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Allianz Beihilfetarife: the policy wording in full
Von den Allianz Beihilfetarifen liegt der Zahntarif BHZ30 als Text vor: 30 Prozent für Zahnbehandlung, Zahnersatz mit bis zu 6 Implantaten je Kiefer und Kieferorthopädie bis 21 Jahre, bis zum Höchstsatz der Gebührenordnung und ohne Wartezeiten.
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 70 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for Allianz Beihilfetarife.
Basics and link to the state allowance
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Eligible persons (civil servants, judges, pensioners, dependants, trainees) | yes | „Anspruch auf Beihilfe nach den Beihilfevorschriften des Bundes“ | Teil A Ziffer 2.1.2 Absatz 1 a), page 13 |
| Reimbursement levels matching the allowance rate (for example 20, 30, 50 per cent) | yes | „Wir ersetzen 30 Prozent der Aufwendungen für“ | Teil A Ziffer 2.2.1.6, page 14 |
| Total reimbursement from allowance and insurance capped at 100 per cent of costs | not addressed | ||
| Adjustment to a changed allowance rate or loss of the allowance without new health check (deadline) | yes | „wenn der Antrag innerhalb von 6“ | Teil A Ziffer 1.8.5, page 10 |
| Change of reimbursement level on retirement (for example from 50 to 30 per cent) | yes | „Die Umstellung erfolgt zum Monatsersten, zu dem die Erhöhung“ | Teil A Ziffer 2.4 Absatz 3, page 17 |
| Valid for the allowance rules of the federation and all federal states | yes | „gilt für Personen mit Anspruch auf Beihilfe nach den Richtlini“ | Teil A Ziffer 2 Tarif BHZ30, Vorbemerkung, page 13 |
| Tariff or dormant cover for recipients of free medical care (police, fire service, armed forces) | not addressed | ||
| Admission under the industry opening scheme (no exclusion, surcharge at most 30 per cent) | not addressed | ||
| Free choice of doctors, dentists and hospitals | yes | „hat die freie Wahl unter den niedergelas“ | Teil A Ziffer 2.2.1.3 Absatz 1, page 14 |
| Reimbursement above the maximum rate of the fee schedule | no | „bis zum Höchstsatz der jeweils geltenden Gebührenordnung für“ | Teil A Ziffer 2.2.1.6 Absatz 1, page 14 |
Outpatient benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient medical treatment at the tariff percentage | not addressed | ||
| Medicines and dressings (including non-prescription) | not addressed | ||
| Naturopaths and natural therapies (annual maximum) | not addressed | ||
| Therapies (physiotherapy, occupational therapy, speech therapy) | not addressed | ||
| Therapies only up to the amounts eligible for the allowance | not addressed | ||
| Medical aids with an open catalogue | not addressed | ||
| Glasses and contact lenses (amount and period) | not addressed | ||
| Hearing aids (amount per ear and period) | not addressed | ||
| Outpatient psychotherapy (rate, approval) | not addressed | ||
| Psychotherapy limited to a number of sessions | not addressed | ||
| Check ups and vaccinations (also beyond statutory programmes) | not addressed | ||
| Home nursing and palliative care | not addressed | ||
| Travel and transport costs (ambulance, journeys to outpatient treatment) | not addressed | ||
| Fertility treatment (conditions, number of attempts) | not addressed |
Inpatient benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| General hospital services (shared room, ward doctor) | not addressed | ||
| Two bed room as optional service | not addressed | ||
| Single room as optional service | not addressed | ||
| Treatment by senior consultant of choice | not addressed | ||
| Optional hospital services at 100 per cent where the employer does not grant an allowance for them | not addressed | ||
| Treatment in private clinics without public contract | not addressed | ||
| Hospital daily allowance or substitute allowance when optional services are not used | not addressed | ||
| Follow up treatment and inpatient rehabilitation | not addressed | ||
| Spa and sanatorium treatment (subsidy, interval between two stays) | not addressed | ||
| Inpatient psychotherapy and psychiatry (days, prior approval) | not addressed |
Dental
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Dental treatment and prophylaxis | yes, up to the sum insured | „allgemeine zahnärztliche Leistungen,“ | Teil A Ziffer 2.2.1.6 Absatz 1, page 14 |
| Dentures (crowns, bridges, prostheses) | yes, up to the sum insured | „prothetische Leistungen einschließlich Brücken, Stiftzähnen,“ | Teil A Ziffer 2.2.1.6 Absatz 4, page 15 |
| Implants (number per jaw, link to cases eligible for the allowance) | yes, up to the sum insured | „implantologische Leistungen für bis zu 6 Implantate pro Kiefer,“ | Teil A Ziffer 2.2.1.6 Absatz 4, page 15 |
| Material and laboratory costs at the tariff percentage | yes | „zusammenhängenden zahntechnischen Leistungen, die nach“ | Teil A Ziffer 2.2.1.6, page 14 |
| Orthodontics (children, adults) | yes, up to the sum insured | „noch nicht 21 Jahre alt sind,“ | Teil A Ziffer 2.2.1.6 Absatz 6, page 15 |
| Caps on dentures in the first policy years | not addressed |
Supplement and allowance gaps
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Supplementary tariff for costs the allowance does not or only partly recognise | not addressed | ||
| Supplement pays only after a decision of the allowance office | not addressed | ||
| Compensation of the cost dampening lump sum or the allowance retention | not addressed | ||
| Reimbursement of fees above the rate eligible for the allowance | not addressed | ||
| Extra costs abroad above the domestic allowance rates | yes, up to the sum insured | „Dabei gilt keine Begrenzung unserer Leistungspflicht auf die Ge“ | Teil A Ziffer 2.2.2.3 Absatz 1, page 16 |
| Cover abroad for temporary stays (duration, worldwide or Europe) | yes | „6 Monate eines vorübergehenden Aufenthalts im außereuro“ | Teil A Ziffer 2.2.2.2, page 16 |
| Repatriation from abroad | not addressed |
Trainees, admission and waiting periods
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Trainee tariff with reduced premium (without or with low ageing reserves) | not addressed | ||
| Maximum age or duration for the trainee tariff | not addressed | ||
| Conversion to the regular tariff after training without new health check | not addressed | ||
| General waiting period | none | „Die Wartezeiten nach Ziffer 1.1.3 Absätze 1 und 2 der Allgemeinen“ | Teil A Ziffer 2.2.1.7, page 16 |
| Special waiting periods (childbirth, psychotherapy, dentures, orthodontics) | none | „Die Wartezeiten nach Ziffer 1.1.3 Absätze 1 und 2 der Allgemeinen“ | Teil A Ziffer 2.2.1.7, page 16 |
| Waiver of waiting periods (transfer from statutory insurance, appointment as civil servant, medical exam) | yes | „Die Wartezeiten nach Ziffer 1.1.3 Absätze 1 und 2 der Allgemeinen“ | Teil A Ziffer 2.2.1.7, page 16 |
| Cover for newborns without health check and waiting period | yes | „Wir versichern Neugeborene ohne Risikozuschläge, ohne Leis“ | Teil A Ziffer 1.8.4 Absatz 1, page 9 |
| Exclusion or surcharge for pre existing conditions | not addressed |
Contract and premium
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Annual deductible per insured person | not addressed | ||
| Premium refund for claim free years (monthly premiums, guaranteed or performance based) | not addressed | ||
| Check ups and dental prophylaxis without loss of the premium refund | not addressed | ||
| Dormant cover (free medical care, service abroad, leave, parental leave) | not addressed | ||
| Insurer waives ordinary termination | yes | „Wir verzichten auf unser ordentliches Kündigungsrecht.“ | Teil A Ziffer 1.9.6 Absatz 1, page 11 |
| Continuation as full cover at 100 per cent on leaving the civil service | yes | „Der Beihilfeanspruch entfällt vollständig.“ | Teil A Ziffer 1.8.5, page 10 |
| Premium adjustment rules (triggering factor) | yes | „Abweichung von mehr als 5 Prozent können alle Beiträge dieser“ | Teil A Ziffer 1.7, page 8 |
| Direct billing with the hospital | not addressed |
Austria and Spain
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Group tariff for public servants for private ward cover alongside the statutory scheme | not addressed | ||
| Reimbursement of the statutory treatment contribution | not addressed | ||
| Insurer under agreement with MUFACE, ISFAS or MUGEJU (term of the agreement) | not addressed | ||
| Provider catalogue (doctors and clinics per province, care levels by municipality size) | not addressed | ||
| Change of insurer or to the public system (ordinary change windows per year) | not addressed | ||
| Treatment outside the catalogue (life threatening emergency, refused service) | not addressed | ||
| Care through the public system in rural municipalities | not addressed |
Evaluated by NAMMERT from published policy wordings.
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legally only the wording of your own contract in the edition stated there applies.
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Policy wordings and provider
- Legal entity
- Allianz Private Krankenversicherungs-Aktiengesellschaft
- Distribution
- through tied agents
- Dokument BHZ30B (Titel und Tarif am Text prüfen) Edition: 01.21 (Januar 2021), B4U289603Z0 Original from the insurer (PDF, German)
Full text of the wording
The full text exists only in German.
It is printed on the German page for Allianz Beihilfetarife and available as plain text.
Volltext Allianz Beihilfetarife Beihilfeversicherung · As text (Markdown) Allianz Beihilfetarife Beihilfe cover