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LKH BeihilfeUpgrade Klinik: the policy wording in full
Wahlleistungstarif zum Krankenhaus für Beihilfe- und Heilfürsorgeberechtigte: Wahlarzt und Zweibettzimmer zum Prozentsatz passend zum Beihilfebemessungssatz oder zu 100 Prozent ohne Beihilfe für Wahlleistungen, mit Ersatzkrankenhaustagegeld bei Verzicht.
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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 Klinik.
Basics and link to the state allowance
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Eligible persons (civil servants, judges, pensioners, dependants, trainees) | yes | „Nach diesem Tarif sind Personen versicherungsfähig, die im Krankheitsfall einen …“ | A.1, page 4 |
| Reimbursement levels matching the allowance rate (for example 20, 30, 50 per cent) | yes | „Sofern ein Beihilfeanspruch auf stationäre Wahlleistungen besteht, wird der Tarif BK in …“ | A.5, page 6 |
| Total reimbursement from allowance and insurance capped at 100 per cent of costs | yes | „Beträgt die Erstattungsleistung zusammen mit den Leistungen aus anderen Tarifen und der …“ | B.2.1, page 10 |
| Adjustment to a changed allowance rate or loss of the allowance without new health check (deadline) | yes | „Sofern der Antrag innerhalb von sechs Monaten nach eingetretener Änderung gestellt …“ | A.2, page 4 |
| Change of reimbursement level on retirement (for example from 50 to 30 per cent) | yes | „Die Tarifstufen entfallen mit Eintritt des Versorgungsfalles.“ | B.2.2, page 11 |
| Valid for the allowance rules of the federation and all federal states | yes | „Sollte aufgrund von Länderwechsel (bspw. wegen Wechsel des Dienstherrn) der Anspruch …“ | A.2, page 4 |
| Tariff or dormant cover for recipients of free medical care (police, fire service, armed forces) | yes | „Ist die versicherte Person heilfürsorgeberechtigt und im Tarif BeihilfeUpgrade Klinik …“ | A.6 a), page 6 |
| Admission under the industry opening scheme (no exclusion, surcharge at most 30 per cent) | not addressed | ||
| Free choice of doctors, dentists and hospitals | yes | „Bei stationärer Behandlung hat die versicherte Person die Wahl unter allen …“ | B.1.1, page 7 |
| Reimbursement above the maximum rate of the fee schedule | yes | „Bei Abschluss einer rechtswirksamen Honorarvereinbarung sind für einen Arzt oder …“ | B.1.2, page 8 |
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 | yes | „gesondert berechenbare Unterbringung im Zweibettzimmer“ | B.3.1 b), page 11 |
| Single room as optional service | no | „Bei Unterbringung im Einbettzimmer ist der Unterkunftszuschlag für ein Zweibettzimmer …“ | B.3.1, page 12 |
| Treatment by senior consultant of choice | yes | „gesondert berechenbare ärztliche Leistungen (Wahlarzt und Belegarzt)“ | B.3.1 a), page 11 |
| Optional hospital services at 100 per cent where the employer does not grant an allowance for them | yes | „Bei Nichtbestehen eines Beihilfeanspruchs wird der Tarif BK in der Tarifstufe BK100 …“ | A.5, page 6 |
| Treatment in private clinics without public contract | not addressed | ||
| Hospital daily allowance or substitute allowance when optional services are not used | yes, up to EUR 80 | „so erhält die versicherte Person in Abhängigkeit der versicherten Tarifstufe ein …“ | B.3.2, page 12 |
| Follow up treatment and inpatient rehabilitation | yes, up to the sum insured | „Zu 100 % in Abhängigkeit der versicherten Tarifstufe erstattungsfähig sind bei einer …“ | B.4, page 12 |
| Spa and sanatorium treatment (subsidy, interval between two stays) | yes, up to the sum insured | „Zu 100 % in Abhängigkeit der versicherten Tarifstufe erstattungsfähig sind bei einer …“ | B.4, page 12 |
| Inpatient psychotherapy and psychiatry (days, prior approval) | yes, up to the sum insured | „bei einer akutstationären Behandlung (auch stationäre Psychotherapie und zahnärztliche …“ | B.3.1, page 11 |
Dental
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Dental treatment and prophylaxis | not addressed | ||
| Dentures (crowns, bridges, prostheses) | not addressed | ||
| Implants (number per jaw, link to cases eligible for the allowance) | not addressed | ||
| Material and laboratory costs at the tariff percentage | not addressed | ||
| Orthodontics (children, adults) | not addressed | ||
| 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 | yes | „werden nach Vorleistung der Beihilfe in voller Höhe übernommen, sofern ein …“ | B.3.1, page 12 |
| Compensation of the cost dampening lump sum or the allowance retention | yes, up to the sum insured | „Dies gilt unabhängig von der versicherten Tarifstufe und umfasst auch etwaige …“ | B.3.1, page 12 |
| Reimbursement of fees above the rate eligible for the allowance | yes, up to the sum insured | „Bei Abschluss einer rechtswirksamen Honorarvereinbarung sind für einen Arzt oder …“ | B.1.2, page 8 |
| Extra costs abroad above the domestic allowance rates | not addressed | ||
| Cover abroad for temporary stays (duration, worldwide or Europe) | yes | „Während der ersten 12 Monate eines vorübergehenden Aufenthaltes außerhalb dieser Länder …“ | B.6.1, page 14 |
| 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 | „Versicherungsfähig nach den Sonderbedingungen sind Personen, die das 38. Lebensjahr …“ | A.3.1, page 4 |
| Maximum age or duration for the trainee tariff | yes | „Die Versicherung zu den Sonderbedingungen endet in den Beamtenanwärtertarifstufen …“ | A.3.3, page 5 |
| Conversion to the regular tariff after training without new health check | yes | „so hat die versicherte Person das Recht auf Fortsetzung der Versicherung ohne erneute …“ | A.3.4, page 5 |
| 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) | yes | „Es besteht die Möglichkeit den Tarif in Form einer Anwartschaftsversicherung fortzuführen.“ | A.5, page 6 |
| Insurer waives ordinary termination | not addressed | ||
| Continuation as full cover at 100 per cent on leaving the civil service | yes | „Bei Wegfall des Beihilfeanspruchs auf stationäre Wahlleistungen oder Änderung des …“ | A.2, page 4 |
| 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.
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Policy wordings and provider
- Legal entity
- Landeskrankenhilfe V.V.a.G.
- Distribution
- brokers and direct
- Tarifinformationen BeihilfeUpgrade Klinik 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 Klinik and available as plain text.
Volltext LKH BeihilfeUpgrade Klinik Beihilfeversicherung · As text (Markdown) LKH BeihilfeUpgrade Klinik Beihilfe cover