Exclusions differ from one insurer to another, and checking them is part of our work before we recommend a policy to you.
Your doctor asks for a scan and the appointment through the national health insurance fund (RFZO) is months away. With voluntary health insurance the appointment is booked at a private provider in the network within a few days, and the cost goes on the policy up to the agreed limit. What matters is whether the package requires a referral from a doctor in the network, because without one the insurer can decline the cost.
The policy starts on the first of the month and a week later you need a specialist. Most packages have a waiting period for planned consultations and a longer one for hospital treatment, so costs in that window are not accepted. This is why a policy is worth arranging while you are healthy, not once the problem has appeared.
You arrange a policy for yourself, your partner and two children. On family versions the limit is often shared across the family, so one member can use it up alone. We check whether the limit is joint or per person, because that is the most common source of misunderstanding when claims are settled.
The examples are illustrative and show how the cover works in practice.
It does not replace it. Voluntary health insurance is an addition to the compulsory cover through the national health insurance fund (RFZO), not a substitute for it, and you keep paying your contributions in the same way. The policy shortens waiting times, opens up private providers and covers services the state does not cover, or covers only with long waiting lists.
The waiting period is the time from the start of the policy during which the cover is not yet active, and it exists to prevent people from taking out insurance only once a problem appears. Its length differs by insurer and by type of service, and it is usually longest for hospital treatment and childbirth. The exact periods for each package are part of the comparison we send you.
As a rule they are not. Conditions known and diagnosed before the cover started are treated as pre existing and excluded, and with some insurers so is anything that follows from them. Some packages allow them to be included after a medical assessment and at a higher premium, so the health questionnaire has to be filled in accurately, because an incorrect answer can void a payout.
It depends on the package. Most policies work through a network of contracted private providers where the insurer pays directly, while providers outside the network are either not paid at all or reimbursed only in part. If a particular doctor or clinic matters to you, give us the name when you enquire and we will check which insurers have that provider in their network.
The premium depends on the age of the insured, the scope of the package, the annual limit and whether hospital treatment and medicines are included. That is why the same person gets noticeably different prices from different insurers for similar cover. We collect the quotes and compare them on limits and exclusions, not only on premium, and our service is free for you because the insurer pays our commission.
Send us a short enquiry. We collect offers from every insurer that covers this risk and explain the differences before you sign anything.
