Exclusion of benefits - all you need to know

What restrictions are there when it comes to your health insurance’s obligation to perform?

1. There is no obligation to perform in the following cases:

a) if it was certain prior to the journey, that a treatment would have to take place under normal circumstances, unless the death of a spouse or a first degree relative was the reason for the journey;

b) diseases and their consequences as well as consequences of an accident that are the reason for traveling abroad;

c) treatments due to employment abroad;

d) treatment of mental disorders and illnesses, psychosomatic treatment (e. g. hypnosis, autogenous training) and psychotherapy;

e) childbirth, abortion as well as examinations and treatments due to pregnancy;

f) purchase of medical appliances, e. g. glasses, contact lenses, shoe lifts, prostheses, etc.;

g) health damage and death caused by war and unrest. There is, however, insurance coverage if the insured person faces sudden and unexpected war or civil war. Such insurance coverage expires at the end of the 7th day after the outbreak of war or civil war in the country where the insured person stays;

h) diseases or accidents based on intent, including suicide, attempted suicide and addiction (e.g. alcohol, drugs, etc.), as well as the consequences of such diseases or accidents and detoxification and withdrawal treatments;

i) housing due to need for long-term care or keeping;

j) treatment at a health resort and at a sanitarium as well as rehabilitation measures;

k) examination or treatment methods and medicine that are neither scientifically recognized in the respective country of stay nor in the patient’s home country;

l) dental treatment that goes beyond treatment for pain relief, repair of dentures and temporary solutions, like new dentures including dental crowns, dental cosmetics and orthodontics.

For further details, please, refer to the General Insurance Conditions.

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