Health insurance for employed and self-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 and self-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.

Adjust your selection
Premium
Economy
Business
Class
Experts' recommendation
Business
Class Pro
First
Class
Top performance
First
Class Pro+
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

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
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 €1,000 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 4 insurance years, minus €100 per pair.
100% up to €500 aids
from €500 100% after approval, otherwise 75%

Hearing aids: up to €1,000 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 4 insurance years, minus €100 per pair.
100% up to €500 aids
from €500 100% after approval, otherwise 75%

Hearing aids: up to €1,000 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 4 insurance years, minus €100 per pair.
100% up to €500 aids
from €500 100% after approval, otherwise 75%

Hearing aids: up to €1,000 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 4 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 4 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 Permission required for the 6th session and following sessions Permission required for the 6th session and following sessions Permission required for the 6th session and following sessions Permission required for the 6th session and following sessions no authorization required
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

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

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

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
Preventive medical checkups without age limit
Preventative vaccinations for foreign travel
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
Deductibles (not applicable for dental services, preventive health screenings, medical devices, outpatient psychotherapy) 10% per invoice amount up to a €500 deductible/­calendar year or 50% per invoice amount up to a €1,000 deductible/­calendar year 10% per invoice amount up to a €500 deductible/­calendar year or 25% per invoice amount up to €1,250 deductible/­calendar year no deductible 10% per invoice amount up to a €500 deductible/­calendar year or 25% per invoice amount up to €1,250 deductible/­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

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 for employees who received a pay raise, no later than 2 months after the raise for employees who received a pay raise, no later than 2 months after the raise for employees who received a pay raise, no later than 2 months after the raise for employees who received a pay raise, no later than 2 months after the raise for employees who received a pay raise, no later than 2 months after the 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

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)

Guaranteed premium refund

Guaranteed premium refund (maximum 1 annual average monthly premium, excluding the statutory surcharge) (maximum 1 annual average monthly premium, excluding the statutory surcharge)

Satisfaction guarantee

Satisfaction guarantee
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.

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