Supplementary cover · Outpatient treatment
Outpatient supplementary policies may add cover for certain private invoices or selected extras. For broader policies, the GKV cost-reimbursement procedure often plays a central role.
GKV generally provides necessary outpatient care as benefits in kind. Supplementary policies can add defined additional costs from private invoices or expressly agreed extras.
Depending on the policy, one or more areas may be agreed:
It changes the billing route for the selected area of GKV care, but does not automatically expand the statutory entitlement.
A person in GKV chooses cost reimbursement for outpatient care and receives a private invoice. GKV reimburses its statutory share. A supplementary policy can only pay the remaining difference within the agreed scope and limits.
Illustrative example only — not personal advice and not a guarantee of cover, benefits or price.We separate the desired benefit from the billing route and explain which costs may remain despite the policy.
Private billing, glasses, preventive care and other extras are considered separately.
Statutory benefits, any additional benefits offered by the statutory health insurer and any optional-plan benefits are considered.
Prepayment, GKV share, binding period and possible administration deduction are explained.
Percentages, limits under the German Medical Fee Schedule (Gebührenordnung für Ärzte, GOÄ), caps and deductibles are compared.
Health information is prepared completely and truthfully.
We support the contractual billing process when benefits are claimed.
Outpatient, hospital and dental benefits are governed by separate policies.
The precise billing route depends on the GKV choice and supplementary policy.
Often for policies covering outpatient private invoices. Separate benefit modules such as glasses may work differently.
No. Insured services, percentages, caps, fee limits and exclusions determine reimbursement.
No. Services provided by Heilpraktiker — non-medical practitioners licensed under German law — must be expressly insured and often have special fee schedules and annual caps.
The next page explains why the European Health Insurance Card does not cover every cost and why medical-repatriation wording matters.
General information, last updated 31 August 2026. Descriptions of typical benefits are not a guarantee of cover or payment. The application, policy schedule, conditions and chosen GKV billing method are decisive.
