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What does outpatient supplementary health insurance cover?

In short

What does it cover? Outpatient supplementary health insurance (ambulante Zusatzversicherung) pays where German public health insurance gives little outside hospital: glasses and contact lenses, often EUR 100 to 400 every one to three years, alternative practitioners (Heilpraktiker) up to about EUR 800 a year, check-ups and vaccinations. It usually costs EUR 5 to 35 a month.

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What does outpatient supplementary health insurance cover?

What it costs

Premiums and benefits from published plan data in Germany, as of October 2026.

Example	Typical range
Simple plan with glasses benefit, adult	from about EUR 3 to 8 a month
Medium plan, age 26 to 39	about EUR 12 to 18 a month
Strong plan, age 40 and over	about EUR 22 to 35 a month
Children under 15	from about EUR 2 to 3 a month
Glasses benefit	about EUR 100 to 400 every one to three years

Guide values as of October 2026 from published plan data.

Grouping plans into simple, medium and strong is a guide value from our quoting practice.

Your premium depends on age and scope; we obtain the exact quote for you.

Worked example

Age 35, varifocals, occasional Heilpraktiker

How a medium plan works out over three years.

Premium EUR 16 a month, 36 months	EUR 576
Glasses refund, once in three years	EUR 300
Heilpraktiker, EUR 400 a year, 80 percent	EUR 960 over three years
Check-ups and vaccinations	about EUR 100

Around EUR 1,360 back for EUR 576 in premiums. Without the Heilpraktiker you get EUR 400 back and pay more than you receive.

The gaps it fills

Public health insurance (gesetzliche Krankenversicherung) pays for what is medically necessary at the doctor. Adults only get glasses if their eyesight is very poor, a Heilpraktiker is not paid at all, and many check-ups and travel vaccinations are left to you.

An outpatient supplementary plan refunds part of these costs. Think of it as a set of building blocks: each plan mixes them differently, and almost every plan caps them with fixed annual limits. If you come from a country where private plans pay for everything, adjust your expectations.

Benefit	Typical refund	What to check
Glasses and contact lenses	EUR 100 to 400 every one to three years	frames included or lenses only
Heilpraktiker and naturopathy	often 80 percent up to about EUR 800 a year	billing under the official fee schedule for Heilpraktiker
Check-ups and vaccinations	grant for tests public insurance does not pay	which tests are listed
Non-prescription medicines	mostly only in strong plans	only with a doctor's prescription
Travel abroad	often included as a module	maximum trip length, often six to eight weeks
Co-payments and hearing aids	rare or limited	annual limit

What it costs and why the price rises

Simple plans mainly for glasses start at about EUR 3 to 5 a month. Plans with Heilpraktiker, check-ups and travel cover usually cost EUR 12 to 35, depending on your age.

Many outpatient plans build no reserves for old age. The premium then jumps when you move into the next age band, for example at 26 or 40. Look at what you will pay over the next ten years, not just today.

Type of plan	Monthly premium
Simple, mainly glasses	about EUR 3 to 8
Medium with glasses, Heilpraktiker, check-ups	about EUR 12 to 22
Strong with medicines and check-up programmes	about EUR 20 to 35
Children under 15	often from EUR 2 to 3

When it pays off and when it does not

It pays off if you regularly need expensive glasses or varifocals, or often see a Heilpraktiker or osteopath. You will usually get your premiums back.

It does not pay off if you buy simple glasses every three years and rarely need other treatment. At EUR 10 a month you pay EUR 360 in three years and get less back from a EUR 300 glasses benefit.

For most people in Germany, dental supplementary insurance and travel health insurance matter more. Those risks cost more than a pair of glasses.

Health questions and limits

Many insurers ask about current treatment and known conditions. Anything already recommended before the start date is usually excluded.

Limits apply per year or per period and are lost if you do not use them. A plan paying 80 percent always leaves you a share to pay yourself.

Step by step

Add up what you paid yourself for glasses, Heilpraktiker and check-ups in the last three years.
Choose plans by the benefits you actually use.
Compare annual limits and periods, not just percentages.
Check the premium in the next age band.
Answer the health questions fully and honestly.

Checklist

Glasses benefit in euros and period known
Heilpraktiker benefit with annual limit checked
Waiting period noted
Premium jump at the next age band known
Current treatment declared
Dental and travel cover sorted first

Common mistakes

Buying a plan for a single pair of glasses
Looking at the percentage and missing the annual limit
Ignoring premium jumps with age
Not declaring current treatment

Questions and answers

Frequently asked

What is the difference from inpatient supplementary insurance?

Outpatient cover applies to doctors, opticians and Heilpraktiker outside hospital. Inpatient cover applies to hospital stays, for example treatment by the head physician and a two-bed room.

Does it pay for dental work?

Usually not. There are separate dental plans, and some insurers combine both.

Can I get it if I am privately insured?

These plans are designed for people in public health insurance. Full private health insurance already sets its own outpatient benefits.

Does it cover osteopathy?

Many plans with a Heilpraktiker module pay for osteopathy up to the annual limit if a doctor or Heilpraktiker treats you.

Can I claim for glasses right after signing up?

Only if the plan has no waiting period and your eyesight problem was not known before. Read the terms carefully.

Is it worth it for children?

Often yes, because the premium is low and children often need new glasses. For children without glasses it is usually not needed.

Sources

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Supplementary health insurance in Germany

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