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BarmeniaGothaer Barmenia Tarif VS 1 und VS 2 Vs 1: the policy wording in full
Barmenia Tarif VS 1 für Einbettzimmer und Chefarzt bei stationärer Behandlung von gesetzlich Versicherten, mit Krankenhaustagegeld als Ersatz, wenn die Wahlleistung nicht berechnet wird.
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Everything about this policy
What the policy covers: 61 points, each with its clause
Quotes are shortened.
The full German wording of each point is on the German page for BarmeniaGothaer Barmenia Tarif VS
1 und VS 2 Vs 1.
Basics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Insurable daily rate per day in hospital (maximum) | yes, up to EUR 26 | „26,00 EUR an Stelle der Aufwendungen“ | Ziffer 1.24, page 2 |
| Selectable benefit levels (minimum and steps) | not addressed | ||
| Benefit from the first day in hospital | not addressed | ||
| Minimum length of stay required (e.g. 24 hours or overnight) | not addressed | ||
| Admission and discharge days count as full days | not addressed | ||
| Limit on benefit duration (days per claim or policy year) | not addressed | ||
| Paid without proof of costs, free to use | yes | „nicht gesondert berechnet, so wird hierfür ein Krankenhaustagegeld gezahlt“ | Ziffer 1.23, page 2 |
| Reduction for benefits from other insurers or schemes | not addressed | ||
| Daily rate capped at income or need (also with other policies) | not addressed |
Covered stays
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Inpatient treatment for illness | yes | „Bei einer stationären Heilbehandlung, Entbindung oder Fehlgeburt fallen unter den …“ | Ziffer 1.11, page 2 |
| Inpatient treatment after an accident | yes | „Bei einer stationären Heilbehandlung, Entbindung oder Fehlgeburt fallen unter den …“ | Ziffer 1.11, page 2 |
| Benefit only after accidents (accident-only tariff) | not addressed | ||
| Inpatient childbirth | yes | „Bei einer stationären Heilbehandlung, Entbindung oder Fehlgeburt fallen unter den …“ | Ziffer 1.11, page 2 |
| Day-patient treatment (day clinic) | no | „Das gilt nicht für eine teilstationäre (stundenweise) Behandlung im Krankenhaus.“ | Ziffer 1.23, page 2 |
| Outpatient surgery replacing an inpatient stay | not addressed | ||
| Follow-up rehabilitation in hospital | not addressed | ||
| Spa and sanatorium stays | not addressed | ||
| Inpatient treatment of mental illness | not addressed | ||
| Mixed institutions (acute and cure) without prior approval | not addressed | ||
| Inpatient hospice and palliative care | not addressed | ||
| Higher daily rate in intensive care | not addressed | ||
| Higher daily rate after an accident | not addressed | ||
| Benefit for a parent staying with a child in hospital | not addressed | ||
| Newborns covered from birth without waiting period | not addressed | ||
| Stays abroad (territorial scope, duration) | yes | „im außereuropäischen Ausland besteht auch ohne besondere Vereinbarung Versicherungsschutz“ | Ziffer 4.11, page 2 |
Additional benefits
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Recovery benefit after discharge | not addressed | ||
| Minimum stay required for the recovery benefit | not addressed | ||
| Lump sum for surgery (also graded by severity) | not addressed | ||
| Rising daily rate for long stays | not addressed | ||
| Replacement daily benefit when private room or chief physician is waived | yes, up to EUR 26 | „26,00 EUR an Stelle der Aufwendungen“ | Ziffer 1.24, page 2 |
| Benefit for home care replacing a hospital stay | not addressed | ||
| Increase of the daily rate without new health check | not addressed |
Waiting periods
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| General waiting period (months) | not addressed | ||
| Special waiting period (childbirth, psychotherapy, certain illnesses) | yes | „Für Psychotherapie beträgt die besondere Wartezeit sechs Monate.“ | Ziffer 4.15, page 2 |
| No waiting period for accidents | not addressed | ||
| Credit for prior cover or waiver after medical exam | not addressed |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion of known or ongoing illnesses at inception | none | „wird auch für solche Versicherungsfälle geleistet, die vor Beginn des …“ | Ziffer 4.12, page 2 |
| Exclusion of war and civil unrest | not addressed | ||
| Exclusion for intent, addiction and withdrawal | not addressed | ||
| Exclusion of cosmetic and non-necessary procedures | not addressed | ||
| Exclusion of hazardous sports or motor racing | not addressed | ||
| Exclusion of purely custodial or nursing care stays | not addressed | ||
| Exclusion when travel abroad is for treatment | not addressed | ||
| Exclusion of treatment by spouse, parents or children | not addressed | ||
| Exclusion of epidemics, pandemics or nuclear energy | not addressed |
Contract and duties
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Maximum entry age | yes | „Für diesen Tarif gilt kein Aufnahmehöchstalter.“ | Ziffer 2.2, page 2 |
| Cover ends at a certain age | not addressed | ||
| Health questions at application (scope, period) | not addressed | ||
| Insurer waives ordinary right to cancel | not addressed | ||
| Premium adjustment after inception (conditions) | not addressed | ||
| Deductible or excess days before benefit | yes | „Leistungen ein Selbstbehalt von 25,00 EUR je Tag“ | Ziffer 1.24, page 2 |
| Deadline to report the hospital stay | not addressed | ||
| Proof required (admission and discharge certificate, diagnosis) | not addressed | ||
| Policy can be suspended or held dormant | not addressed | ||
| Minimum term and policyholder notice period | not addressed | ||
| Premium waiver during a long hospital stay | not addressed |
Specifics Spain
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Franchise days: first days without benefit | not addressed | ||
| Scheduled modality: benefit per table instead of actual days | not addressed | ||
| Family policy for all household members | not addressed | ||
| For self employed, combinable with temporary incapacity | not addressed | ||
| Consequences of incorrect health declaration (Art. 10 LCS) | 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
- Barmenia Krankenversicherung AG
- Distribution
- brokers and direct
- Tarif VS (Krankenhaustagegeld bei Verzicht auf Einbett- oder Zweibettzimmer), Teil III AVB Edition: 01.01.2011 (K 3847 0625) 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 BarmeniaGothaer Barmenia Tarif VS 1 und VS 2 Vs 1 and
available as plain text.
Volltext BarmeniaGothaer Barmenia Tarif VS 1 und VS 2 Vs 1 Krankenhaustagegeld · As text (Markdown) BarmeniaGothaer Barmenia Tarif VS 1 und VS 2 Vs 1 Hospital cash