In today’s world, it’s more important than ever to choose the right health insurance to optimally protect your health.
Ottonova, a pioneer in digital insurance, specializes in offering you
innovative and uncomplicated solutions. Here we focus on the ottonova BC100 plan. In this
text, we will illuminate the most important contents and advantages of ottonova BC100 in detail, to provide you with a
well-founded basis for decision-making. We will discuss the various service areas, the
flexibility, and the unique features of this plan to give you a comprehensive overview.
Outpatient treatments: Health without compromises with the ottonova BC100 plan
Outpatient medical treatments are fully reimbursed. Even methods proven in practice that do not
belong to conventional medicine are co-insured up to the amount of conventional medical treatment costs. If
no conventional medical method is available, the private health insurance even covers methods that are not
recognized by conventional medicine
Prevention: Preventive care for all age groups
Outpatient preventive examinations according to legally introduced programs, including glaucoma prevention,
are reimbursed without age limits. These preventive services are independent of any deductible, which
means you can take advantage of these important examinations without additional costs.
Medicines and dressings: Comprehensive care
Medicines and dressings are also reimbursed by the private health insurance, including artificial nutrition. This ensures comprehensive care for illnesses and injuries.
Therapeutic aids: Wide spectrum for your recovery
Therapeutic aids are reimbursed up to 120% of the maximum rates of the Federal Aid Ordinance. These include:
- Inhalations
- Physiotherapy
- Massages
- Packs
- Hydrotherapy
- Medical baths
- Cold and heat treatments
- Electrotherapy
- Light therapy
- Occupational therapy
- Speech therapy
- Podiatry
- Osteopathy
- Nutritional therapy
- Childbirth preparation course
- Pregnancy gymnastics
- Postnatal gymnastics
For osteopathy and alternative practitioners, there is a reimbursement of up to 1,000 EUR per insurance year.
Medical aids: Support in everyday life
An open medical aids catalog ensures that medical aids are 100% reimbursed if they cost a maximum of 500 EUR or are obtained through the insurer or are obtained for initial care after an accident. Otherwise, 75% of the costs are covered. This includes bandages, insoles, prostheses, dialysis machines, and guide dogs.
Visual aids: Clear vision for the future
For visual aids such as eyeglass frames, lenses, and contact lenses, up to 300 EUR are reimbursed within 2 insurance years.
For surgical vision corrections, including laser/LASIK, the private health insurance reimburses a maximum of 500 EUR in the first 24 months and up to 1,000 EUR from the 25th month.
Alternative practitioners and naturopathic treatments: Alternative healing methods
The private health insurance reimburses 100% of the costs for treatments by alternative practitioners (except for psychotherapy) according to GebüH or Hufeland directory.
This includes prescribed medications, dressings, therapeutic aids, and medical aids. Up to a maximum amount of 1,000 EUR per insurance year, osteopathic treatments are also reimbursed.
Psychotherapy: Professional support
For outpatient psychotherapy, 90% of the costs for the first 25 sessions are covered, then 75%.
A prior approval is required. Without approval, up to five trial sessions are reimbursed.
Fee schedule for outpatient care: Transparent billing
Billing is done 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 services: Quality care for hospital stays
In addition to the extensive outpatient services, your private health insurance also offers comprehensive inpatient services that ensure you receive the best possible care in case of a hospital stay.
Here are the essential contents available to you in this plan.
Inpatient Accommodation: Comfort and Privacy
Your well-being is a priority. That’s why your private health insurance offers:
- Double room: Enjoy the comfort of a room you’ll share with at most one other patient.
- Private doctor treatment: You have the option of chief physician treatment if desired.
- Inpatient psychotherapy: This is reimbursed without prior approval, except in mixed institutions.
- Services in private clinics: Tip: Get treatment and cost plan approved in advance.
Services in German hospitals that are not subject to the Hospital Remuneration Act (KHEntgG) or the
Federal Nursing Rate Ordinance (BPflV) are also reimbursed. The reimbursement for general
hospital services is limited to a maximum of 1.5 times the costs that would have been incurred in a hospital
subject to KHEntgG or BPflV.
Substitute Hospital Daily Allowance: Financial Flexibility
If you want to forgo certain services, ottonova offers a substitute hospital daily allowance:
20 EUR for foregoing a double room.
60 EUR for foregoing private doctor treatment.
Children and adolescents receive the same substitute hospital daily allowance.
Fee Schedule for Inpatient Care: Upper Middle Class
Billing is done according to the following rates of the Fee Schedule for Physicians (GOÄ):
Up to 5 times the standard rate for medical services.
Up to 2.5 times the standard rate for technical services.
Up to 1.3 times the standard rate for laboratory services.
Mixed Institutions and Transport Costs
Inpatient treatment in mixed institutions is also covered. Additionally, BC100 covers transport costs:
Transport to and from the hospital.
Trips to and from the hospital up to 100 km. Beyond that, to the nearest suitable clinic.
Outpatient Surgeries and Pre-/Post-Inpatient Treatment
Outpatient surgeries are fully reimbursed, allowing you a quick return to your normal routine.
Pre-/post-inpatient treatment: Outpatient admission and discharge treatments are also covered, supporting your return to full health.
Accompanying Persons for Children's Hospital Stays
For children’s inpatient stays, the stay of an accompanying person is reimbursed. This ensures that your child is emotionally and practically supported during the hospital stay.
Hospice Services: Dignified Support at the End of Life
Your private health insurance also offers comprehensive hospice services:
Inpatient or semi-inpatient hospice care: These costs are fully reimbursed if they
can be billed according to the remuneration agreements with the PKV Association or the expenses of the
statutory health insurance (GKV).
Dental Treatment: Comprehensive Protection for Your Teeth
Dental Prosthetics: High-Quality Solutions for Missing Teeth
Dental treatment is reimbursed at 100% and includes:
- Plastic fillings
- Root canal treatments
- Periodontal treatments
- Prophylaxis
For dental prosthetics (such as crowns, bridges, veneers, inlays, onlays, implants including bone augmentation, functional analysis and functional therapy), costs are covered at 80%. If you choose a cooperation partner of the insurer, the reimbursement increases to 90%.
Inlays: Perfect Aesthetics and Function
Inlays are also reimbursed at 80%, or 90% if treated by cooperation partners. Before the age of 15, these costs are fully covered.
Implants: Long-Term Solutions
Implants are reimbursed at 80%, or 90% if you choose a cooperation partner. This reimbursement also includes necessary measures such as bone augmentation.
Orthodontics: Straight Teeth for All Ages
Orthodontic treatments are reimbursed at 80%. If you choose a cooperation partner, the reimbursement increases to 90%.
Up to the age of 21, upon successful completion of treatment, even 100% of the costs are reimbursed.
Professional Teeth Cleaning: Prevention Pays Off
Professional teeth cleaning is reimbursed twice per insurance year at 100% up to an amount of 125 EUR per treatment.
If you choose a cooperation partner, the limit is removed, and costs are fully covered.
Material and Laboratory Costs: Full Transparency
Material and laboratory costs are reimbursed according to the percentage of the respective treatment measure.
Dental scale: Limits in the first years
In the first five years, there is reimbursement for dental prosthetics and orthodontics according to the following scale:
- 500 EUR in the 1st-12th month
- 1,000 EUR in the 1st-24th month
- 2,000 EUR in the 1st-36th month
- 4,000 EUR in the 1st-48th month
From the fifth year onwards, this limitation is completely removed. In the case of an accident, there is no limitation through this
dental scale. A medical report does not lead to a waiver of the sum limitation.
Fee schedule for dental services: Fair billing
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Billing is done up to the maximum rates of the fee schedule for dentists (GOZ) or the fee schedule for doctors (GOÄ):
- Up to 3.5 times the GOZ rate for dental services.
- Up to 2.5 times the GOÄ rate for technical services.
- Up to 1.3 times the GOÄ rate for laboratory services.
Treatment and cost plan: Plan your expenses
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 benefits: Your comprehensive protection with private health insurance
Your private health insurance not only covers you in the areas of outpatient, inpatient and dental treatments, but also offers a variety of general benefits that provide you with comprehensive protection and comfort.
The following details these general benefits.
Deductible: Cost control for your healthcare
Your deductible is 10%, but no more than 500 EUR per insurance year. This rule also applies to children and adolescents.
In the first calendar year, the deductible is calculated proportionally per month. Preventive services are independent of the deductible and are fully reimbursed.
Performance-related premium refund: Contribution without refund
A premium refund (BRE) is not paid.
Enter your heading for worldwide coverage: Protection abroad too
Your private health insurance offers worldwide insurance coverage for temporary stays (max. 6 months) abroad. If return travel would endanger health due to inpatient treatment, this period is extended. For longer stays outside the European Union or the European Economic Area, the contract is continued under special conditions.
Repatriation and accompaniment: Support even abroad
- Repatriation: Additional costs for repatriation to a suitable location in Germany are covered if the insurer is commissioned with the organization and the repatriation is medically necessary or the inpatient stay abroad is expected to last longer than 14 days.
- Travel costs for accompanying persons: The travel costs of an accompanying person for children up to the age of 18 are reimbursed if the insurer is commissioned with the organization. This also applies to the return journey of co-insured children.
- Rescue: The costs of rescue are reimbursed up to 2,500 EUR per insured event.
- Repatriation of mortal remains: The repatriation costs are covered up to 10,000 EUR.
Additional services abroad: Basic coverage without extras
There are no special foreign services and no option for higher-quality protection. You have no simplified tariff change right, and children cannot be insured alone.
Childbirth and parental allowance: Additional support
For childbirth, in addition to cost reimbursement, a childbirth allowance of 400 EUR is paid, regardless of the deductible.
A premium exemption for newborns is provided for the month of birth and the next three months.
Spa and rehabilitation services: Support on the path to recovery
Inpatient spa and follow-up treatment (AHB): The costs of AHB that begins within 4 weeks after inpatient acute treatment are covered. For other rehabilitation measures, cures, and sanatorium treatments, a maximum of 5,000 EUR is reimbursed within 10 insurance years for outpatient and inpatient measures. Benefits from a statutory provider must be used first. Prior approval is not required but is recommended.
Outpatient Rehab and Follow-up Treatment: Similar to inpatient measures, the costs of follow-up treatment that begins within 4 weeks after inpatient acute treatment are covered. The same conditions and reimbursement limits apply for other outpatient rehabilitation measures and treatments
Insurance Card: Simple Processing
The company issues you an insurance card that facilitates your access to medical services.
Conclusion
In summary, the ottonova BC100 plan can be classified in the upper mid-range category. The plan is particularly aimed at people who are looking for an innovative and digital insurer. Ottonova focuses on modern technologies and customer-centricity to offer you an uncomplicated and efficient insurance experience. If you value digital solutions, you should take a closer look at the ottonova BC100 plan.
If you are interested in other plans, please feel free to check out our Blog.
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