Insurance broker / Company health insurance in Germany (bKV) / Policy wording archive
Debeka Flex-F: the policy wording in full
Budgettarif Flex-F mit Höchsterstattungsbetrag von 300 bis 1.500 Euro je Kalenderjahr für Naturheilverfahren, Sehhilfen, Augenlasern, Hörgeräte, Vorsorge, Heil-, Hilfs- und Arzneimittel, Zahnreinigung und Gesundheitsprogramme (Stand 01.02.2026).
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 68 points, each with its clause
Quotes are shortened. The full German wording of each point is on the German page for Debeka Flex-F.
Group contract and enrolment
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Minimum number of insured employees for the group contract | not addressed | ||
| Employer funded version (the company pays the premium) | not addressed | ||
| Employee funded version on group terms | not addressed | ||
| Spouses, partners and children can be insured | not addressed | ||
| Enrolment without health questions | not addressed | ||
| Ongoing treatment and pre-existing conditions covered | yes | „Abweichend von § 2 AVB für die Debeka-bKV leisten wir auch für Versicherungsfälle, die …“ | Nr. 1, page 1 |
| Waiting periods | not addressed | ||
| Both statutory and privately insured persons are eligible | yes | „Versicherungsfähig als versicherte Person sind alle Personen, deren Arbeitgeber mit der …“ | Nr. 3, page 2 |
| Maximum age at enrolment | not addressed | ||
| New employees join without health questions (registration deadline) | not addressed | ||
| Continuation as individual cover on leaving the company | not addressed | ||
| Continuation without new health questions or waiting period | not addressed | ||
| Cover suspended during parental leave, sick pay periods or unpaid leave | yes | „Bei bestehendem Gruppenversicherungsvertrag ist eine vorübergehende Beitragsbefreiung …“ | Nr. 2.1, page 2 |
Health budget
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Annual budget per insured person | yes, up to EUR 1,500 | „Je nach gewählter Tarifstufe gelten pro Person und Kalenderjahr 300 Eu- ro (Tarifstufe …“ | Nr. 1, page 1 |
| Selectable budget levels | yes | „Die Tarifbezeichnung enthält die jeweilige Tarifstufe: Flex300-F, Flex600-F, Flex900-F …“ | Nr. 1, page 1 |
| Budget usable freely across all benefit areas of the catalogue | yes | „Der Höchsterstattungsbetrag gilt insgesamt für alle aufgeführten Leistungen.“ | Nr. 1, page 1 |
| Sub-limits inside the budget (e.g. glasses at most half) | yes | „Erstattet werden insgesamt bis zu 50 Prozent des in der jeweiligen Tarifstufe …“ | Nr. 1.4, page 1 |
| Pro rata budget when cover starts during the year | none | „Der vereinbarte Höchsterstattungsbetrag gilt auch dann, wenn der Versicherungsvertrag …“ | Nr. 1, page 1 |
| Carry over of unused budget to the next year | not addressed | ||
| Budget increase after a claim free year or extra budget | not addressed | ||
| Additional benefit beyond the budget in severe cases (e.g. hospital, serious illness) | not addressed |
Outpatient benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Glasses and contact lenses | yes | „Der Versicherer erstattet Aufwendungen für Brillengläser, Brillengestelle und …“ | Nr. 1.2, page 1 |
| Laser eye surgery (LASIK and similar) | yes | „Erstattungsfähig sind die Aufwendungen für operative Sehschärfenkorrekturen (z. B …“ | Nr. 1.3, page 1 |
| Check-ups beyond the statutory programme, without age limits | yes | „Der Versicherer erstattet Aufwendungen für ambulante Untersuchungen zur Früherkennung …“ | Nr. 1.5, page 1 |
| Vaccinations including travel vaccines | not addressed | ||
| Non-medical practitioners and naturopathy | yes | „Erstattungsfähig sind Aufwendungen für Heilpraktikerleistungen, die dem …“ | Nr. 1.1.2, page 1 |
| Osteopathy | yes | „Erstattungsfähig sind Aufwendungen für ärztliche Leistungen, die auf die Bereiche …“ | Nr. 1.1.1, page 1 |
| Remedies such as physiotherapy, occupational and speech therapy | yes | „Heilmittel müssen von einem Arzt oder Heilpraktiker verordnet und von einem staatlich …“ | Nr. 1.6.2, page 1 |
| Medicines and dressings including co-payments | yes | „Arznei- und Verbandmittel einschließlich eventueller Zuzahlungen.“ | Nr. 1.6.4, page 1 |
| Medical aids such as insoles and braces | yes | „Als Hilfsmittel gelten medizinisch-technische Mittel, Körperersatzstücke und Geräte“ | Nr. 1.6.1, page 1 |
| Hearing aids | yes | „Erstattungsfähig sind die Aufwendungen (einschließlich etwaiger Zuzahlungen) für ein …“ | Nr. 1.4, page 1 |
| Private doctor treatment and fees above statutory rates | not addressed | ||
| Specialist appointment service | not addressed | ||
| Telemedicine and video consultation | not addressed | ||
| Outpatient psychotherapy or psychological counselling | not addressed |
Dental
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Professional dental cleaning | yes | „Der Versicherer erstattet Aufwendungen für professionelle Zahnreinigung nach der Nummer …“ | Nr. 1.7, page 1 |
| Dental treatment (fillings, root canal, periodontal) | not addressed | ||
| Dentures (crowns, bridges, prostheses) | not addressed | ||
| Implants | not addressed | ||
| Orthodontics | not addressed | ||
| Graded dental limits in the first years | not addressed |
Hospital
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Single room | not addressed | ||
| Two bed room | not addressed | ||
| Senior consultant or chosen doctor in hospital | not addressed | ||
| Daily hospital cash | not addressed | ||
| Substitute cash if elective services are waived | not addressed | ||
| Free choice of hospital including private clinics | not addressed |
Further modules and services
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Daily sickness allowance | not addressed | ||
| Long term care module | not addressed | ||
| Travel health insurance abroad | not addressed | ||
| Benefit on diagnosis of serious illness | not addressed | ||
| Medical second opinion | not addressed | ||
| Health services for the company (prevention, employee counselling, app) | yes | „Der Versicherer erstattet Aufwendungen für Gesundheitsangebote, die online über die …“ | Nr. 1.8, page 2 |
Contract, premium and claims
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Uniform premium regardless of age and sex | not addressed | ||
| Premium adjustment (trigger and procedure) | not addressed | ||
| Minimum term of the group contract | not addressed | ||
| Notice period for the company | not addressed | ||
| Ordinary right of the insurer to terminate | not addressed | ||
| Reimbursement rate as a percentage of the invoice | yes | „Erstattet werden 100 Prozent der erstattungsfähigen Aufwendungen bis zur Höhe des in …“ | Nr. 1, page 1 |
| Deductible | not addressed | ||
| Statutory health insurance must pay first | not addressed | ||
| Deadline for submitting invoices | not addressed | ||
| Territorial scope (domestic, Europe, worldwide) | not addressed |
Austria and Spain specifics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Designed for the tax free provision up to 300 euros a year (Austria) | not addressed | ||
| Own provider network (benefits only from network doctors) | not addressed | ||
| Reimbursement option (free choice with refund) | not addressed | ||
| Co-payment per visit or service | not addressed | ||
| Taken out through flexible remuneration (tax free up to 500 euros per person) | 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.
Please report errors, we correct them the same day.
Policy wordings and provider
- Legal entity
- Debeka Krankenversicherungsverein auf Gegenseitigkeit Sitz Koblenz am Rhein
- Distribution
- through tied agents
- Tarifbedingungen für die betriebliche Krankenversicherung Teil II, Tarif Flex-F Edition: 01.02.2026 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 Debeka Flex-F and available as plain text.