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HUK-COBURG Beihilfeergänzungstarif BE2: the policy wording in full
Beihilfeergänzungstarif zum Beihilfetarif der HUK-COBURG: Differenz Ein- zu Zweibettzimmer, Krankenhaus- und Kurtagegeld von 15 €, verbleibende Material- und Laborkosten bei Zahnersatz, Sehhilfen, Zuzahlungen, Heilpraktiker und Auslandsreiseschutz, auch für Empfänger freier Heilfürsorge.
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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 HUK-COBURG Beihilfeergänzungstarif
BE2.
Basics and link to the state allowance
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Eligible persons (civil servants, judges, pensioners, dependants, trainees) | yes | „Versicherungsfähig sind Personen, die beim Versicherer eine Grundabsicherung nach dem“ | Kopf, page 1 |
| Reimbursement levels matching the allowance rate (for example 20, 30, 50 per cent) | not addressed | ||
| Total reimbursement from allowance and insurance capped at 100 per cent of costs | yes | „Die Leistungen aus diesem Tarif dürfen zusammen mit der Erstattung der Beihilfe und den …“ | Nr. 1, page 1 |
| Adjustment to a changed allowance rate or loss of the allowance without new health check (deadline) | not addressed | ||
| Change of reimbursement level on retirement (for example from 50 to 30 per cent) | not addressed | ||
| Valid for the allowance rules of the federation and all federal states | not addressed | ||
| Tariff or dormant cover for recipients of free medical care (police, fire service, armed forces) | yes | „Weiterhin kann der Tarif von Empfängern freier Heilfürsorge vereinbart werden.“ | Kopf, page 1 |
| Admission under the industry opening scheme (no exclusion, surcharge at most 30 per cent) | not addressed | ||
| Free choice of doctors, dentists and hospitals | not addressed | ||
| Reimbursement above the maximum rate of the fee schedule | yes | „die im Rahmen einer Honorarvereinbarung über den Höchstsätzen der Gebührenordnung …“ | Nr. 8 c), page 3 |
Outpatient benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient medical treatment at the tariff percentage | not addressed | ||
| Medicines and dressings (including non-prescription) | yes, up to EUR 400 | „Erstattet werden die von der Beihilfe einbehaltenen Zuzahlungen zu Arznei-, Heil- und …“ | Nr. 7 b), page 2 |
| Naturopaths and natural therapies (annual maximum) | yes, up to EUR 500 | „Erstattet werden die Aufwendungen für ambulante Behandlungen durch Heilpraktiker im …“ | Nr. 7 d), page 2 |
| Therapies (physiotherapy, occupational therapy, speech therapy) | yes, up to EUR 400 | „Erstattet werden die von der Beihilfe einbehaltenen Zuzahlungen zu Arznei-, Heil- und …“ | Nr. 7 b), page 2 |
| 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) | yes, up to EUR 300 | „sind bis zu einem Höchstbetrag von 300 € innerhalb von zwei Kalenderjahren …“ | Nr. 7 a), page 2 |
| 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) | yes, up to EUR 100 | „Präventionskurse und Auslandsschutzimpfungen sind zusammen bis zu einem …“ | Nr. 7 e), page 2 |
| Home nursing and palliative care | not addressed | ||
| Travel and transport costs (ambulance, journeys to outpatient treatment) | yes, up to the sum insured | „Erstattet werden Aufwendungen für Fahrten bei ärztlich bescheinigter …“ | Nr. 7 c), page 2 |
| 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 | yes | „bei stationärer Heilbehandlung die verbleibenden erstattungsfähigen Aufwendungen für …“ | Nr. 3, page 1 |
| 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 | yes, up to the sum insured | „ein Krankenhaustagegeld von 15 €, sofern nicht Leistungen nach Nr. 5 zu zahlen sind.“ | Nr. 4, page 1 |
| Follow up treatment and inpatient rehabilitation | not addressed | ||
| Spa and sanatorium treatment (subsidy, interval between two stays) | yes, up to the sum insured | „bis zu einer Dauer von 35 Tagen ein Tagegeld von 15 €.“ | Nr. 5, page 1 |
| Inpatient psychotherapy and psychiatry (days, prior approval) | yes, up to the sum insured | „Für stationäre psychotherapeutische Behandlungen wird ein Krankenhaustagegeld für bis …“ | Nr. 4, page 1 |
Dental
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Dental treatment and prophylaxis | not addressed | ||
| Dentures (crowns, bridges, prostheses) | yes, up to the sum insured | „Erstattet werden bei Zahnersatz und Inlays die verbleibenden Aufwendungen für besonders …“ | Nr. 6, page 2 |
| Implants (number per jaw, link to cases eligible for the allowance) | yes, up to the sum insured | „Als Zahnersatz gelten prothetische, implantologische (z.B. Implantate, Stiftzähne …“ | Nr. 6, page 2 |
| Material and laboratory costs at the tariff percentage | yes | „Erstattet werden bei Zahnersatz und Inlays die verbleibenden Aufwendungen für besonders …“ | Nr. 6, page 2 |
| Orthodontics (children, adults) | not addressed | ||
| Caps on dentures in the first policy years | yes, up to EUR 1,000 | „im 1. Versicherungsjahr (siehe § 8 (2.1) der AVB) auf 1.000 €, in den ersten beiden …“ | Nr. 6, page 2 |
Supplement and allowance gaps
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Supplementary tariff for costs the allowance does not or only partly recognise | yes | „Die erstattungsfähigen Aufwendungen werden nach Anrechnung von Ansprüchen aus …“ | Nr. 1, page 1 |
| Supplement pays only after a decision of the allowance office | yes | „Die erstattungsfähigen Aufwendungen werden nach Anrechnung von Ansprüchen aus …“ | Nr. 1, page 1 |
| Compensation of the cost dampening lump sum or the allowance retention | no | „Weitere in den Beihilfevorschriften vorgesehene Kürzungen, z.B …“ | Nr. 1, page 1 |
| Reimbursement of fees above the rate eligible for the allowance | not addressed | ||
| Extra costs abroad above the domestic allowance rates | not addressed | ||
| Cover abroad for temporary stays (duration, worldwide or Europe) | yes | „besteht Versicherungsschutz nach den Zusatzbedingungen für die …“ | Nr. 2, page 1 |
| 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 | not addressed | ||
| Special waiting periods (childbirth, psychotherapy, dentures, orthodontics) | not addressed | ||
| Waiver of waiting periods (transfer from statutory insurance, appointment as civil servant, medical exam) | not addressed | ||
| Cover for newborns without health check and waiting period | not addressed | ||
| 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 | not addressed | ||
| Continuation as full cover at 100 per cent on leaving the civil service | no | „Bei Wegfall dieser Voraussetzungen endet zum gleichen Zeitpunkt“ | Kopf, page 1 |
| Premium adjustment rules (triggering factor) | not addressed | ||
| Direct billing with the hospital | yes | „Versicherer gibt gegenüber dem Krankenhaus eine Kostenübernahmegarantie ab“ | Nr. 8 b), page 3 |
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
- HUK-COBURG-Krankenversicherung AG
- Distribution
- brokers and direct
- Allgemeine Versicherungsbedingungen Beamte, Beihilfeergänzung BE2 Edition: Stand 01.2014 (AP0-0105U) 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 HUK-COBURG Beihilfeergänzungstarif BE2 and available as plain
text.
Volltext HUK-COBURG Beihilfeergänzungstarif BE2 Beihilfeversicherung · As text (Markdown) HUK-COBURG Beihilfeergänzungstarif BE2 Beihilfe cover