Private health insurance for international students abroad

Costs for medication are generally covered, provided they have been prescribed by a doctor for medically necessary treatment of an acute illness.

Vaccinations recommended by STIKO (Standing Committee on Vaccination) are reimbursed on the MAWISTA Student Comfort tariff up to an amount of €250 per insurance term. The MAWISTA Expatcare Premium tariff also covers vaccinations recommended by STIKO.

An excess means that part of the invoice submitted to your insurer must be paid by you. For the MAWISTA Student tariffs, the following excesses apply for outpatient treatment or dental treatment:

• MAWISTA Student Classic: 20% per insured benefit, max. €250 per calendar year
• MAWISTA Student Classic Plus: 15% per insured benefit, max. €250 per calendar year
• MAWISTA Student Comfort: 10% per insured benefit, max. €250 per calendar year

Examples for MAWISTA Student Comfort:

1. A doctor’s invoice of €100 is submitted to the insurer. If all services are insured, the insurer will reimburse €90.
2. A doctor’s invoice of €5,000 is submitted to the insurer. In this case, the insurer will reimburse €4,750 for the insured services, as the annual maximum limit of €250 applies.

More information on excesses can be found here.

The abbreviation ‘GOÄ’ stands for Gebührenordnung für Ärzte (scale of fees for doctors). ‘GOZ’ stands for Gebührenordnung für Zahnärzte (scale of fees for dentists). German doctors and dentists are obliged to charge for treatment in accordance with the respective scale of fees. For each treatment, a specific amount is specified for each treatment and varying percentages can be charged based on this amount. The insurer pays 1.8-3.5 times the rate depending on the tariff that has been taken out.

Examples:

1. Invoice with a fee rate that exceeds the reimbursable rate: With the MAWISTA Student Classic tariff, the insurer will generally reimburse 1.8 times the scale of fees. The insured person receives an invoice with 2.3 times the rate of the scale of fees. The insurer will reimburse the incurred costs at 1.8 times the rate after they have checked the invoice (with deduction of excess depending on tariff). The difference must be covered by the insured person. We therefore recommend discussing the invoicing methods with the doctor before receiving treatment.
2. Invoice with a fee rate that is lower than the reimbursable rate: With the MAWISTA Student Classic Comfort tariff, the insurer will generally reimburse all insured benefits from 1.8 to 3.5 times the rate.

With MAWISTA Student, the insurer will generally only reimburse treatment that is medically necessary and has occurred after the start of the insurance term. Treatment for pre-existing conditions will therefore not be paid for by the insurer.

Section 4 of the conditions of insurance outlines the cases where there is no insurance cover:

1. Medical treatments and other medically prescribed measures which are the reason for coming to the country in which insurance cover has been agreed;
2. Medical treatments and other medically prescribed measures which were known to be necessary by the insured person prior to coming to the country in which insurance cover has been agreed or were known at the time the policy was taken out, or which must have been expected by you due to known circumstances;
3. Nutriments and restoratives;
4. Orthodontic treatment, dental treatment that goes beyond treating pain, repairing dental prostheses and temporary solutions;
5. Remedies (e.g. massage and mud baths, lymphatic drainage) exceeding six treatments in the insurance year;
6. The purchase of prostheses and medical aids; except for accident-related medical aids where cover up to €250 is provided per insurance year;
7. Treatment of alcohol, drug and other additions and their consequences;
8. Treatment for pregnancy which began prior to the start of the insurance policy and treatment for pregnancy during the waiting period after the start of the insurance policy;
9. Treatment or hospital stays related to prolonged illness, nursing care or psychiatric commitment;
10. Psychoanalytical and psychotherapeutic treatment and hypnosis;
11. Fees that exceed what is generally considered normal and reasonable in the country in question and fees for selective services, such as a private room or treatment by the head physician. Reimbursement may be reduced to the rates standard for the country in question;
12. Repatriation for any of the reasons stated in no. 1, 2, 7 or 9.
13. Screenings for illnesses, check-ups for children or teenagers, dental check-ups and preventative treatment, and fees for doctor’s certificates, diagnostic reports and (incapacity for work) certificates that were not requested by the insurer.

The ‘waiting period’ is the period after the insurance has commenced during which there is no entitlement to insurance benefits.

With MAWISTA Student, any treatments for pregnancy (three months from the start of the policy), childbirth and dental prostheses (eight months from the start of the policy) are subject to waiting periods. With the MAWISTA Student Comfort tariff, pregnancy is covered without a waiting period.

Example: An insurance policy is taken out on 1 January. The insurance company will reimburse costs for dental prostheses from the start of treatment only after 1 August (after eight months).

If the pregnancy began before the start of the insurance cover, pregnancy treatments and childbirth are not insured. If the pregnancy begins after the start of the insurance cover, the tariffs cover the costs as follows:

Student Classic / Student Classic Plus

• Waiting period for pregnancy treatment: 3 months
• Waiting period for childbirth:  8 months

Student Comfort

• Waiting period for pregnancy treatment: 0 months
• Waiting period for childbirth:  0 months

Regardless of when the pregnancy began and waiting period, the insurer will reimburse costs of medical treatment in the case of acute pregnancy complications including miscarriage and premature birth.