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Plan combination Premium-MED, SP1
Suitable for Doctors
Data as of July 2026, source: plan terms and our advisory practice

Why this plan is in our selection

The Continentale combination of Premium-MED and SP1 is in our selection because it offers a strong range of benefits at one of the lowest premiums in the doctors' segment. For the premium level we give 8 out of 10 points. The main plan Premium-MED secures outpatient and dental benefits as well as a multi-bed room, and the top-up plan SP1 raises inpatient accommodation to a single room with a private doctor. The refund is a plus: the guaranteed lump sum and the performance-based refund together come to up to six monthly premiums. You need to know two things: there is a deductible of €20 per benefit up to at most €500 per year, and we rate premium stability at 4 out of 10 points, the weakest value in the package.

01

Low premium in the doctors' segment

For the premium level we give 8 out of 10 points, one of the best values in our selection for doctors. The combination reaches its benefit level with a very low starting premium, among other things through a moderate deductible per benefit.

02

Refund of up to six monthly premiums

In addition to a guaranteed lump sum of two monthly premiums after a claim-free year, the Premium-MED pays a performance-based refund of up to four monthly premiums after five claim-free years. Together that is up to six monthly premiums.

03

Single room through the top-up plan

The top-up plan SP1 raises inpatient accommodation to a single room with private doctor treatment and reimburses the fee schedule also above the maximum rates. This lets you bring inpatient cover specifically to private clinic level.

Our rating

Five key figures from our plan analysis, each on a scale from 1 to 10. They are based on the plan terms, the premium histories and our experience from advisory practice.

7/10

Benefit coverage

How much the cover really pays in a serious case.

4/10

Premium stability

How reliably premiums have developed in the past.

7/10

Claims handling

How quickly and fairly bills are reimbursed.

8/10

Family friendliness

Terms for children and co-insured family members.

8/10

Premium level

10 means a comparatively low premium. Low values stand for a higher premium.

The benefits in detail

The core benefits from the plan terms, grouped by area. Open an area to see the details.

Outpatient treatment

Outpatient care decides how freely you choose doctors and how much of private doctors' fees is reimbursed. The Premium-MED reimburses above the maximum rates of the GOÄ and covers alternative practitioners through the GebüH.

Choice of doctor

Free choice of doctor, no primary doctor principle

Fee schedule (GOÄ)

Reimbursement also above the maximum rates

Preventive checkups

According to the statutory programs, plus up to €500 per year for further preventive care

Psychotherapy

100% for 30 sessions per year, then 80%, without prior approval

Alternative practitioner

100% according to the fee directory for alternative practitioners and the insurer's list

Medicines and dressings

Reimbursed, including homeopathic medicines

Remedies (physiotherapy and others)

According to the federal allowance regulation for civil servants or section E of the GOÄ, whichever amount is higher

Medical aids

Open catalog, 100% up to €1,000, above that with a cost estimate, hearing aid up to €1,500 per ear and year

Visual aids and laser eye surgery

Up to €400 per 2 years, Lasik up to €2,500 from year 3

Inpatient treatment

In hospital the cover consists of two modules. The Premium-MED provides a multi-bed room, and the top-up plan SP1 raises this to a single room and private doctor.

Accommodation

Single room through the top-up plan SP1

Medical treatment

Private doctor treatment through SP1, GOÄ also above the maximum rates

Substitute daily hospital allowance

€40 per day if you do without a single or two-bed room, €20 if you do without the single room, €50 if you do without a private doctor

Private clinics

Reimbursed through the Premium-MED

Inpatient psychotherapy

Reimbursed, without prior approval

Companion

Covered in hospital for children up to age 15

Transport

To and from the nearest suitable hospital

Dental benefits

Dentures are one of the most common reasons for a claim. The Premium-MED reimburses dental treatment in full, while a percentage deduction applies to dentures. Here the dental benefit limits run over the first six years.

Dental treatment

100%, including professional teeth cleaning, root canal and periodontal treatment

Dentures

85%, including crowns, bridges, implants

Inlays

85%

Implants

85%, including bone grafting

Orthodontics

85%

Fee schedule (GOZ)

Reimbursement also above the maximum rates

Dental benefit limits

Maximum €2,000 up to year 2, €5,000 up to year 4, €10,000 up to year 6, unlimited from year 7

Deductible and its effect

The Premium-MED works with a deductible that applies per benefit and is capped. This keeps your share predictable and the premium low.

Deductible per benefit

€20 per treatment day or per product, on outpatient and dental benefits

Annual cap

Maximum €500 per calendar year, €250 up to age 20

Exception

For generics, there is no deductible on medicines

First year

Deductible pro rata per month

No-claims refund

If you submit no bills, you get money back. Continentale combines a guaranteed lump sum with a performance-based refund, together up to six monthly premiums.

Guaranteed lump sum

2 monthly premiums after a claim-free year

Performance-based refund

1 monthly premium after 2 years, staggered up to 4 monthly premiums after 5 claim-free years

Children and young people

Receive the same refund

Note on preventive care

If preventive care or vaccinations are reimbursed, there is no refund for that year

Family, travel and extras

The points beyond the core benefits often decide how comfortable everyday life is, especially when your life situation changes.

Fertility treatment

100% after approval for organic infertility, with limits on the number of attempts

Premium exemption

From the 2nd month while receiving parental allowance for at most 6 months

Cover abroad

Outside Europe 12 months through the Premium-MED

Health cures and rehab

Only follow-up rehabilitation after a hospital stay, other health cures are not reimbursed

Option right

No option for higher-level cover

Krankentagegeld KrankentagegeldPrivate sick pay: a daily allowance from private insurance while you are unable to work. It replaces lost income from an agreed day of illness.More about Krankentagegeld → is not part of this combination. As an employed doctor you need it from the end of continued pay during illness, as a doctor in private practice from the first day of incapacity for work. We add the right daily rate in our advice.

All benefit details come from the insurer's plan terms and are summarized in simplified form. Only the insurance conditions are binding. In a consultation we check the details for your situation.

Strengths and limits

No plan is the right choice for everyone. This is what speaks for this combination, and this is what you should know.

What speaks for it

  • ✓

    Very low premium (8 out of 10 points) with a solid range of benefits.

  • ✓

    Refund from a guaranteed lump sum and a performance-based share of up to six monthly premiums together.

  • ✓

    Single room with private doctor through the top-up plan SP1, reimbursement above the maximum rates.

  • ✓

    Alternative practitioners at 100 percent according to the fee directory, open catalog of medical aids.

  • ✓

    Predictable deductible per benefit with an annual cap of €500.

What you should know

  • !

    At 4 out of 10 points, premium stability is the weakest value in the package.

  • !

    There is a deductible of €20 per benefit up to at most €500 per year.

  • !

    The dental benefit limits run over six years and are therefore longer than in many other plans.

  • !

    The combination includes neither an option right nor a simplified right to switch.

  • !

    A strong plan only pays off if your application is accepted cleanly. If you have pre-existing conditions, we recommend an anonymous risk enquiry before you apply.

Who this plan suits

The combination suits doctors who want a good benefit level at a low premium and can live well with a predictable deductible per benefit. If you value a high refund, you will find one of the stronger values in our selection here.

It is less suitable if the highest possible premium stability is the priority or if you do not want a deductible. For these cases we show you better alternatives from our comparison in our advice.

Premium development at Continentale: A plan is only as good as its calculation. We show the adjustments of past years transparently by year and plan.

View the premium history →

Frequently asked questions

How does the refund of up to six monthly premiums come about?

The Premium-MED pays two benefits together: a guaranteed lump sum of two monthly premiums after a claim-free year and a performance-based refund of up to four monthly premiums after five claim-free years. In total that is up to six monthly premiums. The condition is that no claims are made in the entire plan.

How does the deductible work?

The plan deducts €20 per benefit, for example per treatment day or per product, capped at €500 per calendar year. For generics, there is no deductible on medicines. This design keeps the premium low. We explain more under deductible.

Does my employer contribute to this plan?

As an employed hospital doctor you receive the employer contribution of half your premium, up to the statutory maximum. As a doctor in private practice you can deduct the premiums from tax instead.

What happens if premiums rise?

Premium adjustments are part of how private health insurance works. What matters is their long-term size. You can find Continentale's specific adjustments by year and plan in our overview of premium adjustments. If an increase is large, we check plan optimization with you.

How is our rating calculated?

The five key figures come from our ongoing plan analysis. They are based on the plan terms, the published premium histories and our experience with claims handling. The rating is our professional assessment, not a ranking by a testing institute.

Contact our experts

Get all your questions answered, free of charge and without obligation.

Talk to an expert

Personal advice from our specialists. Response time: under 24 hours.

The PKV-Welt team: Tim and Sandra Bökemeier
Direct contact

Please answer three short questions about the person who is to be insured.

Currently insured
Occupation

Switching to private health insurance is probably not advisable for you.

From the age of 55, admission to private health insurance is often possible only with restrictions. A late switch can also mean higher premiums.

It matters to us that a switch pays off for you in the long run. That is why we do not recommend a consultation when your answers already show that the conditions are rather unfavorable.

Not sure, or want to correct your answers? Feel free to contact us. We will help you assess your situation.

 

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