What are supplementary health insurances?
If you are in the public health insurance (GKV) you have the option to enhance your coverage in a variety of ways. The reason is that there are many gaps in coverage, such as only partial payment for dental work, shared rooms in the hospital, no visual aids coverage and many more.
Furthermore, the GKV is subject to the so-called “economic efficiency principle”, they are simply not allowed to pay for everything / for the high quality materials. The measures they take must correspond to the extent of what is necessary and must therefore be "sufficient, appropriate and economical".
These gaps have gradually been filled with private supplementary insurances, meant to give you the opportunity to get the coverage that you want.
What types of supplementary health insurances exist?
The types of supplementary health insurances mirror the basic build-up of health and nursing-care insurance in Germany:
In 2021 the dental insurances alone had nearly 18 million members, showing how far these kind of insurances are in usage in Germany.
What do In-patient supplementary health insurance (“Stationäre Kranken-Zusatzversicherung”) do?
If you have to be treated in a hospital, GKV only covers your basic costs, you will be accommodated in a multi-bed room and be treated by the attending physician. Furthermore, you have to go to the nearest suitable hospital, not necessarily the best one.
There are two in-patient add-ons you can take out:
1. Supplementary hospital insurance (“Krankenhaus-Zusatzversicherung”)
With this you are mainly buying:
The premiums depend on
a) your age and b) the scope of coverage but here a rough overview:
2. Hospital daily cash (“Krankenhaustagegeld”)
What do Out-patient supplementary health insurance (“ambulante Kranken- Zusatzversicherung”) do?
This type of add-on is a little bit more elusive as the coverage can differ greatly, with some policies only giving you money in case you need glasses and some policies covering the whole field.
However, there are the things that you can get, you just need to let us know what you are looking for:
The premium naturally depends on the scope of coverage, but to give you a broad idea:
What do dental supplementary health insurance (“Zahn-Zusatzversicherung”) do?
Private supplementary dental insurance reimburses the costs of dental treatment that is not or only partially covered by GKV. If e.g. a tooth has to be replaced, GKV generally only pays 60 % of the costs for standard care and you can top these 60 % up to 80 %, 90 % or 100 %.
Standard care means (and it is written into law) that the treatments covered by public health insurance need to be “economical, appropriate and satisfactorily”, which means: they need to get the job done and not much more. In practice this means the cheapest material for fillings, no ceramic for crowns, no teeth cleaning, etc. If you are in GKV and want better materials, you can to pay for it yourself, unless you have such a supplementary dental insurance.
There are four main pieces of coverage:
The table below shows you a few examples of dental costs and the regular reimbursements:
The costs of treatment naturally need to keep in balance with the costs for such insurances:
What do nursing-care supplementary health insurance (“Zahn-Zusatzversicherung”) do?
More and more people are dependent on professional care in old age but also more often when younger now, e.g. due to illnesses. Adequate care can be very expensive and the public nursing-care insurance (“Pflegepflichtversicherung or PVN”) helps to finance only the partial costs.
How much the PVN exactly pays is determined by a number of factors ( the state you live in, the degree of care needed, whether it is in-patient or out-patient, etc.), however, it does not even remotely cover the entire costs and there always are costs that the patient has to pay herself.
There are three types of nursing-care add-ons:
