Allianz – Everything new?
Allianz is one of the largest insurance companies, not only in Germany, but worldwide. It offers a wide range of tariffs in various areas, from health insurance to car insurance. There was a major upheaval in the health insurance sector in mid-2024: the ‘old’ tariffs were removed from the catalogue and replaced by two new ones, which can be improved with the help of add-on modules. In the following, we reveal together what the new tariffs have to offer, what can be flexibly customised and for whom the tariffs are suitable.
The two new tariffs are called GSB and GSP and have a ‘70’ at the end in the standard version. The 70 indicates that the tariff has a deductible of 30%, up to €1500 per year for outpatient and inpatient services, 1-/2-bed and private doctor, as well as services in private clinics at 2.5 times the rate of a normal hospital and above the maximum rates of the fee schedule. It is important to note that a dental tariff must always be included, for example the GSZ75, as otherwise dental benefits are not insured at all. The 75 here also indicates how much is covered, namely 75% for dental prostheses. Regular dental benefits are reimbursed at 100%.
Let’s now take a closer look at the GSB tariff and finally calculate the costs using a case study.
Ambulant GSB:
Outpatient treatment
Outpatient medical treatment is reimbursed. This also includes naturopathic treatments that have been tried and tested in practice, as well as treatments according to the Hufeland list. The costs of naturopathic treatments are reimbursed up to the amount that would have been incurred for conventional medicine.
method, the PKV even covers methods that are not recognised by conventional medicine
Precaution
Preventive medical check-ups by doctors are also reimbursed, even if they are not introduced by law. A maximum of EUR 400 is covered per calendar year for up to two health courses. Deductibles also apply to preventive services and immunisations. If you participate in an insurer’s prevention programme, flat rates for preventive check-ups, vaccinations and health courses are not subject to a deductible. If preventive services or immunisations are reimbursed, there is no premium refund.
Medicines and dressings: Comprehensive care
Prescribed medicines and dressings are reimbursed. Non-prescribed medicines are covered up to EUR 100 per calendar year. This also includes artificial nutrition products. Prescription contraceptives are reimbursed up to the age of 22.
Remedies
Remedies such as inhalations, physiotherapy, massages, packs, hydrotherapy, medical baths, cold and heat treatment, electrotherapy, light therapy, occupational therapy, speech therapy, podiatry, nutritional therapy, antenatal classes, pregnancy gymnastics, postnatal gymnastics, rehabilitation sports and functional training in groups are reimbursed up to 130% of the maximum amounts of the Federal Allowance Ordinance.
Technical aids
Aids are technical aids and body substitutes that compensate for or alleviate disabilities, the consequences of illness or accidents, such as bandages, insoles and prostheses. Dialysis machines and guide dogs are also reimbursed. Reimbursement is limited to a maximum of EUR 1,000 per wig, EUR 3,000 per hearing aid and EUR 6,000 for BAHA hearing aids. Digital health applications that are approved as medical devices are reimbursed at 100%.
Visual aids
Visual aids such as glasses, spectacle frames and contact lenses are reimbursed up to an amount of EUR 1,000 within 36 months. Surgical correction of visual acuity, including laser/lasik, is also covered.
Alternative practitioner
Treatments by alternative practitioners in accordance with the GebüH are reimbursed up to an amount of EUR 2,000 per calendar year, including prescribed medicines.
Psychotherapy
Outpatient psychotherapy is reimbursed without prior authorisation. Treatment by psychotherapists is possible.
Outpatient fee schedule
Reimbursement is also made in excess of the maximum rates of the German Medical Fee Schedule (GOÄ).
Stationary GSB:
Inpatient accommodation:
The insurance covers the costs of accommodation in a 1- or 2-bed room.
Inpatient treatments
Private medical treatment is reimbursed.
Private clinics
Services in German hospitals that are not subject to the Hospital Remuneration Act (KHEntgG) or the Federal Hospitalisation Rate Ordinance (BPflV) are reimbursed. The reimbursement for general hospital services amounts to a maximum of 2.5 times the costs that would have been incurred in a hospital that charges according to the KHEntgG or BPflV.
Replacement daily hospital allowance
– 70 EUR for waiver of 1- and 2-bed rooms.
– EUR 40 if private medical treatment is waived.
Children up to the age of 16 receive half the replacement daily hospital allowance.
Psychotherapy inpatient
Inpatient psychotherapy is reimbursed; prior authorisation is not required.
Inpatient fee schedule
Reimbursement is also made in excess of the maximum rates of the German Medical Fee Schedule (GOÄ).
Tooth GSZ75:
Dental treatment
Dental treatment is reimbursed at 100%, subject to the dental scale.
Dentures
Dental prostheses are reimbursed at 75%, subject to the dental scale.
Inlays
Inlays are reimbursed at 75%, subject to the dental scale.
Implants
Implants, including bone augmentation, are reimbursed at 75%, subject to the dental scale.
Orthodontics
Orthodontics are reimbursed at 75% up to the age of 21. The age limit does not apply in the event of an accident or serious illness (insurer’s list).
Dental services
– Dental treatment, including plastic fillings, root canal treatment, periodontal treatment, prophylaxis and professional teeth cleaning, is reimbursed at 100%.
– Dental prostheses, including crowns, bridges, veneers, inlays, onlays, implants (including bone augmentation), functional analyses and functional therapy, are reimbursed at 75%.
– Orthodontics are reimbursed at 75% up to the age of 21. The age limit does not apply in the event of an accident or serious illness (insurer’s list).
– Material and laboratory costs are reimbursed at the percentage of the treatment – Bleaching is reimbursed at 100%, up to a maximum of EUR 150 within 2 calendar years.
– Pain elimination through analgo-sedation (twilight sleep), nitrous oxide sedation, hypnosis, acupuncture and anaesthesia is reimbursed at the percentage of the treatment.
Tooth relay
The reimbursement for dental treatment, dentures and orthodontics amounts to a maximum of
– EUR 1,000 in the 1st calendar year.
– EUR 1,500 in the 1st – 2nd calendar year.
– EUR 2,000 in the 1st-3rd calendar year.
From the 4th year onwards, reimbursement is made without a dental scale limit. There is no limit in the event of an accident. A report of findings does not lead to a waiver of the limit.
Dental fee schedule
Reimbursement also exceeds the maximum rates of the scale of fees for dentists (GOZ) and doctors (GOÄ).
Treatment and cost plan
A treatment and cost plan is recommended for dental prostheses and orthodontics.
For dental prostheses and orthodontic treatments costing more than 1,000 EUR, creating a treatment and cost plan is recommended.
Note that treatments may be rejected if more than five teeth are missing.
General Information GSB:
Lump Sum Benefit
Guaranteed lump sum benefit for claim-free calendar years: 1 year: 10% of the contributions paid in the claim year.
The prerequisite for the lump sum benefit is being claim-free in the comprehensive health insurance.
When participating in an insurer’s prevention program, lump sums for preventive examinations (insurer’s list), vaccinations as recommended by the Standing Committee on Vaccination, and health courses are not counted towards the lump sum benefit.
Premium Refund
Premium refund (BRE) after claim-free years:
1 year : 1.8 MB
2 years : 2.4 MB
3 years : 3.0 MB
4 years : 3.6 MB
Children and adolescents up to the age of 21:
1 year : 4.2 MB
For mid-year starts, the BRE is paid proportionally.
Full and immediately preceding claim-free calendar years with another insurer or statutory health insurance are credited.
Requirements:
-at least 12 months of previous insurance
-claim-free until the time of switch for mid-year changes
-proof required.
The prerequisite for the premium refund is being claim-free in all eligible plans.
If preventive services or vaccinations are reimbursed, no premium refund will be given.
When participating in an insurer’s prevention program, lump sums for preventive examinations (insurer’s list), vaccinations as recommended by the Standing Committee on Vaccination, and health courses do not affect the BRE.
Spa, Rehabilitation, and Follow-up Treatment of GSB
Inpatient Spa Treatment
Medical services, accommodation, meals, medication, therapeutic remedies, spa treatments, spa plan, and spa tax are reimbursed up to 1,500 EUR once within 36 months for outpatient and inpatient spa treatments.
Other Rehabilitation Measures and Follow-up Treatments (AHB)
Medical services, accommodation, meals, medication, and therapeutic remedies are reimbursed up to 1.5 times the rate that would have been reimbursed by statutory health insurance (GKV), once within 36 months for outpatient and inpatient rehabilitation.
Benefits from a statutory provider must be claimed first. Prior approval is not required.
Outpatient Spa Treatment
Medical services, medication, therapeutic remedies, spa treatments, spa plan, and spa tax are reimbursed up to 1,500 EUR once within 36 months for outpatient and inpatient spa treatments.
Other Rehabilitation Measures and Follow-up Treatments (AHB)
Medical services, medication, therapeutic remedies, counseling, and training are reimbursed up to 1.5 times the rate that would have been reimbursed by the GKV, once within 36 months for outpatient and inpatient rehabilitation.
Benefits from a statutory provider must be claimed first. Prior approval is not required.
Summary GSB:
In summary, the GSB is a premium-class plan that truly stands out in terms of benefits. However, you have to pay for these benefits. For example, for a 35-year-old with no health issues in the last 5 years, the GSB + GSZ75 (for dental benefits) costs a total of 705.64€, including mandatory long-term care insurance. For employees, this amount is halved as the employer contributes half, bringing the contribution to 352.82€. If our example insured person remains claim-free (meaning only preventive check-ups and no other bills submitted), there’s a premium refund at the end of the year, which reduces the monthly contribution to only 207.95€.
It’s important to note that this price is tied to the condition of good health. If this is not the case, an individual risk surcharge must be evaluated, preferably anonymously through a broker. Furthermore, the deductible in this plan is still 30% up to 1500€ per year, which is relatively high in comparison. Here are the prices in tabular form:
Self-employed: 705.64€
-> In a claim-free year: 560.77€
Employees: 352.82€
-> In a claim-free year: 207.95€
Let’s now take a closer look at the GSP plan. It’s essentially the ‘light’ version of the GSB, whose benefits are of course better, but also more expensive. Here are the details:
Outpatient GSP:
Outpatient treatments
Outpatient medical treatments are reimbursed. Also covered are proven alternative healing methods that are not part of conventional medicine, up to a maximum of the amount that would have been incurred with conventional medicine. Other alternative healing methods (insurer’s list) are also covered.
Advance Care Planning
Preventive medical check-ups by doctors are reimbursed, even those not part of statutory programs. A maximum of 200 EUR per calendar year is covered for up to two health courses. Deductibles also apply to preventive services and vaccinations. When participating in an insurer’s preventive program, lump sums for preventive check-ups, vaccinations, and health courses are independent of a deductible. If preventive services or vaccinations are reimbursed, no premium refund is provided.
Medicines and dressings
Medicines and dressings are reimbursed if they are generics or original products for which no generics exist. There is a deductible of 10 EUR per medication, up to a maximum of 1,000 EUR per calendar year, if the insured person uses original products despite generics being available. This also includes artificial nutrition products. Prescription contraceptives are reimbursed up to the age of 22.
Therapeutic treatments
Therapeutic treatments are reimbursed up to 110% of the maximum rates of the Federal Aid Regulation. These include inhalations, physiotherapy, massages, packs, hydrotherapy, medical baths, cold and heat treatments, electrotherapy, light therapy, ergotherapy, speech therapy, podiatry, nutritional therapy, prenatal classes, pregnancy gymnastics, postnatal gymnastics, rehabilitation sports, and group functional training.
Medical aids
An open catalog of medical aids is available. Medical aids are reimbursed if obtained through the insurer or within 2 days after an accident or emergency. Otherwise, 80% is reimbursed. Medical aids are technical devices and prosthetics that compensate for or alleviate disabilities, illness or accident consequences, such as bandages, insoles, and prostheses. Dialysis machines and guide dogs are also reimbursed. Reimbursement is limited to a maximum of 500 EUR per wig, 1,500 EUR per hearing aid, 3,000 EUR for BAHA hearing aids, and 2,000 EUR for orthopedic shoes per calendar year. Digital health applications approved as medical devices are reimbursed at 100%.
Vision aids
A maximum of 500 EUR is reimbursed for vision aids (lenses, frames, contact lenses) within 36 months, as well as 1,500 EUR for surgical vision correction (including laser/LASIK) per eye.
Alternative practitioners
Treatments by alternative practitioners according to GebüH are reimbursed up to an amount of 1,000 EUR per calendar year, including prescribed medications.
Alternative healing methods
Alternative healing methods are reimbursed at 100%, but excluding Hufeland.
Outpatient psychotherapy
Outpatient psychotherapy is reimbursed; prior approval is not required. Treatment by psychotherapists is possible.
Fee schedule for outpatient services
Reimbursement is made up to the maximum rates of the Fee Schedule for Physicians (GOÄ):
– Up to 3.5 times the rate for medical services.
– Up to 2.5 times the rate for technical services.
– Up to 1.3 times the rate for laboratory services.
Inpatient GSP
Inpatient accommodation
The insurance covers the costs for accommodation in a single or double room.
Inpatient treatments
Private doctor treatments are reimbursed.
Private clinics
Services in German hospitals that are not subject to the Hospital Remuneration Act (KHEntgG) or the Federal Hospital Rate Ordinance (BPflV) are reimbursed. The reimbursement for general hospital services is limited to a maximum of 2.5 times the costs that would have been incurred in a hospital that bills according to KHEntgG or BPflV.
Substitute daily hospital allowance
– 70 EUR for waiving single or double room.
– 40 EUR for waiving private doctor treatment.
Children up to the age of 16 receive half the substitute daily hospital allowance.
Inpatient psychotherapy
Inpatient psychotherapy is reimbursed; prior approval is not required.
Fee schedule for inpatient services
Reimbursement is also made beyond the maximum rates of the Fee Schedule for Physicians (GOÄ).
Dental GSZ75
Dental treatment
Dental treatments are reimbursed at 100%, subject to the dental treatment scale.
Dental prostheses
Dental prostheses are reimbursed at 75%, subject to the dental treatment scale.
Inlays
Inlays are reimbursed at 75%, subject to the dental treatment scale.
Implants
Implants, including bone augmentation, are reimbursed at 75%, subject to the dental scale.
Orthodontics
Orthodontics is reimbursed at 75% up to the age of 21. The age limit does not apply in case of accidents or severe illnesses (insurer’s list).
Dental Services
– Dental treatments, including plastic fillings, root canal treatments, periodontal treatments, prophylaxis, and professional teeth cleaning, are reimbursed at 100%.
– Dental prostheses, including crowns, bridges, veneers, inlays, onlays, implants (including bone augmentation), functional analysis, and functional therapy, are reimbursed at 75%.
– Orthodontics is reimbursed at 75% up to the completed 21st year of age. The age limit does not apply in case of accidents or severe illnesses (insurer’s list).
– Material and laboratory costs are reimbursed at the percentage of the treatment.
– Bleaching is reimbursed at 100%, up to a maximum of 150 EUR within 2 calendar years.
– Pain relief through analgo-sedation (twilight sleep), nitrous oxide sedation, hypnosis, acupuncture, and anesthesia is reimbursed at the percentage of the treatment.
Dental Scale
The reimbursement for dental treatment, dental prostheses, and orthodontics is limited to a maximum of:
– 1,000 EUR in the 1st calendar year.
– 1,500 EUR in the 1st-2nd calendar year.
– 2,000 EUR in the 1st-3rd calendar year.
From the 4th year onwards, reimbursement is without dental scale limitation. In case of an accident, there is no limitation. A medical report does not lead to the waiver of the sum limitation.
Dental Fee Schedule
Reimbursement is also provided beyond the maximum rates of the fee schedule for dentists (GOZ) and doctors (GOÄ).
Treatment and Cost Plan
A treatment and cost plan is recommended for dental prostheses and orthodontics.
General Information GSP
Lump Sum Benefit
Guaranteed lump sum benefit for claim-free calendar years:
– 1 year: 10% of the premiums paid in the year of entitlement.
The prerequisite for the lump sum benefit is the absence of claims in the comprehensive health insurance. If participating in a prevention program of the insurer, lump sums for preventive examinations, vaccinations, and health courses are not counted towards the lump sum benefit.
Performance-Related Premium Refund (BRE)
Premium refund after claim-free years:
– 1 year: 1.8 monthly premiums (MP)
– 2 years: 2.4 MP
– 3 years: 3.0 MP
– 4 years: 3.6 MP
For children and adolescents up to the completed 21st year of age:
– 1 year: 4.2 MP
For mid-year starts, the BRE is paid proportionally. Full and immediately preceding claim-free calendar years with another insurer or statutory health insurance (GKV) are credited. Prerequisites for this are at least 12 months of previous insurance, claim-free status until the time of change for mid-year changes, and corresponding proof. The prerequisite for the premium refund is the absence of claims in all eligible tariffs. If preventive services or vaccinations are reimbursed, no premium refund is provided.
Cure, Rehabilitation, and Follow-up Treatment of GSP:
Inpatient Cure
Cures: Medical services, accommodation, meals, medication, remedies, cure resources, cure plan, and cure tax are reimbursed up to 1,500 EUR once within 36 months for outpatient and inpatient cures.
Other Rehabilitation Measures and Follow-up Treatments (AHB):
Medical services, accommodation, meals, medication, and remedies are reimbursed up to 1.5 times the rate that would have been reimbursed by the statutory health insurance, once within 36 months for outpatient and inpatient rehabilitation.
Benefits from a statutory provider must be claimed first. Prior approval is not required.
Outpatient Cure
Outpatient cure: Medical services, medication, remedies, cure resources, cure plan, and cure tax are reimbursed up to 1,500 EUR once within 36 months for outpatient and inpatient cures.
Other rehabilitation measures and follow-up treatments (AHB): Medical services, medication, remedies, consultation, and training are reimbursed up to 1.5 times the rate that would have been reimbursed by the statutory health insurance, once within 36 months for outpatient and inpatient rehabilitation.
Benefits from a statutory provider must be claimed first. Prior approval is not required.
Summary GSP:
As already mentioned, the GSP is a kind of “light” version of the GSB tariff. In fact, it doesn’t fall far behind the GSB in many aspects. When comparing the two tariffs, you’ll notice that they mainly differ in two categories: outpatient and wellness benefits. The most important differences are that the wellness budget for GSB is twice as high, the outpatient fee schedule for GSP is limited to 3.5 times the base rate, and with GSP, as with statutory insurance, there’s a co-payment of 10€ per prescription for medications. It’s worth considering whether you’re willing to potentially pay a little extra for some services in exchange for monthly savings. The costs for GSP, using our example of a healthy 35-year-old, are as follows:
Self-employed: 664.44€
-> With a claim-free year: 528.94€
Employees: 332.22€
-> With a claim-free year: 196.72€
Good to know:
As mentioned before, important aspects of the tariffs can still be modified.
The Deductible
There’s the GSUB 90, which sets the deductible at 10% with a maximum of 500€ per year. If you add GSUB 90 and GSUB 100, the deductible is reduced to 0%.
Dental Coverage
Of course, there’s the GSZ75, which we used for our example. Additionally, there are GSZ90 and GSZ100, which, as the names suggest, cover 90% and 100% for dental prostheses and increase the dental scale to 3000€ and 4000€ in the third year.
The Option Tariff
Option for full insurance with higher-quality coverage. This option is available three times on January 1st of a calendar year, starting from January 1st of the 4th calendar year.
Additionally, daily sickness benefits, daily hospital benefits, supplementary long-term care insurance, and a contribution relief tariff can be added.
My tip: Definitely take a look at the contribution relief tariff to lower your premiums in old age!
Conclusion:
The two new Allianz tariffs offer very good value for money. They’re also flexible, meaning you can add more benefits according to your budget and wishes. If you currently don’t have the budget but might in the future, add the option tariff to upgrade your benefits later. If you have any questions, feel free to use our chat function.
For more information on other tariffs, please visit our Blog
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