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Study SmartFair and good tariff€0 deductible
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Study ProtectOptimal protection with self deductible€500 deductible
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Study FreeOptimal protection€0 deductible
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Ambulant |
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| Outpatient medical treatment | |||
| Direct specialist treatment | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge-Service – otherwise 80 % | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge-Service – otherwise 80 % | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge-Service – otherwise 80 % |
| Physician's fee rates for outpatient services | up to 3.5-fold | up to 5.0-fold | up to 5.0-fold |
| Dressings and medication | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge Service – otherwise 80 % | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge Service – otherwise 80 % | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge Service – otherwise 80 % |
| Ambulance Transportation Costs | |||
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Vision (i.e. glasses, contact lenses) |
up to €100 every 60 months | up to €550 every 36 months | up to €550 every 36 months |
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Medical Aids (i.e. hearing aids, wheelchairs) |
Up to €500 for medical aids 100 % with permission above €500, otherwise 60 % Hearing aids: up to €1,500 per hearing aid once per contract period, with BAHA (hearing aid implant) up to €4,000 per hearing aid. Shoe inserts: 2 pairs every 36 months. Custom orthopedic shoes: 4 pairs every 36 months, minus €100 per pair |
Up to €500 for medical aids 100 % with permission above €500, otherwise 60 % Hearing aids: up to €1,500 per hearing aid once per contract period, with BAHA (hearing aid implant) up to €4,000 per hearing aid. Shoe inserts: 2 pairs every 36 months. Custom orthopedic shoes: 4 pairs every 36 months, minus €100 per pair |
Up to €500 for medical aids 100 % with permission above €500, otherwise 60 % Hearing aids: up to €1,500 per hearing aid once per contract period, with BAHA (hearing aid implant) up to €4,000 per hearing aid. Shoe inserts: 2 pairs every 36 months. Custom orthopedic shoes: 4 pairs every 36 months, minus €100 per pair |
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Remedies (i.e. Massages, occupational therapy, physiotherapy) |
80 % up to €2,000, from €2,000 100 % every insurance year |
80 % up to €2,000, from €2,000 100 % every insurance year |
80 % up to €2,000, from €2,000 100 % every insurance year |
| Alternative practitioner | up to €2,000 every 36 months combined with 'osteopathic services' | up to €2,000 every 36 months combined with 'osteopathic services' | |
| Osteopathic services provided by non-medical care providers | up to €2,000 every 36 months combined with 'alternative practitioner' | up to €2,000 every 36 months combined with 'alternative practitioner' | |
| Prenatal courses, pregnancy and postnatal therapy | 80 % up to €2,000, from €2,000 100 % every insurance year in connection with other natural healing methods | 80 % up to €2,000, from €2,000 100 % every insurance year in connection with other natural healing methods | 80 % up to €2,000, from €2,000 100 % every insurance year in connection with other natural healing methods |
| Birthing centers | |||
| Alternative medicine - administered by a doctor | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge Service – otherwise 80 % | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge Service – otherwise 80 % | Primary physician principle 100 % reimbursement with referral by primary physician or use of the ottonova Concierge Service – otherwise 80 % |
| Psychotherapy | reimbursement per session for session 1-25, 50 % reimbursement per session after 25 sessions | reimbursement per session for session 1-25, 80 % reimbursement per session after 25 sessions | reimbursement per session for session 1-25, 80 % reimbursement per session after 25 sessions |
Inpatient |
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| Attending 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 |
| Physician's fee rates for inpatient services | up to 3.5-factor | up to 5.0-factor | up to 5.0-factor |
| 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), €150 personal cost per day | up to 150 % in accordance with the Hospital Remuneration Act (Krankenhausentgeldgesetz) or Federal Hospital Rate Regulation (Bundespflegesatzverordnung), €150 personal cost per day |
| Replacement daily hospital benefits |
€60 in the event of renunciation of private medical services €20 in the event of renunciation of accommodation in a double room |
€60 in the event of renunciation of private medical services €20 in the event of renunciation of accommodation in a double room |
€60 in the event of renunciation of private medical services €20 in the event of renunciation of accommodation in a double room |
| Acute inpatient psychotherapy without required pre-approval | (Except for 'mixed hospital institutions') | (Except for 'mixed hospital institutions') | (Except for 'mixed hospital institutions') |
| Stationary transport costs | |||
| Treatments in mixed sanatoriums without approval requirements | (Except for psychological treatment) | (Except for psychological treatment) | (Except for psychological treatment) |
Dental |
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| Dental treatment | |||
| Dental replacement treatments (incl. inlays and implants) | 70 % | 80 % | 80 % |
| Dentist's fee rates for dental services | up to 3.5-fold | up to 3.5-fold | up to 3.5-fold |
| Professional dental cleanings | 1x each insurance year, maximum of €80 per treatment. | 1x each insurance year, maximum of €125 per treatment. | 1x each insurance year, maximum of €125 per treatment. |
| Orthodontia | up to 100 %before the insured person turns 18 and for KIG 3 (reimbursement of 20 % personal cost after the successful completion of the treatment) | up to 100 %before the insured person turns 21 (reimbursement of 20 % personal cost after the successful completion of the treatment), subsequently up to 80 % | up to 100 %before the insured person turns 21 (reimbursement of 20 % personal cost after the successful completion of the treatment), subsequently up to 80 % |
| Limitation scale for dental coverage (Dental replacement treatments and orthodontia) | does not apply to prophylaxis, professional dental cleaning and in the event of an accident | does not apply to dental treatment, prophylaxis, professional dental cleaning and in the event of an accident | does not apply to dental treatment, prophylaxis, professional dental cleaning and in the event of an accident |
| Reimbursement for "Healing and cost plan" | |||
| Dental technical services and coverage | |||
Additional Full-Insurance Subjects |
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| Follow-up treatment (outpatient and inpatient) | |||
| Additional rehabilitation measures (including outpatient and inpatient therapies) | Up to €1,500 within 36 months (no withdrawal treatments) | Up to €1,500 within 36 months (no withdrawal treatments) | Up to €1,500 within 36 months (no withdrawal treatments) |
| Preventive medical checkups without age limit | |||
| Protective | except for travel vaccinations | except for travel vaccinations | except for travel vaccinations |
| Digital Health Applications | Reimbursement up to the amount also paid by the GKV | Reimbursement up to the amount also paid by the GKV | Reimbursement up to the amount also paid by the GKV |
| 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) |
| Insurance protection for travel within the European Economic Area (EAA) | unlimited cover according to German medical fee schedule (German GOÄ) | unlimited cover according to German medical fee schedule (German GOÄ) | unlimited cover according to German medical fee schedule (German GOÄ) |
| Repatriation back to Germany | Organised by ottonova | Organised by ottonova | Organised by ottonova |
| Deductible (not applicable for inpatient treatments, preventative medical checkups and professional dental cleanings) | €0 | €500 | €0 |
| After the studies (continuation) | |||
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This is a summary of the coverage details. 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. |
