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Is the supplementary aid tariff worthwhile and how can civil servants benefit?

In short: What is the private health insurance supplement tariff?

The Supplementary aid tariff for private health insurances is a tariff that closes the gaps in benefit and private health insurance. The employer pays a certain part of the medical costs through the allowance, but not for all services. Even a private health insurance tariff for civil servants does not always provide 100 percent. As a civil servant, you would have to bear the difference yourself. With an additional subsidy tariff you protect yourself against extra costs. In the following chapters, we will explain to you why the supplementary allowance tariff is necessary and what is important when choosing the tariff.

Advantage for civil servants: In principle, you do not need a full PKV tariff, precisely because of the subsidy. The residual cost insurance, also called percentage tariff or civil servant tariff, therefore falls significantly cheaper out. After all, only the remaining costs of the aid need to be insured.

more about private health insurance for civil servants

What is the supplementary aid tariff for?

Aid supplement tariffs can be taken out by civil servants to cover the medical expenses that not from the employer or your own private health insurance be taken over. Beneficiaries receive part of the medical costs from their employer through the allowance, but they have to pay part of it themselves. You can cover this part with private health insurance. The aid and a supplementary private health insurance tariff are intended to cover all costs - according to them theory. This is in the reality however, it is often not the case.

Aid and private health insurance often have gaps in benefits

The official's allowance and the supplementary private health insurance contract often have not the same scope of services. So it can happen that the aid pays, but the private health insurance just does no benefit for this treatment provides or vice versa. Then the officer has to pay this part himself in the end.

Loopholes in aid

Especially those Aid shows some gaps or restrictions in the service area. Which costs are covered by the aid is in the statutory State aid regulation regulated. There you can also read where the performance gaps can be found. Another problem is that this regulation can still be changed in the future, that is, other services can be canceled.

Depending on the type of tariff, the additional civil servant tariff can also have gaps in services or restrictions. The scope of benefits of private health insurance is in Set of conditions regulated. One advantage of the private health insurance contract: In contrast to the State Aid Ordinance, the scope of benefits cannot simply be changed or restricted by the insurance company. Since both tariffs can have different service restrictions, it often happens that 100 percent of the services are not covered. In this case, the supplementary aid tariff was introduced.

State aid supplement tariff as a solution

Since both the benefit and the private health insurance tariff have different service ranges or gaps, it cannot generally be assumed that 100 percent of the costs will be replaced by the benefit and private health insurance in every case. These gaps occur particularly often in relation to, among other things the following service areas on:

  • Alternative practitioner treatments
  • Glasses, contact lenses
  • Cures
  • dentures
  • Rehab

The services provided by private health insurances differ greatly between the individual providers and tariffs. In addition, the state aid regulations provide for different regulations in the various federal states. For this reason, most now offer health insurance Aid Supplementary Tariffs that these gaps, which are left by benefits and private health insurance, close partially or completely can.

Expert tip: optional benefits for aid make sense

“The so-called supplementary aid tariff is very important for civil servants in particular. In short, this closes the gap between the benefit and private health insurance. "

Benefits of the supplementary aid tariff

The benefits of a supplementary aid tariff are different depending on the tariff. In principle, supplementary aid tariffs for civil servants are comparable to private supplementary health insurances that are open to other insured persons. Most tariffs offer to cover the cost of the following services at:

  • Dental treatments
  • Daily allowance
  • Daily hospital allowance
  • Outpatient expenses
  • International travel health insurance
  • Optional services such as single or double rooms, head physician treatment

Example: This is how the allowance, supplementary tariff and private health insurance share the treatment costs

You need dentures and you go to a dentist. He bills his services at 3.5 times the GOZ rate. You will receive two inlays and two gold crowns. The cost amounts to 3,600 euros. As a single civil servant, you receive 50 percent allowance, are privately insured and have also taken out a supplementary allowance tariff that includes dentures.

Without a supplementary aid tariff, you would have one Own contribution of 288 euros had.

What does a subsidy supplement tariff cost?

Since the subsidy supplement tariff only insures the medical costs that remain after the subsidy and private health insurance, the costs for civil servants are manageable. So is the cost of an aid supplement tariff for a 35-year-old civil servant for single rooms and head physician treatment 40 euros a month. Note that these costs are in addition to the cost of public health insurance.

The exact cost of the supplementary aid tariff, however, is depends on several factors, for example from:

  • Age at the start of insurance
  • Pre-existing illness
  • specific services that are covered
  • concrete state aid regulation

The cost increases sharply when the tariff of one older policyholders is completed. At 55 you pay between 30 and 50 percent more for a supplementary aid tariff than at 35.

more about private health insurance in old age

What does private health insurance cost you?

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How to get the Optimal Allowance Supplementary Tariff

Because the subsidy supplement tariffs are neither the same in terms of content nor price, you should compare exactly which tariffs offer the best price-performance ratio and whether the scope of the services fits the individual needs and the performance gaps of the subsidy and the private health insurance contract.

Check your own needs

First of all, the insured person should get an overview of which services or Performance gaps the benefit and the personal private health insurance contract. For this, on the one hand, the State aid regulation of the relevant federal state and the terms and conditions of the personal private health insurance contract are checked. If there are gaps in certain areas, the supplementary tariff should apply here.

Use the help of our experts

If you feel unsafe in this area, or if this is simply too much effort, you can get support from one of our competent experts. They check which gaps exist and find the tariffs that best suit the insured in terms of value for money.

State aid supplement tariffs in the test

Independent test reports can serve as a first point of orientation when choosing suitable offers. In July 2016, Stiftung Warentest last checked state aid tariffs for civil servants for their price-performance ratio. 53 tariffs were tested, the model customer was a 35-year-old civil servant. The experts showed what grants can be expected from the supplementary tariffs and whether the conclusion of such a contract is accordingly worthwhile. You can find the complete report here. If you are interested in general test reports on private health insurance rates, we have summarized the latest test reports for you here:

PKV in the test: current test winner (2021)

Free tariff comparison with private health insurance

Custom-made and individually created by our award-winning experts.

In many cases it's worth it the conclusion of a Supplementary aid tariffs. The insurance premiums are manageable and you as a civil servant are protected from any additional costs. Because the aid and also the private health insurance for civil servants do not always cover 100 percent of all costs in practice. However, make sure that your supplement tariff is tailored to your needs. Before signing up, check carefully whether and in which service areas there is a need for a supplementary tariff.

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