Allowable charge

This allowable charge is also known as the approved charge, maximum allowable, or allowable amount.

The allowable charge is the maximum amount covered by your insurance for a given treatment


In the USA, most health insurance providers have a network of approved doctors, dentists and other healthcare professionals with whom they have agreed specific reduced rates. The agreed fee is considered payment in full for a given treatment or service.

Most American health insurance providers cover this agreed fee in full, minus any deductibles or co-payments due from the policyholder. However, if you choose to see a doctor, dentist or healthcare professional outside your health insurance provider’s network, you will likely be liable for any costs above the allowable charge.

The system in Germany operates slightly differently. 
Each German health insurance provider sets their own coverage structure, so we will examine the situation at ottonova:

  • ottonova policyholders have the freedom to choose which doctor they see and can be reimbursed for fees up to 3.5 times the amount stated in the medical fee schedule (GOÄ) – which can be useful for seeing specialists. We provide the same level of cover no matter which doctor you choose.
  • At ottonova, we cover the full cost of dental treatment (such as fillings or root canals) up to 3.5 times the amount stated in the dental fee schedule (GOZ). 
  • When it comes to dental implants (such as inlays or crowns), we cover a larger proportion of the costs if you choose a dentist in our extensive ottonova dentist network.

This is one area where the health insurance system in Germany differs from those of Anglophone countries. If you have any questions about how health insurance works in Germany, you can explore our Expat Guide or arrange a consultation to discuss matters with one of our English-speaking insurance experts.

FAQ

Do you pay me back money if I don´t make usage of the insurance?

At the moment we do not offer any money back if you don´t make usage of the insurance, as we want you to go and have your annual check-ups.

However, we offer reward points via our Health X program. Read more about Health X here.

Where do I get a “Sozialversicherungsnummer”?

To get your social security number you need to contact Deutsche Rentenversicherung. They also provide English support.  

Do you help me finding an English-speaking doctor?

Of course! Through our ottonova Concierge Service we can book appointments for you. You just easily write us a message with your requirements, and we will find the best option for you. 

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