Outpatient Additional Insurance: Your Key to Comprehensive Healthcare
1 Apr 2025
5
Minutes
Katrin Straub
Managing Director at nextsure
Statutory health insurance (GKV) does not cover all healthcare services; often, costs for visual aids, alternative practitioners, or specific preventive examinations must be borne by you. An outpatient supplementary insurance fills these gaps and ensures you receive optimal care. Find out how the right policy can help reduce your healthcare expenses and let you benefit from extended services.
The topic in brief and concise terms
An outpatient supplementary insurance bridges important gaps in the statutory health insurance, especially for visual aids, alternative practitioners and preventive services, often starting from as little as ten euros per month.
When selecting, pay attention to individual needs, reimbursement levels, waiting periods, and health questions to find the optimal tariff.
Long-term contribution stability can be promoted through tariffs with age reserves; check flexibility and adjustment options.
Understanding and Closing Gaps in Statutory Health Insurance
Statutory health insurance (GKV) provides a solid basic coverage, yet many specific needs remain unmet. For example, costs for visual aids are often covered only up to a small fixed amount or not at all, especially for adults. Additionally, alternative treatment methods, such as osteopathy or acupuncture, often have to be paid completely out of pocket by the insured. Without outpatient supplementary insurance, costs of several hundred euros per year can quickly arise. This insurance strategically complements the protection provided by the GKV. It offers access to extended preventive examinations that are covered by the GKV only from a certain age or not at all. This way, you can effectively close coverage gaps and better plan your healthcare expenses. The supplementary health insurance is an important component. The necessity of such coverage is further clarified in the next section.
Weighing the costs and benefits of an outpatient supplementary insurance
The contributions for outpatient supplementary insurance often start at under ten euros per month for young insured individuals. The exact costs depend on age, health status, and the chosen scope of benefits. In contrast, possible reimbursements can amount to several hundred or even over a thousand euros per year, for example, for alternative practitioner treatments or visual aids. Many tariffs reimburse eighty to one hundred percent of the costs for covered services. An additional insurance for alternative practitioners can quickly pay off. Also, consider co-payments for medicine, therapeutic, and auxiliary aids, which can add up. Good outpatient supplementary insurance can significantly reduce these costs. The specific benefit modules are crucial for the individual added value.
Quick Facts: Key Services at a Glance
An outpatient supplementary insurance often combines several service areas to close any gaps in coverage. Here are typical core services that are frequently included:
Coverage of costs for visual aids (glasses, contact lenses) up to agreed maximum amounts, often every two years.
Reimbursement for alternative medicine, such as treatments from a non-medical practitioner or osteopath, often up to eighty percent.
Grants or coverage for advanced preventive examinations not included in the statutory health insurance catalogue.
Coverage of statutory co-payments for medicines, therapies (e.g., physiotherapy), and aids.
Some policies also include travel health insurance for trips of up to six weeks.
Services for non-prescription, but doctor-prescribed medications.
These components provide comprehensive protection. But how does this work in practice?
Practical examples: How you benefit in everyday life
Imagine you need a new pair of glasses that costs 300 euros. Without supplementary insurance, you often have to cover these costs entirely yourself. With a good policy, you may receive reimbursement for the full amount or a significant portion of it. Another example: you opt for a series of ten osteopathy sessions at 80 euros each, totalling 800 euros. The statutory health insurance usually doesn’t cover these costs. Supplementary outpatient insurance could cover eighty percent, which is 640 euros. Even in these two examples, the savings can significantly exceed the annual premium. In the case of important preventive examinations, such as an extended skin cancer screening for those under 35, supplementary insurance takes effect. The supplementary insurance for children's glasses is a specific aspect. These examples demonstrate the direct financial benefit. However, for a well-informed decision, the contract details are also important.
Select service modules specifically: Vision aids, alternative practitioners, and preventive care
Not everyone requires every component of an outpatient supplementary insurance to the same extent. Consider which areas are personally relevant to you. Do you regularly need new glasses or contact lenses? Then look for high reimbursement rates for visual aids, as some policies offer up to €300 every two years or even more with savings options. Do you value alternative healing methods? Then good coverage for naturopathic services and complementary medicine is important, often covering eighty percent of costs up to an annual maximum of, for example, €800. Customising your insurance coverage is key to cost optimisation. For those less inclined towards prevention, high subsidies for preventive measures may be less relevant than for health-conscious individuals who wish to take advantage of extended check-ups, where up to €1000 every two years can be reimbursed. Selecting the right policy requires a detailed analysis of your needs.
Comparison and Selection: Finding the Right Plan
The market for supplementary outpatient insurance is diverse, with differences in contributions and benefits. A careful comparison is essential. Pay attention not just to the price, but especially to the price-performance ratio. Define your needs: What benefits are important to you? How high should the reimbursement rates be? Are there waiting periods or health questions? Some providers allow you to assemble modular tariffs. Use independent comparison portals and carefully check the insurance terms and conditions (AVB). Our expert tip: Pay attention to the regulations regarding maximum rates and exclusions. A private supplementary insurance should cover your individual health risks. Good advice can be invaluable here. This way, you ensure optimal protection in the event of a claim.
Our expert tip: Think long-term and stay flexible
Your healthcare needs can change throughout your life. A plan that suits you today might not be appropriate in ten years. Therefore, check whether your contract offers options for adjustments or if a later switch to a more comprehensive plan with the same provider is possible without a new medical examination. Some insurers offer plans with age reserves that promote contribution stability in old age. This may mean a slightly higher premium initially, but it often pays off over the long term. A TK supplementary insurance is an example of insurer-specific offers. Also, consider combining it with other supplementary insurances, such as a dental insurance or glasses insurance, if these are not adequately covered in the outpatient policy. Comprehensive planning ensures the long-term security of your healthcare provision. Now you are ready to take the next step.
More useful links
Wikipedia provides a comprehensive overview of outpatient supplementary insurance in Germany.
Wikipedia explains private supplementary health insurance in Germany.
Statista delivers statistics on medically treated individuals and treatment cases in Germany.
Statistisches Bundesamt offers information on healthcare expenditures in Germany.
Kassenärztliche Bundesvereinigung (KBV) provides statistics on outpatient care in Germany.
Bundesgesundheitsministerium informs about outpatient medical care in Germany.
Verband der Ersatzkassen (VdEK) provides data and statistics of substitute health insurance funds.
OECD offers the 2023 country health profile for Germany.
Wikipedia provides general information on supplementary insurance.
Wikipedia explains the principle of cost reimbursement in health insurance.
FAQ
Was genau deckt eine ambulante Zusatzversicherung ab?
Sie deckt Kosten für ambulante ärztliche Behandlungen, die nicht im Krankenhaus stattfinden und über den Leistungskatalog der GKV hinausgehen. Dazu zählen oft Sehhilfen, Heilpraktiker, Vorsorge, Zuzahlungen und alternative Medizin.
Wie finde ich die beste ambulante Zusatzversicherung für mich?
Vergleichen Sie Angebote basierend auf Ihren individuellen Bedürfnissen. Achten Sie auf Leistungsumfang (z.B. Höhe der Erstattung für Brillen, Heilpraktiker), Wartezeiten, Gesundheitsfragen und Beitragshöhe. Eine Beratung kann hilfreich sein.
Kann ich meine ambulante Zusatzversicherung kündigen?
Ja, in der Regel können Sie mit einer Frist von drei Monaten zum Ende des Versicherungsjahres kündigen. Ein Sonderkündigungsrecht besteht bei Beitragserhöhungen oder Leistungskürzungen. [,üü]
Werden auch Kosten für Psychotherapie übernommen?
Psychotherapien durch approbierte Psychotherapeuten werden meist von der GKV übernommen. Einige ambulante Zusatzversicherungen leisten für psychotherapeutische Behandlungen durch Heilpraktiker, oft mit besonderen Wartezeiten und Begrenzungen. [1,]
Was passiert bei falschen Angaben zu Gesundheitsfragen?
Wahrheitsgemäße Angaben bei den Gesundheitsfragen sind sehr wichtig. Falsche oder unvollständige Angaben können dazu führen, dass der Versicherer vom Vertrag zurücktritt, ihn kündigt oder die Leistungen verweigert. [8,]
Übernimmt die ambulante Zusatzversicherung auch Kosten im Ausland?
Viele Tarife beinhalten eine Auslandskrankenversicherung für vorübergehende Auslandsaufenthalte, oft für die ersten sechs bis acht Wochen einer Reise. Diese übernimmt Kosten für medizinisch notwendige Behandlungen im Ausland und oft auch den Rücktransport. [1,]
