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NÜRNBERGER Beihilfetarife in Ausbildung: the policy wording in full
Ausbildungstarife AA, SA und ZA für Beamtenanwärter und Studenten mit Beihilfeanspruch bis zum 34. Lebensjahr: ambulant, stationär mit Zweibettzimmer und Privatarzt sowie Zahn in Stufen von 20 bis 50 Prozent, ohne Wartezeiten und ohne Deckungsrückstellung, längstens 60 Monate.
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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 NÜRNBERGER Beihilfetarife in
Ausbildung.
Basics and link to the state allowance
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Eligible persons (civil servants, judges, pensioners, dependants, trainees) | yes | „Personen mit Anspruch auf Beihilfe, die in der Ausbildung zu einem Beamtenberuf stehen“ | Allgemeine Bestimmungen Nr. 1 a), page 1 |
| Reimbursement levels matching the allowance rate (for example 20, 30, 50 per cent) | yes | „AA20 AA30 AA35 AA40 AA45 AA50“ | Versicherungsleistungen Nr. 1, page 2 |
| Total reimbursement from allowance and insurance capped at 100 per cent of costs | yes | „der jeweils vereinbarten Tarifstufe darf zusammen mit dem Beihilfebemessungssatz 100 % …“ | Versicherungsleistungen Nr. 1 a), page 2 |
| Adjustment to a changed allowance rate or loss of the allowance without new health check (deadline) | yes | „Der entsprechende Antrag muss spätestens sechs Monate nach Änderung des …“ | Allgemeine Bestimmungen Nr. 10 b), page 1 |
| 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 | no | „bis zu den Höchstsätzen der jeweils gültigen Gebührenordnung ersetzt.“ | Versicherungsleistungen Nr. 1, page 2 |
Outpatient benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient medical treatment at the tariff percentage | yes | „Die erstattungsfähigen Aufwendungen für ambulante Heilbehandlung (§ 4 Teil II Abs. 1 …“ | Versicherungsleistungen Nr. 1, page 2 |
| 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 150 | „Aufwendungen für Brillengestelle sind innerhalb von zwei Kalenderjahren bis zu einem …“ | Versicherungsleistungen Nr. 1, 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) | 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) | yes | „Die erstattungsfähigen Aufwendungen für allgemeine Krankenhausleistungen (§ 4 Teil II …“ | Versicherungsleistungen Nr. 2 a), page 2 |
| Two bed room as optional service | yes | „gesondert berechenbare Unterkunft im Zweibettzimmer sowie gesondert berechenbare …“ | Versicherungsleistungen Nr. 2 a), page 2 |
| Single room as optional service | no | „die bei gesondert berechenbarer Unterkunft im Zweibettzimmer entstanden wären …“ | Versicherungsleistungen Nr. 2 a), page 2 |
| Treatment by senior consultant of choice | yes | „gesondert berechenbare Unterkunft im Zweibettzimmer sowie gesondert berechenbare …“ | Versicherungsleistungen Nr. 2 a), page 2 |
| Optional hospital services at 100 per cent where the employer does not grant an allowance for them | yes | „so kann die Erstattung von Aufwendungen für Wahlleistungen durch den Abschluss eines …“ | Versicherungsleistungen Nr. 3 c), page 2 |
| 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 | „wird ein Krankenhaustagegeld in Höhe des der vereinbarten Tarifstufe entsprechenden …“ | Versicherungsleistungen Nr. 2 b), page 2 |
| 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 | „Die erstattungsfähigen Aufwendungen für Zahnbehandlung (§ 4 Teil II Abs. 1 Buchst. n …“ | Versicherungsleistungen Nr. 3 a), page 2 |
| Dentures (crowns, bridges, prostheses) | yes, up to the sum insured | „Die erstattungsfähigen Aufwendungen für Zahnbehandlung (§ 4 Teil II Abs. 1 Buchst. n …“ | Versicherungsleistungen Nr. 3 a), page 2 |
| 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) | yes, up to the sum insured | „Die erstattungsfähigen Aufwendungen für Zahnbehandlung (§ 4 Teil II Abs. 1 Buchst. n …“ | Versicherungsleistungen Nr. 3 a), page 2 |
| 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 | not addressed | ||
| Cover abroad for temporary stays (duration, worldwide or Europe) | not addressed | ||
| 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 | „In den Beiträgen der Tarife für Beihilfeberechtigte in Ausbildung ist …“ | Allgemeine Bestimmungen Nr. 3, page 1 |
| Maximum age or duration for the trainee tariff | yes | „in dem die Höchstversicherungsdauer von 60 Monaten erreicht ist.“ | Allgemeine Bestimmungen Nr. 4 e), page 1 |
| Conversion to the regular tariff after training without new health check | yes | „Endet die Versicherung, erfolgt zum Ersten des Folgemonats eine Umstellung auf die …“ | Allgemeine Bestimmungen Nr. 6, page 1 |
| General waiting period | none | „Die Wartezeiten (§ 3 AVB) entfallen.“ | Allgemeine Bestimmungen Nr. 2, page 1 |
| Special waiting periods (childbirth, psychotherapy, dentures, orthodontics) | none | „Die Wartezeiten (§ 3 AVB) entfallen.“ | Allgemeine Bestimmungen Nr. 2, page 1 |
| Waiver of waiting periods (transfer from statutory insurance, appointment as civil servant, medical exam) | yes | „Die Wartezeiten (§ 3 AVB) entfallen.“ | Allgemeine Bestimmungen Nr. 2, page 1 |
| 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 | yes | „Vermindert sich der Beihilfeanspruch für die versicherte Person oder entfällt er, so …“ | Allgemeine Bestimmungen Nr. 10 b), page 1 |
| 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.
Despite care, a value may be misread;
legally only the wording of your own contract in the edition stated there applies.
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Policy wordings and provider
- Legal entity
- NÜRNBERGER Krankenversicherung Aktiengesellschaft
- Distribution
- brokers and direct
- Allgemeine Versicherungsbedingungen für die Krankheitskosten Versicherung, Beihilfeberechtigte in Ausbildung (KV335) Edition: KV335_202105 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 NÜRNBERGER Beihilfetarife in Ausbildung and available as
plain text.
Volltext NÜRNBERGER Beihilfetarife in Ausbildung Beihilfeversicherung · As text (Markdown) NÜRNBERGER Beihilfetarife in Ausbildung Beihilfe cover