Health insurance: The best complementary insurance

doctor’s office in the country

With the complementary insurance, the obligatory insured can obtain benefits outside the catalog of the Social Security Code.

Dusseldorf The German health system performs well in an international comparison. According to an assessment by the British agency for the medical professions ID Medical, Germany ranks second after Japan. The basis of the health system is the statutory health insurance companies, with which 90 percent of German citizens are insured. People must be admitted regardless of previous illnesses.

Expensive dialysis or cancer treatment costs are covered. In principle, however, the benefits of health insurance companies must be “sufficient, adequate and economic”, as established by the Social Security Code. They must not exceed the “measure of necessity”.

Supplementary insurance covers treatments that are not included in the catalog of services provided by mandatory health insurance companies. “There is a wide range of offers on the market. The choice should depend on individual needs,” says Michael Franke, managing director of the rating agency Franke und Bornberg. He analyzed the products for the Handelsblatt. Specifically, complementary insurance for treatment at the dentist, both for the hospitalization area and for the outpatient clinic.

According to the Federal Association of Private Health Insurance Companies, more than 28 million Germans have taken out at least one supplementary insurance. Providers ask in advance about health status. “You must answer all the health questions on the application completely and truthfully,” emphasizes Bianca Boss of the Association of Insured Persons. If this is not the case, the insurer does not have to pay in the event of a claim. Pre-existing illnesses may result in rejection, illness exclusion or a risk premium.

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Supplemental dental insurance: Cover the costs of dentures

Dental insurance is popular. 17 million Germans have a policy. Mandatory health insurance companies contribute to the costs of dentures with a flat subsidy, which is only enough for basic care with crowns or simple prosthetics. “Dental prosthetics with implants are becoming more and more popular. However, the subsidy from compulsory health insurance companies can only cover a small part of the costs”, says Bianca Boss.

Of a total of 23 tariffs examined, 15 received the maximum rating of very good. Most insurance companies do not establish provision for aging: In the case of rates classified as very good, the monthly premiums for a 30-year-old person range between EUR 12.41 and EUR 23.50.

With these rates, the insured should expect a greater increase in the contribution than with the rates that make up aging provisions. Here the premiums for rates rated as very good are between EUR 31 and EUR 34.57 per month in the sample case.

Three supplemental dental insurance policies scored the maximum of 100 points on the Franke and Bornberg test. They offer a very high quality, but they convince with their bonus: after all, the rating, which examines the quality of the rates, represents 70 percent of the overall rating, and the bonus represents 30 percent.

The tariff “ZP 9” of the Süddeutsche Krankenversicherung received all the points. For dentures and dental treatments such as root canals, the insurance company, together with the statutory health insurance, covers 90 percent of the total costs. The service catalog also includes the payment of 100 percent of the costs of professional dental cleaning, up to a maximum of 150 euros per year.

The Süddeutsche Krankenversicherung, together with the fixed subsidy from statutory health insurers, covers 90 percent of the cost of dentures. An example: If a tooth is lost in the anterior area, the total cost of an implant restoration is 3,580 euros. The fixed subsidy is 661.54 euros. The additional policy covers expenses of 2,560.46 euros. The end result is a personal contribution of 358 euros. Without an additional policy, the patient would have to pay an additional 2,976 euros.

Continentale Krankenversicherung’s “CEZE” tariff, which also received a very good rating, even covers 100 percent of the cost of dentures. Here the monthly premium in the model case is 34.57 euros, which also constitutes aging provisions. “The contributions do not increase as a result of aging, as is the case with many other complementary dental fees,” says Helmut Hofmeier, Director of Health and Life Insurance at the Continentale Versicherungsverbund. “The trend is toward rates that guarantee high reimbursements with acceptable premiums at the same time,” adds Hofmeier.

Hospitalization area: Head Physician and individual rooms

Anyone who wants to be treated as a private patient as a patient in the hospital can take out supplementary insurance for the hospitalization area. 8.2 million people with compulsory health insurance in Germany have opted for this. Eleven of the tariffs examined received the maximum rating of very good. All these rates take into account the provisions relating to ageing.

With a maximum of 94 points, Gothaer Krankenversicherung’s “MediClinic Premium” rate prevailed. The monthly contribution for a 30-year-old person is 39.60 euros. This rate includes accommodation in a single or double room.

Costs for private medical treatment in excess of the maximum rates in the Doctors Fee Schedule (GOÄ) are also covered. Interest in complementary health insurance for hospital patients is growing: “The Covid-19 pandemic has further increased health awareness and the corresponding protection through complementary insurance,” says Sylvia Eichelberg, CEO of Gothaer Krankenversicherung .

Outpatient area: naturopathic treatment

The third type of private supplementary insurance is for outpatient treatment. Of the fares examined, five received the highest rating of very good. Franke and Bornberg took into account the rates with visual aid services, naturopathic treatments and preventive care.

In the sample case of a 30-year-old person, Barmenia’s health insurance fared better with the rate “More health 1000, more vision” with 95 out of 100 points. A 30-year-old person has to pay 21.50 euros per month. The insurance covers the costs of naturopathic treatments or from a naturopath. Preventive check-ups are also part of the catalog of services, which are not covered by mandatory health insurance. The range of additional outpatient services is diverse: “There are different limits for individual areas up to which an insurance company will pay treatment costs,” says Franke.

The examples show that anyone taking out supplemental insurance should seek individual advice. Specialized brokers and fee advisors can accompany those interested.

Plus: The best private health insurance

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