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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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Adjust your selection
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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 principle100% reimbursement for treatment by your primary physician or use of the ottonova concierge service; otherwise 80% | 100% | 100% | 100% | 100% |
| Doctors' Fees | up to 3.5 times the rate | up to 3.5 times the rate | up to 3.5 times the rate | up to 5 times the rate | up to 5 times the rate |
| Medication | 100% | 100% | 100% | 100% | 100% |
| Medication prescribed directly by a medical specialist | Primary physician principle100% reimbursement for treatment by your primary physician or use of the ottonova concierge service; otherwise 80% | 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 |
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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 |
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 inserts: 2 pairs every 2 insurance years Custom orthopaedic 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 inserts: 2 pairs every 2 insurance years Custom orthopaedic 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 inserts: 2 pairs every 2 insurance years Custom orthopaedic 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 inserts: 2 pairs every 2 insurance years Custom orthopaedic 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 inserts: 2 pairs every 2 insurance years Custom orthopaedic shoes: 4 pairs every 2 insurance years, minus €100 per pair. |
| General Reimbursement for therapy (i.e. massages, ergotherapy) | 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 osteopatic services by non-medical practitioners | 100% up to €1,000 per insurance year including osteopatic services by non-medical practitioners | 100% up to €1,000 per insurance year including osteopatic and chiropractic services by non-medical practitioners | 100% up to €1,500 per insurance year including osteopatic services by non-medical practitioners | 100% up to €2,000 per insurance year including osteopatic and chiropractic services by non-medical practitioners |
| Osteopatic 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% reimbursement for 50 sessions, 80% reimbursement per session from the 51st 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 Treatments | up to €3,000 during the first 36 month, afterwards unlimited | up to €3,000 during the first 36 month, afterwards unlimited | up to €3,000 during the first 36 month, afterwards unlimited | up to €3,000 during the first 36 month, afterwards unlimited | |
| Prenatal Courses, Pregnancy and Postnatal Therapy | 100% | 100% | 100% | 100% | 100% |
| Birthing centers | |||||
| Lump sum for childbirth | €400 per delivery | €400 per 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 room, optional: double room | private room |
| Inpatient services above the maximum rate (3.5 times) | up to 5 times the rate at most | up to 5 times the rate at most | unlimited | unlimited | |
| Private clinic | up to 150% in accordance with 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 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) | 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 old, no limitation on duration | Children up to 14 years old, no limitation on duration | Children up to 14 years old, no limitation on duration | Children up to 14 years old, no limitation on duration | Children up to 14 years old, no limitation on duration |
| Replacement daily hospital benefits |
€60
if private medical services are waived €20 if accommodation in a double room is waived |
€60
if private medical services are waived €20 if accommodation in a double room is waived |
€60
if private medical services are waived €20 if accommodation in a double room is waived |
€60
if private medical services are waived (First Class one-bed and First Class twin bed) €35 if accommodation in a private room is waived (First Class one-bed) €20 if accommodation in a double room is waived (First Class one-bed and First Class twin-bed) |
€60 if private medical services are waived €35 if accommodation in a private room is waived €20 if accommodation in a double room is waived |
| Acute in-patient psychotherapy without required pre-approval | (Exception: combined hospital and rehabilitation centers) | (Exception: combined hospital and rehabilitation centers) | (Exception: combined hospital and rehabilitation centers) | (Exception: combined hospital and rehabilitation centers) | (Exception: combined hospital and rehabilitation centers) |
| 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-fold | up to 5-fold |
| Professional dental cleanings | 100% 1x per insurance year, max €125 per treatment | 100% 2x per insurance year, max €125 per treatment | 100% 2x per insurance year, max €125 per treatment | 100% 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. €1,000 up to 24 months after your insurance coverage begins max. €2,000 up to 36 months after your insurance coverage begins max. €4,000 up to 48 months after your insurance coverage begins unlimited from the 49th months on does not apply for professional teeth cleanings and dental treatments |
max. €500 up to 12 months after your insurance coverage begins max. €1,000 up to 24 months after your insurance coverage begins max. €2,000 up to 36 months after your insurance coverage begins max. €4,000 up to 48 months after your insurance coverage begins unlimited from the 49th months on does not apply for professional teeth cleanings and dental treatments |
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 does not apply for professional teeth cleanings and dental treatments |
max. €500 up to 12 months after your insurance coverage begins max. €1,000 up to 24 months after your insurance coverage begins max. €2,000 up to 36 months after your insurance coverage begins max. €4,000 up to 48 months after your insurance coverage begins unlimited from the 49th months on does not apply for professional teeth cleanings and dental treatments |
max. €1,000 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 does not apply for professional teeth cleanings and dental treatments |
| Reimbursement for healing and cost planning | 100% | 100% | 100% | 100% | 100% |
| Dental technical services during dental treatment | 100% | 100% | 100% | 100% | 100% |
Additional Full-Insurance Subjects |
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| Preventive and curative electronic health services | max. €360 within 36 months in First Class private room max. €180 within 36 months in First Class double room | max. €360 within 36 months | |||
| Follow-up treatment (outpatient + inpatient) | |||||
| Additional rehabilitation measures (incl. outpatient + inpatient therapies) | max. €5,000 within 10 years (incl. withdrawal treatment) | max. €5,000 within 10 years | max. €5,000 within 10 years | max. €5,000 within 5 years | max. €5,000 within 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 years optional inpatient services are not reimbursable |
max. 3 treatments within 10 years optional inpatient services are not reimbursable |
max. 3 treatments within 10 years optional inpatient services are not reimbursable |
max. 3 treatments within 10 years optional inpatient services are not reimbursable |
| Insurance cover outside 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 |
| 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 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 when receiving parental allowance) | ||||
| 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. |
