Insurance broker / International health insurance for expats / Policy wording archive Health insurance when leaving Germany
Hallesche langfristige: the policy wording in full
Langfristige Auslandskrankenversicherung der Hallesche nach Art der Krankheitskostenvollversicherung für die Dauer des Auslandsaufenthalts, ohne ordentliches Kündigungsrecht des Versicherers und mit Wechselrecht in Standard- und Basistarif; Leistungen im nicht vorliegenden Tarif.
German market: tariffs for people living in Germany.
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Everything about this policy
What the policy covers: 67 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for Hallesche langfristige.
Basics and area of cover
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Overall annual limit per insured person | not addressed | ||
| Open ended cover without maximum duration (renewable for life) | yes | „Der Versicherer verzichtet auf das ordentliche Kündigungsrecht.“ | § 12 Abs. 2, page 7 |
| Maximum policy term or stay abroad | yes | „Das Versicherungsverhältnis endet ferner“ | § 12 Abs. 7, page 8 |
| Selectable areas of cover (Europe, worldwide excluding USA, worldwide) | not addressed | ||
| USA and Canada included or optional | not addressed | ||
| Cover during stays in the home country | yes | „so gilt die Fortführung der Versicherung und die Ausdehnung“ | § 1 Abs. 4, page 2 |
| Cover on trips to third countries outside the area of cover | not addressed | ||
| Maximum age at entry | not addressed | ||
| Requirements on residence, nationality or minimum stay abroad | yes | „Der Versicherungsschutz erstreckt sich auf Heilbehandlung im Ausland“ | § 1 Abs. 4, page 2 |
| Certificate for visa or residence permit | not addressed | ||
| Cover for spouse or partner and children | yes | „Bei Neugeborenen beginnt der“ | § 2 Abs. 2, page 2 |
| Rules on compulsory local insurance in the country of residence | not addressed |
Outpatient treatment
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Outpatient medical treatment | not addressed | ||
| Free choice of doctor (no network or gatekeeper) | yes | „Der versicherten Person steht die Wahl unter den Ärzten und Zahnärzten frei“ | § 3 Abs. 2, page 2 |
| Prescribed medication and dressings | not addressed | ||
| Therapies (physiotherapy, speech therapy) | not addressed | ||
| Medical aids and appliances | not addressed | ||
| Health checks and vaccinations | not addressed | ||
| Complementary therapies (acupuncture, chiropractic) | yes, up to the sum insured | „Es dürfen auch Heilpraktiker im Sinne des deutschen Heilpraktikergesetzes in Anspruch …“ | § 3 Abs. 2, page 3 |
| Outpatient psychotherapy | not addressed | ||
| Telemedicine (video consultation) | not addressed |
Inpatient treatment
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Inpatient hospital treatment | not addressed | ||
| Private or semi private room | not addressed | ||
| Parent accommodation when a child is in hospital | not addressed | ||
| Cancer treatment (chemotherapy, radiotherapy) | not addressed | ||
| Organ transplant | not addressed | ||
| Rehabilitation after hospital treatment | not addressed | ||
| Home nursing after hospital treatment | not addressed | ||
| Inpatient psychiatric treatment | not addressed | ||
| Treatment of chronic conditions (ongoing, not only acute) | not addressed |
Dental, optical, maternity
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Dental treatment (fillings, root canal) | not addressed | ||
| Dental prosthetics (crowns, bridges, implants) | not addressed | ||
| Orthodontics | not addressed | ||
| Emergency dental pain relief | not addressed | ||
| Glasses and contact lenses | not addressed | ||
| Pregnancy and childbirth | not addressed | ||
| Waiting period for maternity | not addressed | ||
| Newborns covered without health questions | yes | „wenn am Tage der Geburt ein Elternteil mindestens drei Monate beim Versicherer“ | § 2 Abs. 2, page 2 |
| Fertility treatment | not addressed |
Emergency, evacuation and service
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Medical evacuation to the nearest suitable hospital | not addressed | ||
| Repatriation to the home country | yes, up to the sum insured | „bei Rücktransport eine ärztliche Bescheinigung über die Notwendigkeit des Rücktransports“ | § 5, page 5 |
| Repatriation of mortal remains | yes, up to the sum insured | „bei Überführung aus dem Ausland oder Bestattung“ | § 5, page 5 |
| 24 hour emergency assistance line | not addressed | ||
| Direct billing with hospitals (guarantee of payment) | not addressed | ||
| Medical second opinion | not addressed | ||
| Compassionate visit by a relative | not addressed | ||
| Elective treatment in the home country instead of the country of residence | yes, up to the sum insured | „die Ausdehnung des Versicherungsschutzes auf die Bundesrepublik Deutschland bis zur …“ | § 1 Abs. 4, page 2 |
Exclusions and benefit rules
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion of pre existing conditions | none | „Ist das Risiko z.B. durch Vorerkrankungen oder Aufenthalt in bestimmten Ländern erhöht …“ | § 1 Abs. 5, page 2 |
| General waiting period | not addressed | ||
| HIV and AIDS covered | not addressed | ||
| Exclusion of war, terrorism and unrest even if not actively involved | none | „Die Leistungseinschränkung gemäß Satz 1 gilt nicht für Kriegsereignisse im Ausland …“ | § 4 Abs. 1 a), page 3 |
| Exclusion of epidemics and pandemics | not addressed | ||
| Exclusion of hazardous sports | yes | „sowie durch aktive Teilnahme an Sportarten, die nach der allgemeinen Lebenserfahrung …“ | § 4 Abs. 1 a), page 3 |
| Annual or per treatment deductible | not addressed | ||
| Percentage co insurance | not addressed | ||
| Refund limited to reasonable and customary charges | yes | „Maßnahme eine unangemessen hohe Vergütung“ | § 4, page 4 |
| Prior authorisation before inpatient or costly treatment | not addressed | ||
| Deadline for submitting claims | not addressed | ||
| Reimbursement currency and exchange rate rule | yes | „Die in einer Fremdwährung entstandenen Kosten werden zum aktuellen Kurs des Tages, an …“ | § 5 Abs. 7, page 5 |
Contract and premium
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Guaranteed renewal, no cancellation by the insurer after claims | yes | „Der Versicherer verzichtet auf das ordentliche Kündigungsrecht.“ | § 12 Abs. 2, page 7 |
| Insurer's right to cancel or not to renew | none | „Der Versicherer verzichtet auf das ordentliche Kündigungsrecht.“ | § 12 Abs. 2, page 7 |
| Premium increases with age bands | yes | „Für die Festsetzung der Beiträge gilt als Eintrittsalter“ | § 7 Abs. 6, page 6 |
| Rule for premium adjustments (trigger, frequency) | yes | „Dementsprechend vergleicht der Versicherer zumindest jährlich für jeden Tarif die …“ | § 7b, page 6 |
| Continuation or transfer on return home (dormant cover, transfer right) | yes | „nach Beendigung des Auslandsaufenthaltes in den Basistarif mit Höchstbeitragsgarantie“ | § 18, page 9 |
| Policyholder's notice period | yes | „Der Versicherungsnehmer kann das Versicherungsverhältnis zum Ende eines jeden …“ | § 12 Abs. 1, page 7 |
| Governing law and contract language | yes | „Das Versicherungsverhältnis unterliegt deutschem Recht.“ | § 1 Abs. 3, page 2 |
| Insurer domiciled and supervised in the EU or EEA | yes | „Hallesche Krankenversicherung auf Gegenseitigkeit“ | Kopf, page 1 |
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
- Hallesche Krankenversicherung auf Gegenseitigkeit
- Distribution
- brokers and direct
- Allgemeine Versicherungsbedingungen langfristige Auslandskrankenversicherung (PM 30u) Edition: PM 30u 08.23, Fassung Januar 2024 Copy hosted by an intermediary, not by the insurer
Full text of the wording
The full text exists only in German.
It is printed on the German page for Hallesche langfristige and available as plain text.
Volltext Hallesche langfristige Krankenversicherung für Auswanderer · As text (Markdown) Hallesche langfristige Expat health