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LKH BeihilfeUpgrade Ergänzung Komfort: the policy wording in full
Beihilfeergänzungstarif zum Tarif BeihilfeUpgrade: erstattet nach Beihilfe und Grundtarif 100 Prozent der verbleibenden Kosten für Sehhilfen, zahnärztliche Leistungen samt Zahntechnik und Privatkliniken, mit Summenbegrenzung für Zahnleistungen in den ersten drei Kalenderjahren.
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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 LKH BeihilfeUpgrade Ergänzung
Komfort.
Basics and link to the state allowance
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Eligible persons (civil servants, judges, pensioners, dependants, trainees) | yes | „Der Tarif BeihilfeUpgrade Ergänzung Komfort kann nur zusätzlich zu dem Tarif …“ | A.6, page 5 |
| Reimbursement levels matching the allowance rate (for example 20, 30, 50 per cent) | no | „Der Tarif BeihilfeUpgrade Ergänzung Komfort wird unabhängig vom individuellen …“ | A.6, page 5 |
| 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) | 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) | 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 | not addressed | ||
| Reimbursement above the maximum rate of the fee schedule | yes | „Bei Abschluss einer rechtswirksamen Honorarvereinbarung sind für einen Arzt Honorare …“ | B.1.2, page 6 |
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) | yes, up to EUR 600 | „Die verbleibenden Aufwendungen für den Kauf, die Anpassung und die Reparatur von …“ | B.3 a), page 8 |
| 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 | yes, up to the sum insured | „werden die verbleibenden Aufwendungen für allgemeine Krankenhausleistungen zu 100 % …“ | B.5, page 11 |
| 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 | „Zu 100 % erstattungsfähig sind die verbleibenden Aufwendungen für allgemeine …“ | B.4.3 a), page 9 |
| Dentures (crowns, bridges, prostheses) | yes, up to the sum insured | „Zu 100 % erstattungsfähig sind die verbleibenden Aufwendungen für prothetische …“ | B.4.5 a), page 10 |
| Implants (number per jaw, link to cases eligible for the allowance) | yes, up to the sum insured | „verbleibenden Aufwendungen für implantologische Leistungen einschließlich der …“ | B.4.5 b), page 10 |
| Material and laboratory costs at the tariff percentage | yes | „Zu 100 % erstattungsfähig sind die verbleibenden Aufwendungen für zahntechnische …“ | B.4.7, page 11 |
| Orthodontics (children, adults) | yes, up to the sum insured | „Zu 100 % erstattungsfähig sind die verbleibenden Aufwendungen für kieferorthopädische …“ | B.4.6, page 11 |
| Caps on dentures in the first policy years | yes, up to EUR 1,250 | „1.250 EUR während des 1. Kalenderjahres - 2.500 EUR während der ersten 2 Kalenderjahre …“ | B.4.2, page 9 |
Supplement and allowance gaps
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Supplementary tariff for costs the allowance does not or only partly recognise | yes | „Erstattungsfähig sind die verbleibenden Kosten, welche nach Anrechnung etwaiger …“ | B.2.1, page 7 |
| Supplement pays only after a decision of the allowance office | yes | „Zum Nachweis etwaiger Vorleistungen ist der Beihilfebescheid oder der …“ | B.2.1, page 7 |
| Compensation of the cost dampening lump sum or the allowance retention | no | „Eigen- oder Selbstbehalte (wie z. B. Minderung der Beihilfe oder der beihilfefähigen …“ | B.2.1, page 7 |
| Reimbursement of fees above the rate eligible for the allowance | yes, up to the sum insured | „Für zahnärztliche Behandlungen sowie ambulante Leistungen erfolgt die Erstattung bis zu …“ | B.1.2, page 6 |
| Extra costs abroad above the domestic allowance rates | yes, up to the sum insured | „Zu 100 % erstattungsfähig sind die verbleibenden Aufwendungen nach den Absätzen B.1 bis …“ | B.7.2, page 13 |
| Cover abroad for temporary stays (duration, worldwide or Europe) | yes | „Während der ersten 12 Monate eines vorübergehenden Aufenthaltes außerhalb dieser Länder …“ | B.7.1, page 12 |
| 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) | yes | „Für diesen Vertragspunkt gelten die allgemeinen Bestimmungen des Vertragsverhältnisses …“ | A.4, page 5 |
| 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 | „Für diesen Vertragspunkt gelten die allgemeinen Bestimmungen des Vertragsverhältnisses …“ | A.2, page 5 |
| Special waiting periods (childbirth, psychotherapy, dentures, orthodontics) | none | „Für diesen Vertragspunkt gelten die allgemeinen Bestimmungen des Vertragsverhältnisses …“ | A.2, page 5 |
| 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) | yes | „Es besteht die Möglichkeit, den Tarif in Form einer Anwartschaftsversicherung …“ | A.6, page 5 |
| Insurer waives ordinary termination | not addressed | ||
| Continuation as full cover at 100 per cent on leaving the civil service | not addressed | ||
| Premium adjustment rules (triggering factor) | not addressed | ||
| 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.
Please report errors, we correct them the same day.
Policy wordings and provider
- Legal entity
- Landeskrankenhilfe V.V.a.G.
- Distribution
- brokers and direct
- Tarifinformationen BeihilfeUpgrade Ergänzung Komfort Edition: 01.07.2026 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 LKH BeihilfeUpgrade Ergänzung Komfort and available as plain
text.
Volltext LKH BeihilfeUpgrade Ergänzung Komfort Beihilfeversicherung · As text (Markdown) LKH BeihilfeUpgrade Ergänzung Komfort Beihilfe cover