairs every 2 insurance years, minus €100 per pair |
100% up to €500 aids from €500 100% after approval, otherwise 75%. Hearing aids: up to €1,500 per hearing aid, with BAHA (hearing implant) up to €4,000 per hearing aid shoe insoles: 2 pairs every 2 insurance years Custom orthopedic shoes: 4 pairs every 2 insurance years, minus €100 per pair |
100% up to €500 aids from €500 100% after approval, otherwise 75%. Hearing aids: up to €1,500 per hearing aid, with BAHA (hearing implant) up to €4,000 per hearing aid shoe insoles: 2 pairs every 2 insurance years Custom orthopedic shoes: 4 pairs every 2 insurance years, minus €100 per pair |
100% up to €500 aids from €500 100% after approval, otherwise 75%. Hearing aids: up to €2,500 per hearing aid, with BAHA (hearing implant) up to €4,000 per hearing aid shoe insoles: 2 pairs every 2 insurance years Custom orthopedic shoes: 4 pairs every 2 insurance years, minus €100 per pair |
| General reimbursement for therapy (i. e. massages, occupational therapy, physical therapy) | Primary physician principle100% reimbursement for treatment by your primary physician or use of the ottonova concierge service – otherwise 80% | 100% | 100% | 100% | 100% |
| Alternative practitioner | 100%up to €500 per insurance year including osteopathic services by non-medical practitioners | 100%up to €1,000 per insurance year including osteopathic services by non-medical practitioners | 100%up to €1,000 per insurance year including osteopathic and chiropractic services by non-medical practitioners | 100%up to €1,500 per insurance year including osteopathic services by non-medical practitioners | 100%up to €2,000 per insurance year including osteopathic and chiropractic services by non-medical practitioners |
| Osteopathic services provided by non-medical practitioners | 100%up to € 500 per insurance year including non-medical practitioner treatments | 100%up to € 1,000 per insurance year including non-medical practitioner treatments | 100%up to € 1,000 per insurance year including non-medical practitioner treatments | 100%up to € 1,500 per insurance year including non-medical practitioner treatments | 100%up to € 2,000 per insurance year including non-medical practitioner treatments |
| Alternative medicine by physicians | Primary physician principle100% reimbursement for treatment by your primary physician or use of the ottonova concierge service – otherwise 80% | 100% | 100% | 100% | 100% |
| Psychotherapy | 75%for a maximum of 50 sessions |
90%reimbursement for 25 sessions, 75%reimbursement per session from the 26th session |
90%reimbursement for 25 sessions, 75%reimbursement per session from the 26th session |
90%reimbursement for 50 sessions, 75%reimbursement per session from the 51st session |
100%for 50 sessions, 80%reimbursement per session from the 51th session |
| Prior approval for psychotherapy | After the probationary sessions (no later than the 6th session) authorization required | After the probationary sessions (no later than the 6th session) authorization required | After the probationary sessions (no later than the 6th session) authorization required | After the probationary sessions (no later than the 6th session) authorization required | no authorization required |
| Preventive medical checkups without age limit | |||||
| Preventative vaccinations for foreign travel | |||||
| Fertility treatment | up to €3,000in the first 36 months, afterwards unlimited | up to €3,000in the first 36 months, afterwards unlimited | up to €3,000in the first 36 months, afterwards unlimited | up to €3,000in the first 36 months, afterwards unlimited | |
| Prenatal classes, pregnancy and postnatal exercises | 100% | 100% | 100% | 100% | 100% |
| Birthing centers | |||||
| Lump sum for childbirth | €400per delivery | €400per delivery | €600 per delivery | €600 per delivery | |
Inpatient |
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| Treating physician | Free choice of physician(including chief physician) | Free choice of physician(including chief physician) | Free choice of physician(including chief physician) | Free choice of physician(including chief physician) | Free choice of physician(including chief physician) |
| Better accommodation | double room | double room | double room | private roomoptional: double room | private room |
| Inpatient services above the maximum rate (3.5 times) | up to 5.0-fold | up to 5.0-fold | unlimited | unlimited | |
| Private clinic | up to 150% in accordance with the Hospital Remuneration Act (Krankenhausentgeldgesetz) or Federal Hospital Rate Regulation (Bundespflegesatzverordnung), €150 personal cost per day | up to 150% in accordance with the Hospital Remuneration Act (Krankenhausentgeldgesetz) or Federal Hospital Rate Regulation (Bundespflegesatzverordnung) | up to 150% in accordance with the Hospital Remuneration Act (Krankenhausentgeldgesetz) or Federal Hospital Rate Regulation (Bundespflegesatzverordnung) | up to 200% in accordance with the Hospital Remuneration Act (Krankenhausentgeldgesetz) or Federal Hospital Rate Regulation (Bundespflegesatzverordnung) | up to 200% in accordance with the Hospital Remuneration Act (Krankenhausentgeldgesetz) or Federal Hospital Rate Regulation (Bundespflegesatzverordnung) |
| Accompanying person for children in hospital (rooming-in) | Children up to 14 years,no limitation on duration | Children up to 14 years,no limit on duration | Children up to 14 years,no limit on duration | Children up to 14 years,no limit on duration | Children up to 14 years,no limit on duration |
| Replacement daily hospital benefits |
€60 per dayif private medical services are waived €20 per dayif accommodation in a double room is waived |
€60 per dayif private medical services are waived €20 per dayif accommodation in a double room is waived |
€60 per dayif private medical services are waived €20 per dayif accommodation in a two-bed room is waived |
€60 per day if private medical services are waived (first class one-bed and first class twin-bed) for the complete hospital stay €55 per day if separately billable accommodation is waived €35 per day if accommodation in a private room is waived (first class one-bed) |
€60 per day if private medical services are waived for the complete hospital stay €55 per day if separately billable accommodation is waived €35 per day if accommodation in a private room is waived |
| Acute in-patient psychotherapy without required pre-approval | (Exception: combined hospital and rehabilitation center) | (Exception: combined hospital and rehabilitation center) | (Exception: combined hospital and rehabilitation center) | (Exception: combined hospital and rehabilitation center) | (Exception: combined hospital and rehabilitation center) |
| Treatments in mixed hospitals without prior approval | (Exception: psychotherapy) | (Exception: psychotherapy) | (Exception: psychotherapy) | (Exception: psychotherapy) | (Exception: psychotherapy) |
Dental |
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| Dental treatment | 100% | 100% | 100% | 100% | 100% |
| Dental prostheses (including inlays and implants) | 60% | 80% | 80% | 90% | 90% |
| Fee rates for dental services | up to 3,5-fold | up to 3,5-fold | up to 3,5-fold | up to 5.0-fold | up to 5.0-fold |
| Professional dental cleaning | 1x per insurance year, max. €125 per treatment | 2x per insurance year, max. €125 per treatment | 2x per insurance year, max. €125 per treatment | 2x per insurance year, max. €125 per treatment | 100%unlimited reimbursement |
| Orthodontia | up to 100%before the age of 21 (reimbursement of personal cost after the successful completion of the treatment), for adults up to 60% | up to 100%before the age of 21 (reimbursement of personal cost after the successful completion of the treatment), for adults up to 80% | up to 100%before the age of 21 (reimbursement of personal cost after the successful completion of the treatment), for adults up to 80% | up to 100%before the age of 21 (reimbursement of personal cost after the successful completion of the treatment), for adults up to 90% | up to 100%before the age of 21 (reimbursement of personal cost after the successful completion of the treatment), for adults up to 90% |
| Dental levels - Limitation for prostheses and dentures |
max. €500 up to 12 months after your insurance coverage begins max. €1000 up to 24 months after your insurance coverage begins max. €2000 up to 36 months after your insurance coverage begins max. €4000 up to 48 months after your insurance coverage begins unlimited from the 49th month after your insurace coverage begins Does not apply for professional teeth cleaning and dental treatment |
max. €500 up to 12 months after your insurance coverage begins max. €1000 up to 24 months after your insurance coverage begins max. €2000 up to 36 months after your insurance coverage begins max. €4000 up to 48 months after your insurance coverage begins unlimited from the 49th month after your insurace coverage begins Does not apply for professional teeth cleaning and dental treatment |
Max. € 500 in the first year of insurance Max. € 1,000 in the first two years of insurance Max. € 2,000 in the first three years of insurance Max. €4,000 in the first four years of insurance unlimited afterwards Does not apply for professional teeth cleaning and dental treatment |
max. €500 up to 12 months after your insurance coverage begins max. €1000 up to 24 months after your insurance coverage begins max. €2000 up to 36 months after your insurance coverage begins max. €4000 up to 48 months after your insurance coverage begins unlimited from the 49th month after your insurace coverage begins Does not apply for professional teeth cleaning and dental treatment |
Max. € 1000 in the first year of insurance Max. € 2,000 in the first two years of insurance Max. € 4,000 in the first three years of insurance unlimited afterwards Does not apply for professional teeth cleaning and dental treatment |
| Reimbursement for healing and cost planning | 100% | 100% | 100% | 100% | 100% |
| Dental technical services and coverage | 100% | 100% | 100% | 100% | 100% |
Additional Full-Insurance Subjects |
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| Preventive and curative electronic health services |
max. €360within 36 months in First Class private room max. €180within 36 months in First Class double room |
max. €360within 36 months | |||
| Follow-up treatment (outpatient + inpatient) | |||||
| Additional rehabilitation measures (incl. outpatient + inpatient therapies) | max. €5,000within 10 years (incl. withdrawal treatment) | max. €5,000within 10 years | max. €5,000within 5 years | max. €5,000within 5 years | max. €5,000within 5 years |
| Withdrawal treatment (outpatient + inpatient) |
max. €5,000 within 10 years (incl. other rehabilitation measures) optional inpatient services are not reimbursable |
max. 3 treatments within 10 yearsoptional inpatient services are not reimbursable | max. 3 treatments within 10 yearsoptional inpatient services are not reimbursable | max. 3 treatments within 10 yearsoptional inpatient services are not reimbursable | max. 3 treatments within 10 yearsoptional inpatient services are not reimbursable |
| Insurance protection for travel outside of the European Economic Area (EEA) | 6 months at no extra charge (extension with country-specific premium supplement possible) | 6 months at no extra charge (extension with country-specific premium supplement possible) | 6 months at no extra charge (extension with country-specific premium supplement possible) | 6 months at no extra charge (extension with country-specific premium supplement possible) | 6 months at no extra charge (extension with country-specific premium supplement possible) |
| Repatriation | organized by ottonova | organized by ottonova | organized by ottonova | organized by ottonova | organized by ottonova |
| Deductibles (not applicable for dental services, preventive health screenings, medical devices, outpatient psychotherapy) |
10% per invoice amount(max. €500 deductible per calendar year) or 50% per invoice amount (max. €1,000 deductible per calendar year) |
10% per invoice amount(max. €500 deductible per calendar year) or 25% per invoice amount(max. €1.250 deductible per calendar year) |
no deductible |
10% per invoice amount(max. €500 deductible per calendar year) or 25% per invoice amount(max. €1.250 deductible per calendar year) |
no deductible |
| Digital Health Applications | Reimbursement up to the amount also paid by the GKV | Reimbursement up to the amount also paid by the GKV | |||
Daily Sickness Allowance |
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| Amount of daily sickness allowance |
max. €315 per day for employed, max. €331 per day for self-employed |
max. €315 per day for employed, max. €331 per day for self-employed |
max. €315 per day for employed, max. €331 per day for self-employed |
max. €315 per day for employed, max. €331 per day for self-employed |
max. €315 per day for employed, max. €331 per day for self-employed |
| Possibility to increase daily sickness allowance without further health examination | (except employees with a pay raise) | (except employees with a pay raise) | (except employees with a pay raise) | (except employees with a pay raise) | (except employees with a pay raise) |
| General dynamic - increase of daily sickness allowance without further health examination | every 3 years 5%for the first time after 5 years | every 3 years 5%for the first time after 5 years | every 3 years 5%for the first time after 5 years | every 3 years 5%for the first time after 5 years | every 3 years 5%for the first time after 5 years |
| Daily sickness allowance in case of cure, rehabilitation, etc. | in case of total incapacity for work | in case of total incapacity for work | in case of total incapacity for work | in case of total incapacity for work | in case of total incapacity for work |
| Additional payment period in case of occupational disability | 3 months | 3 months | 3 months | 3 months | 3 months |
Contribution exemption |
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| Contribution-free during parental leave | up to 9 months | ||||
| Exemption from premiums for newborns | (up to 4 months) | (up to 4 months) | (up to 4 months) | (up to 4 months) | (up to 4 months) |
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This is a summary of the coverage details with maximum rates and reductions. Please note that this table is not conclusive. You will find all tariff-details such as the concrete requirements and limitations for the reimbursement in the tariff and insurance conditions of the respective tariff.
The English translation is a non-binding version for your information only and has no legally binding character. The contract language will be German only. The terms and conditions of the individual insurance contract shall prevail and apply. |
