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BenefitsClaimCancelling your policyBack to statutory insuranceTerminated without noticeHanse Merkur combination with very stable premiums for employees, with solid outpatient and dental cover, private doctor and single room through the module PSV, and a lump-sum payment that rewards claim-free years directly with half a premium.
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The Hanse Merkur combination of AZP, EGO2, PS3 and PSV is in our selection for employees mainly because of one value. We rate premium stability at 9 out of 10 points, the best value in this comparison package. If you see private health insurance as a decision for decades, you will find a calm calculation here. Claims handling is also above average at 8 out of 10 points. The structure is modular. AZP is the main plan for outpatient and dental benefits, the top-up plan EGO2 raises outpatient and dental fees above the maximum rates of the fee schedule and the dental rate from 80 to 90 percent, PS3 provides basic inpatient cover and PSV adds a single room and private doctor. We rate the benefit level at 7 out of 10 points as solid, not top level. Dentures stay at 90 percent even with the top-up plan, and benefits abroad are limited. In return there is no deductible and a lump-sum payment that rewards claim-free years with half a premium. We recommend the combination where reliable premiums matter more than the last percent of benefits.
The lump-sum payment in the main plan AZP works as a premium deferral. As long as you claim no benefits, you only pay half the premium, to the extent of 6 monthly premiums. The requirement is having no claims in the current and the previous year of insurance. Preventive care lump sums, the childbirth lump sum and outpatient surgery do not count as claims.
We rate Hanse Merkur's premium history for this combination at 9 out of 10 points, the best value in the comparison package. The modular structure also helps. The top-up plan EGO2 and the inpatient module for optional hospital services PSV can be managed as separate modules, so benefits and premium can be balanced in a targeted way.
For outpatient and dental care, the top-up plan EGO2 reimburses the part above the maximum rates of the GOÄ and GOZ, raises dentures and orthodontics from 80 to 90 percent and adds one blood test for cancer screening per year from age 18. If the result is abnormal, imaging procedures from the main plan are added.
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.
How much the cover really pays in a serious case.
How reliably premiums have developed in the past.
How quickly and fairly bills are reimbursed.
Terms for children and co-insured family members.
10 means a comparatively low premium. Low values stand for a higher premium.
The core benefits from the plan terms, grouped by area. Open an area to see the details.
Outpatient care decides your free choice of doctor and how much of private doctors' fees is reimbursed. What matters here is how the parts work together: the main plan AZP reimburses up to the maximum rates of the GOÄ, and the top-up plan EGO2 covers the part above.
Free choice of doctor, no primary doctor principle
AZP up to the maximum rates (3.5 times for medical, 2.5 times for technical, 1.3 times for laboratory services), EGO2 reimburses the part above that
Statutory programs and further checkups up to the standard maximum rates, through EGO2 also one blood test for cancer screening per year from age 18
Reimbursed, including products for artificial nutrition
100% up to the maximum amounts of the federal allowance regulation for civil servants
Open catalog of medical aids at 100%, wheelchairs up to €15,000, digital health applications also beyond the statutory directory
100% according to the GebüH or the Hufeland directory, up to the maximum amounts of the GebüH
Together with EGO2 up to €600 for visual aids per 24 months and up to €4,000 for surgical vision correction per 60 months
90% for at most 50 sessions per year, prior approval required
In hospital two modules work together. PS3 covers the standard case in a multi-bed room, PSV raises this to optional hospital services with a single or two-bed room and private doctor. Only this combination brings private comfort.
PS3 multi-bed room, PSV raises this to a single or two-bed room
PS3 standard and affiliated doctor services, PSV private doctor treatment
PS3 affiliated doctor up to the maximum rates, PSV also above the maximum rates
Through PSV €35 if you do without a single or two-bed room, €25 if you do without private doctor treatment
For general hospital services up to 1 times the costs of a hospital that bills under the KHEntgG or BPflV
Reimbursed, without prior approval
After prior approval, without it in emergencies and defined cases
To and from the nearest suitable hospital
The dental benefits are in the main plan AZP, and the top-up plan EGO2 increases dentures and orthodontics. What you need to know are the dental benefit limits, meaning the cap in the first years of insurance.
100%, including root canal and periodontal treatment as well as professional teeth cleaning
AZP 80%, 90% together with EGO2
AZP 80%, 90% together with EGO2
AZP 80%, 90% together with EGO2 (KIG 1 to 5)
AZP up to the maximum rates, EGO2 reimburses the part above that
At most €1,600 in the first 2 years, €3,200 in the first 4 years, €6,400 in the first 6 years, no limit from the 7th year, no limit after an accident
The combination consists of four modules with a clear division of tasks. The main plan provides the basic benefits, the top-up plans raise reimbursement and comfort. There is no deductible.
Basic cover for outpatient and dental benefits, no deductible
Raises outpatient and dental fees above the maximum rates of the GOÄ and GOZ and the dental rate from 80 to 90 percent
Multi-bed room as well as standard and affiliated doctor services
Single or two-bed room and private doctor treatment, GOÄ also above the maximum rates
There is no deductible in this combination
Hanse Merkur does not reward claim-free years with a classic payout but with a premium deferral: your premium is halved as long as you do not submit any bills. Preventive care deliberately does not count against you.
For claim-free years as a premium deferral: as long as no benefits are claimed, only half the premium is payable, up to the amount of 6 monthly premiums
No claims in the current and the previous insurance year
Lump sums for preventive checkups, the childbirth lump sum and outpatient operations do not count as claims
The combination includes no performance-based refund
The top-up plan has no guaranteed lump-sum payment of its own
The points beyond the core benefits often decide everyday life, especially when your life situation changes. Here the combination shows strengths for families and clear limits abroad.
Premium exemption for the first 6 months, provided you have been insured for at least 12 months
Children can be insured alone from birth, and cover can start on the day of birth
Covered through PSV up to the child's age 14
Reimbursed under certain conditions, prior approval not required but recommended
Outside Europe, benefits are reduced by one third from the 2nd month unless agreed otherwise in advance, medically necessary repatriation through PSV for trips of up to 3 months
Outpatient health cure every 3 years, follow-up rehabilitation under certain conditions, no inpatient health cure or sanatorium treatment
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 employee you need it from the end of continued pay during illness, usually from the seventh week. 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.
No plan is the right choice for everyone. This is what speaks for this combination, and this is what you should know.
Very stable premium calculation, in our rating 9 out of 10 points and therefore the best value in the comparison group.
Fast and reliable claims handling with 8 out of 10 points.
Lump-sum payment as a premium deferral: in claim-free years only half the premium is payable, up to the amount of 6 monthly premiums.
Full optional hospital services through PSV with a private doctor, a single or two-bed room and GOÄ also above the maximum rates.
No deductible, plus reimbursement for outpatient and dental care through EGO2 also above the maximum rates of the fee schedule.
Dentures, inlays, implants and orthodontics only reach 90 percent even with the top-up plan EGO2, not 100 percent.
The dental benefit limits cap dentures and orthodontics in the first years at €1,600, €3,200 and €6,400. If you plan larger dental work soon, you should factor this in.
Cover abroad is limited: outside Europe, benefits fall by one third from the 2nd month if nothing else was agreed in advance.
The combination includes neither an option right for higher-level cover nor a simplified right to change plan. The statutory right to change plan under § 204 VVG still applies.
Krankentagegeld is not included and must be added separately for employees. If you have pre-existing conditions, we recommend an anonymous risk enquiry before you apply.
The combination suits employees above the JAEG JAEG · JahresarbeitsentgeltgrenzeThe annual income threshold in Germany. Employees who earn more than this per year may leave statutory health insurance and switch to private health insurance.More about JAEG → for whom reliable premiums over the years matter more than the last percent of benefits. If you mostly remain claim-free, you also benefit from the premium deferral, which halves your premium in such years.
It is less suitable if you expect uncompromising maximum benefits for dentures or comprehensive cover abroad. For these cases we show you better alternatives from our comparison in our advice.
AZP is the main plan for outpatient and dental benefits. The top-up plan EGO2 raises reimbursement above the maximum rates of the GOÄ and GOZ and lifts the dental rate to 90 percent. PS3 secures basic inpatient cover in a multi-bed room, and PSV adds a single or two-bed room and a private doctor. This modular logic makes the combination adjustable: if you want to save on hospital cover or on the dental top-up, you can leave out a top-up plan and lower your premium.
Yes. As a privately insured employee you receive the employer contribution of half your premium, up to the statutory maximum. The contribution applies no matter which plan you choose.
Within Hanse Merkur you can switch to similar plans using the right to change plan under § 204 VVG, and you keep your ageing reserves. According to the plan terms, the combination includes neither a simplified right to switch to higher-level plans nor an option right, so the benefit level should fit from the start.
Premium adjustments are part of how private health insurance works. What matters is their long-term size. You can find Hanse Merkur's specific adjustments by year and plan in our overview of premium adjustments. If an increase is large, we check plan optimization with you.
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 from advisory practice. The rating is our professional assessment, not a ranking by a testing institute.
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Personal advice from our specialists. Response time: under 24 hours.
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.
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