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Differences between private and statutory health insurance

The main differences

The statutory health insurance as well as the private health insurance differ primarily in the services provided and the premiums to be paid.  

Monthly costs

  • Statutory health insurance: from approx. €100.00
  • Private health insurance: from approx. €30.00

Insurance cover

  • Private health insurance: You will be reimbursed for the costs of treatment for illnesses and accidents, and for the costs of medication prescribed by a doctor. Generally, private health insurance covers more additional services and provides a higher amount of cover for treatment costs than statutory health insurance.
  • Statutory health insurance: You will be reimbursed for the costs of treatment for illnesses and accidents, and for the costs of medication prescribed by a doctor. The reimbursed treatment costs are fixed and are generally a lot lower than with private health insurance. Statutory health insurers generally reimburse the costs of fewer additional services than private health insurers. 

Cost reimbursement types

  • Private health insurance: Private health insurers reimburse costs in different ways, depending on their terms and conditions of insurance.
  • Statutory health insurance: Statutory health insurers will settle the bill with your doctor or hospital directly.

Cost reimbursement procedure

  • Private health insurance: Private health insurers reimburse the insured person. The insured person sends the bill to the insurance provider for reimbursement. The relevant amount is then paid into the insured person’s account and the insured person pays the doctor.
  • Statutory health insurance: Statutory health insurance only covers the costs of essential treatment.

Persons who cannot obtain insurance

  • Private health insurance: Often, people can only be insured up to a certain age limit. This varies depending on the provider and tariff and is checked when the application is made.
  • Statutory health insurance: Students studying at language schools, university preparatory colleges or private universities and students who are over 30 years of age cannot obtain statutory insurance.

Limitations on insurance cover

  • Private health insurance: The costs of treatment for pre-existing conditions will not be reimbursed.
  • Statutory health insurance: The costs of treatment for pre-existing conditions can be reimbursed
  • Note: Insurance only covers the costs of treatment provided by registered doctors. Often, the costs of treatment by persons such as natural health professionals and alternative medicine practitioners are not reimbursed.
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