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envivas Krankenhaustagegeld KHT-Plus: the policy wording in full
Krankenhaustagegeld KHT-Plus der Envivas für gesetzlich Versicherte, ohne Kostennachweis in frei gewählter Höhe in Schritten von 1 Euro, bei Entbindung bis zehn Tage.
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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 envivas Krankenhaustagegeld
KHT-Plus.
Basics
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Insurable daily rate per day in hospital (maximum) | yes, up to the sum insured | „Das Krankenhaustagegeld wird in der vereinbarten Höhe für jeden Tag eines medizinisch …“ | Tarif KHTP, Nr. 1, page 2 |
| Selectable benefit levels (minimum and steps) | yes | „Als Krankenhaustagegeld können ganzzahlige Vielfache von 1 Euro versichert werden.“ | Tarif KHTP, Nr. 2, page 3 |
| Benefit from the first day in hospital | yes | „für jeden Tag eines medizinisch notwendigen Krankenhausaufenthaltes ohne Kostennachweis …“ | Tarif KHTP, Nr. 1, page 2 |
| 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 | „für jeden Tag eines medizinisch notwendigen Krankenhausaufenthaltes ohne Kostennachweis …“ | Tarif KHTP, Nr. 1, page 2 |
| Reduction for benefits from other insurers or schemes | not addressed | ||
| Daily rate capped at income or need (also with other policies) | yes | „Eine weitere Krankenhaustagegeldversicherung darf nur mit Einwilligung des Versicherers …“ | § 9 Abs. 6 MB/KK, page 10 |
Covered stays
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Inpatient treatment for illness | yes | „Der Versicherer bietet Versicherungsschutz für Krankheiten, Unfälle und andere im …“ | § 1 Abs. 1 MB/KK, page 3 |
| Inpatient treatment after an accident | yes | „Der Versicherer bietet Versicherungsschutz für Krankheiten, Unfälle und andere im …“ | § 1 Abs. 1 MB/KK, page 3 |
| Benefit only after accidents (accident-only tariff) | none | „Der Versicherer bietet Versicherungsschutz für Krankheiten, Unfälle und andere im …“ | § 1 Abs. 1 MB/KK, page 3 |
| Inpatient childbirth | yes | „Bei Entbindungen und Fehlgeburten in einem Krankenhaus oder einem Entbindungsheim wird …“ | Tarif KHTP, Nr. 1, page 3 |
| Day-patient treatment (day clinic) | not addressed | ||
| Outpatient surgery replacing an inpatient stay | not addressed | ||
| Follow-up rehabilitation in hospital | not addressed | ||
| Spa and sanatorium stays | no | „für Kur- und Sanatoriumsbehandlung sowie für Rehabilitationsmaßnahmen der gesetzlichen …“ | § 5 Abs. 1 d MB/KK, page 6 |
| Inpatient treatment of mental illness | not addressed | ||
| Mixed institutions (acute and cure) without prior approval | yes | „werden die tariflichen Leistungen nur dann gewährt, wenn der Versicherer diese vor …“ | § 4 Abs. 5 MB/KK, page 5 |
| 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 | yes | „Bei Neugeborenen beginnt der Versicherungsschutz ohne Risikozuschläge und ohne …“ | § 2 (2) RB/KK 09, page 5 |
| Stays abroad (territorial scope, duration) | yes | „Die in § 1 (4) RB/KK 09 genannte Frist von einem Monat wird auf drei Monate ausgedehnt.“ | Teil II § 2, page 4 |
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 | not addressed | ||
| 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) | yes | „Die allgemeine Wartezeit beträgt drei Monate.“ | § 3 Abs. 2 MB/KK, page 5 |
| Special waiting period (childbirth, psychotherapy, certain illnesses) | yes | „Die besonderen Wartezeiten betragen für Entbindung, Psychotherapie, Zahnbehandlung …“ | § 3 Abs. 3 MB/KK, page 4 |
| No waiting period for accidents | yes | „Abweichend von § 3 (3) RB/KK 09 entfallen die besonderen Wartezeiten bei Unfällen.“ | Teil II § 4, page 5 |
| Credit for prior cover or waiver after medical exam | yes | „Wartezeiten können erlassen werden, wenn der Antragsteller innerhalb von 14 Tagen nach …“ | Teil II § 4, page 5 |
Exclusions
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Exclusion of known or ongoing illnesses at inception | not addressed | ||
| Exclusion of war and civil unrest | yes | „die durch Kriegsereignisse verursacht oder als Wehrdienstbeschädigung anerkannt“ | § 5 Abs. 1 a MB/KK, page 6 |
| Exclusion for intent, addiction and withdrawal | yes | „für vorsätzlich selbst herbeigeführte Krankheiten und Unfälle einschließlich deren …“ | § 5 (1) b RB/KK 09, page 6 |
| Exclusion of cosmetic and non-necessary procedures | yes | „für Krankenhausaufenthalte wegen kosmetischer Operationen“ | Informationsblatt, page 1 |
| Exclusion of hazardous sports or motor racing | not addressed | ||
| Exclusion of purely custodial or nursing care stays | yes | „für eine durch Pflegebedürftigkeit oder Verwahrung bedingte Unterbringung“ | § 5 Abs. 1 h MB/KK, page 6 |
| Exclusion when travel abroad is for treatment | not addressed | ||
| Exclusion of treatment by spouse, parents or children | yes | „für Behandlungen durch Ehegatten, Eltern oder Kinder“ | § 5 (1) f RB/KK 09, page 6 |
| Exclusion of epidemics, pandemics or nuclear energy | not addressed |
Contract and duties
| Point | Rule | Wording (German) | Clause |
|---|---|---|---|
| Maximum entry age | not addressed | ||
| Cover ends at a certain age | not addressed | ||
| Health questions at application (scope, period) | yes | „Die im Antrag gestellten Fragen, insbesondere zum Gesundheitszustand, sind von …“ | Informationsblatt, page 1 |
| Insurer waives ordinary right to cancel | no | „kann der Versicherer das Versicherungsverhältnis nur innerhalb der ersten drei …“ | § 18 (2) RB/KK 09, page 11 |
| Premium adjustment after inception (conditions) | yes | „Der Vomhundertsatz beträgt 5.“ | Teil II § 10, page 9 |
| Deductible or excess days before benefit | not addressed | ||
| Deadline to report the hospital stay | yes | „Jede Krankenhausbehandlung ist binnen 10 Tagen nach ihrem Beginn anzuzeigen.“ | § 9 Abs. 1 MB/KK, page 10 |
| Proof required (admission and discharge certificate, diagnosis) | yes | „Die Versicherungsleistungen werden gegen Vorlage der Bescheinigung des …“ | Tarif KHTP, Nr. 1, page 1 |
| Policy can be suspended or held dormant | not addressed | ||
| Minimum term and policyholder notice period | yes | „Der Versicherungsvertrag wird mit einer Mindestvertragsdauer von zwei …“ | Teil II § 11, page 10 |
| 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 |
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Policy wordings and provider
- Legal entity
- ENVIVAS Krankenversicherung Aktiengesellschaft
- Distribution
- direct from the insurer only
- Wichtige Vertragsunterlagen KHT-Plus (Informationsblatt, RB/KK 09, TB/KK 09, Tarif KHT-Plus) Edition: 04.2025 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 envivas Krankenhaustagegeld KHT-Plus and available as plain
text.
Volltext envivas Krankenhaustagegeld KHT-Plus Krankenhaustagegeld · As text (Markdown) envivas Krankenhaustagegeld KHT-Plus Hospital cash