Insurance card in private health insurnace

Once you select a health insurance provider and tariff and pass any medical examinations required, you will likely receive an insurance card other or another form of ID. This ID card contains information about you and your insurance and enables healthcare providers to bill correctly for their services.

Medizinisch geprüft - Siegel
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In public health insurance, insured persons receive an electronic health card. It makes it easier for service providers to bill the health insurance company. In private health insurance (PKV), healthcare providers bill their patients directly. Do you also need a chip card? All questions about the card for privately insured persons are answered below.

Insurance card: What's the difference between private and public health insurance?

Public health insurance: The Electronic Health Card

In 2015, the German government introduced the Electronic Health Card (elektronische Gesundheitskarte, or eGK for short) for everyone with public (statutory) health insurance.

It features information about you to confirm your identity and information that allows doctors to treat you and bill for your treatment appropriately. Each card includes:

Two cards in one: eGK and EHIC

The reverse of the eGK is used for the European Health Insurance Card, more commonly known as an EHIC (German: Europäische Krankenversicherungskarte). This allows people insured in the German public insurance system to enjoy free healthcare coverage in EU member states plus Iceland, Liechtenstein, Norway and Switzerland.

In many countries, the EHIC is a separate card, but the modern German system combines two cards in one.

Private health insurance: PKV cards

People with private health insurance in Germany usually receive a card directly from their insurance provider. Each card usually carries the name of the insurance company – so, for example, if you were insured with a fictional insurance provider called AB123, you would receive an AB123 card.

Not all private insurance providers issue insurance cards. Unlike in the public insurance system, cards are not mandatory in the private system. However, because they contain information about you and your insurance cover, they are certainly useful and help to simplify payments to hospitals, doctors and pharmacies.

Do privately insured persons have a health card and an insurance number?

Private health insurance is available to people who, for example:

When signing a contract with a private health insurance company, they receive an insurance number, the format of which depends on the insurance company. In many cases and as a special service, they also receive an insurance card.

Do all insured persons in private health insurance need a card?

The so-called card for privately insured persons is not mandatory. However, most insurance companies issue this card to their customers to save them time at the doctor's office or hospital.

ottonova's customers also receive a corporate-look card in our comprehensive private health insurance tariffs - regardless of whether they are employed, self-employed, students or civil servants.

There are also insurance companies that do not issue a card or where tariffs such as the basic tariff are excluded from this service.

Important to know:

Insurance coverage is available for private patients even without an insurance card.

What information is stored on the card for privately insured persons?

Various information about the policyholder and the insurance company is stored on the card. This typically includes:

What do I have to take with me to the doctor as a private patient?

At the doctor's office, patients with private health insurance become contractual partners for those treating them. In order for doctors to know that they can bill privately and to whom they may bill, they need some information from private patients about themselves and their insurance.

People who are insured with private health insurance can dictate this important information to the receptionist - or use their private health insurance card. All the relevant data is stored there. It makes it easier to read in this data, reduces errors in the billing process and saves time when visiting the doctor.

How does billing work in private health insurance?

In private health insurance, there is the so-called reimbursement principle: patients with private health insurance are self-payers and bill the dentist, orthopedist or family doctor directly. The bill is then submitted to the private insurance company with which they are insured.

The bill is then checked by the insurer and the money is subsequently reimbursed. Which services are reimbursed in private health insurance depends on the individually selected tariff.

In the area of outpatient care, private patients receive an invoice after each visit to the doctor. The costs incurred depend, on the one hand, on the services provided. On the other hand, the invoice amount for individual treatment items is based on the fee schedules that apply to doctors and dentists.

Normally, the standard maximum rate is used for billing. In the case of complex examinations, a certain factor is applied that increases the invoice amount. For this reason, it is difficult to make general statements about the costs of treatment for private health insurance patients. 

The following list shows examples of what providers can charge for outpatient services at the standard maximum rate:

With some private health insurance providers, invoice reimbursement can take up to a month; with ottonova, reimbursement is much faster.

ottonova's express service for medical bills

With ottonova, on the other hand, customers enjoy a special service: they request their invoice reimbursement via app and then have the money in their account within just a few days. This saves our insured persons having to pay in advance, as invoices often have a payment term of 14 days.

FAQ on the insurance card for privately insured persons

As a rule, all insured persons who are covered by a comprehensive insurance tariff receive the chip card in private health insurance. Depending on the provider, members of health insurance companies also receive one of the cards when they take out private supplementary insurance. The cards are issued at the beginning of a new contract - the prerequisite is that the private health insurance company offers such a service to its insured persons.

In the public health insurance system, patients must show their chip card before all medical treatment. This is the only way that service providers can properly bill the public health insurance. In contrast, patients with private health insurance do not have to use their card, as it is not used for direct billing. It does, however, facilitate the billing process, as important data on the insured and the insurance company are stored on it.

Espen Markus Mjøs
HIER SCHREIBT Espen Markus Mjøs

Espen - originally from Norway - is sales agent in ottonova's English sales team. He's in contact with potential customers every day and answers Expats' questions about German health insurance.

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