01.01.2024
Comprehensive health insurance policy
Provisit Student / Science
Insurance Product Information Document
Company: Barmenia Krankenversicherung AG Germany
This fact sheet provides you with an overview of your coverage under the comprehensive health insurance policy Provisit Student/Science. Please note that this information is not exhaustive. You will receive details from us in the insurance conditions and other comprehensive health insurance policy documents. These consist of the conditions for our insurance tariff DR-WALTER come-in (part II), the General Insurance Conditions AVB/Impats (part I), customer information and the insurance policy. For comprehensive information, please read all the documents.
What type of insurance is this?
This policy is a comprehensive health insurance policy that replaces the coverage provided under compulsory German health insurance (GKV). It protects you against financial risks arising from the costs of, for example, outpatient or inpatient medical treatment by doctors.
What is insured?
The comprehensive health insurance policy provides coverage for illnesses, accidents and other events specified in the contract. This includes, for example:
- 100% of the costs of outpatient and inpatient medical treatment*
- 100% of the costs of targeted preventive medical examinations*
- 100% of the cost of medicines*
* applies for primary care physicians. In case of a direct visit to a specialist or prescription directly by a specialist: 75%
- Benefits for dental treatment, dental prophylaxis, dentures and orthodontics
- 75% of psychotherapeutic treatment costs
- 100% of the costs of approved remedies
- 100% of the costs of medical aids
- 100% of midwife and maternity services costs
- 100% of follow-up treatment costs
- 100% of home nursing care costs
- Reimbursement for the costs of return transport and transport of mortal remains
- Daily hospital allowance of € 30, from the 15th day in hospital
- Convalescence allowance of € 1,500
- 100% of the costs of inpatient hospice services
What is not insured?
Not covered, for example, are:
- Illnesses and accidents caused intentionally by the insured person.
Are there any restrictions on cover?
For example, coverage is limited in the following cases:
- In hospitals, you use accommodation and meals in a single room (optional benefits) although only a multi-bed room (standard benefits) is insured. You must cover any additional incurred costs.
- For certain types of benefits, maximum percentage limits or reimbursement rates below 100% of the invoice amount have been agreed (e.g., psychotherapy). You will have to pay the difference yourself.
- For certain types of benefits, maximum percentage limits or reimbursement rates of the invoice amount have been agreed (e.g., dentures). You will have to pay the difference yourself.
- In the case of childbirth, psychotherapy, dentures and orthodontics, a waiting period of 8 months from the start of insurance applies.
- At the start of outpatient medical treatment, a primary care physician must first be consulted for full reimbursement. If a specialist is consulted directly, the reimbursement is reduced to 75% of the invoice amount.
Where am I covered?
- The comprehensive health insurance policy provides you with insurance coverage in Europe. In the event of a temporary stay in non-European countries, insurance coverage is provided for one month without a special agreement.
What are my obligations?
For example, the following obligations apply:
- A medical examination is carried out before the contract is concluded. Therefore, you must truthfully provide all the information requested by the insurer
- In order for benefits to be paid, you must provide the required proof.
- You are obliged to pay the premiums in full and on time. In case of delay, you may be charged additional costs.
- You are obliged to notify us immediately of the conversion of your residence permit for Germany into an unlimited one.
- At our request, you are obliged to provide any information on the occurrence of an insured event or if we have a liability to pay benefits and its scope.
When and how do I pay?
- The premium will be debited from your account on a monthly basis or as a one-time payment according to the agreed payment method when due.
- If the fee is monthly, it is due on the first day of each month.
When does the cover start and end?
- The insurance begins on the date specified in the insurance policy.
- The contract is concluded for an indefinite period, but for a maximum of five years.
- The insurance coverage ends – also for pending claims – with the termination of the insurance contract.
How do I cancel the contract?
- You can terminate the contract if the obligation to insure in the comprehensive health insurance ends, e.g., due to the entry of the obligation to insure in the German compulsory health insurance system, or upon termination of your stay in Germany.
- If the obligation to insure continues, your termination will not take effect until you prove to us within the notice period that you are covered by a new insurer without interruption.