Glossary: the key terms of private health insurance explained

The private premium follows the equivalence principle. It depends on the insured risk, that is, on age, health and the scope of benefits.

Through the ageing reserves, the insurer sets aside capital for old age so that the premium stays stable later in life. The statutory surcharge and premium capping work in the same direction. Terms such as actuarial interest rate, actuarial reserve and transfer value describe the mechanics behind it.

Unlike the statutory health insurance fund, private health insurance reimburses the bills you submit according to the reimbursement principle. How much it pays depends on the fee schedules for doctors and dentists and on the standard maximum rate.

Terms such as affiliated physician, general hospital services, remedies and medical aids and standard hospital benefits show which treatment is covered and within which limits.

When the contract is concluded, the pre-contractual duty of disclosure counts. If you answer the health questions incorrectly, you risk a breach of obligations with consequences for your cover.

During the contract, the duty to provide information and the duty of subsequent disclosure apply. Terms such as medical confidentiality waiver, binding period and underwriting guidelines describe the rules around the application and the contract.

If you lose income because of illness, separate modules close the gap. Krankentagegeld (i) replaces your earnings from an agreed day, incapacity for work is the condition for it, and the employer certificate proves the relevant income.

This cover is especially important for self-employed people because they get no continued pay.

These entries are viewed especially often. The full directory runs from A to Z. The employer certificate stands for the proof needed for the employer contribution, Krankentagegeld (i) for income during illness, and incapacity for work for when it starts and ends.

Also in demand are premium capping as a way to avoid a high premium in old age, the employer contribution as the employer's share of the premium, and the second opinion as the right to a second medical assessment. Standard hospital benefits mean basic care in hospital, remedies and medical aids the reimbursable materials. The duty to provide information and the duty of subsequent disclosure concern what you tell the insurer, the affiliated physician concerns treatment in a hospital with affiliated physicians, and the health cure daily allowance insurance concerns the allowance for a health cure.

Contracts and bills in private health insurance use many technical terms. This reference guide explains them in plain words so that you can understand conditions and bills with confidence.

Private health insurance reimburses the bills you submit according to the reimbursement principle. Statutory health insurance works with the benefits-in-kind principle through the health insurance card.

Terms such as standard maximum rate and fee schedule explain how high private reimbursement turns out.