Our Expat health insurance covers new medical conditions that begin after your policy start date, subject to waiting periods. It does not cover pre-existing conditions. Basic Cover and Premium Cover both include outpatient, inpatient, and hospital treatment. Premium Cover adds higher limits and extra benefits, such as routine pregnancy care, dental check-ups, and dentures, after a 6-month waiting period. This article compares the 2 plans for each benefit area and lists what is not covered.
What medical treatment does Expat health insurance cover?
Expat health insurance covers new medical conditions whose symptoms first begin after your policy start date, subject to the applicable waiting periods. Pre-existing conditions are not covered. You can still take out Expat health insurance if you have one, but you pay out of pocket for care related to it. Basic Cover and Premium Cover both include the following:
Outpatient appointments with registered doctors are covered. This includes general practitioners (Hausarzt) and specialists such as cardiologists and endocrinologists.
Inpatient and outpatient hospital treatment is covered.
Medications prescribed by a doctor registered in the EU or Schengen Area are covered.
Surgeries and surgical dressings are covered.
Ambulance transport is covered only when it leads to inpatient admission and relates to an accident or a new condition.
Medically necessary repatriation and the repatriation of mortal remains are covered.
Radiation therapy and light therapy are covered.
Telemedicine consultations with MD Medicus are included. Basic Cover gives 1 free consultation per year without a copay, and Premium Cover gives 2.
Routine check-ups, preventive screenings, and vaccinations are covered under separate rules. Our article on routine check-ups, preventive care, and vaccinations under Expat health insurance describes them.
What dental treatment does Expat health insurance cover?
Expat health insurance covers dental treatment only for a new condition that begins after your policy start date. Coverage differs by plan:
Basic Cover pays up to €500 per year for pain-relieving dental treatment, such as fillings or denture repairs.
Premium Cover pays up to €1,000 per year for pain-relieving dental treatment.
After 6 months on the plan, Premium Cover also pays up to €200 per year for dental check-ups.
After 6 months on the plan, Premium Cover also pays up to €100 per year for dental cleanings.
After 6 months on the plan, Premium Cover also pays for dentures at 80%, up to €1,250 per year.
What physiotherapy and medical aids does Expat health insurance cover?
Expat health insurance covers physiotherapy only if all 3 of these conditions are met:
You have a referral from a doctor.
The physiotherapy relates to a new medical condition.
An accredited physiotherapist gives the treatment.
Chiropractors and osteopaths count as alternative providers and are not covered.
Physiotherapy limits
Basic Cover pays up to €300 per year for physiotherapy.
Premium Cover covers physiotherapy with no annual limit.
Medical aids and equipment
Basic Cover pays for therapeutic aids only when they are needed after an accident, up to €500 per year. Basic Cover has no general coverage for aids or equipment.
Premium Cover pays for medically necessary aids and equipment up to €500 per year, with prior approval.
Premium Cover pays for repairs to existing aids up to €250 per year.
Premium Cover pays up to €200 for visual aids, such as glasses or contact lenses, after your vision changes by 0.5 diopters or more.
What pregnancy and maternity care does Expat health insurance cover?
Expat health insurance covers pregnancy care only if the pregnancy begins after your policy start date. Coverage differs by plan:
Basic Cover pays for treatment of unexpected pregnancy complications, medically necessary abortion, and premature birth up to the 36th week. Basic Cover does not pay for routine pregnancy check-ups or delivery.
Premium Cover pays for pregnancy check-ups and delivery after a 6-month waiting period.
Here’s an example of the Premium Cover waiting period. You become pregnant 3 months after your policy starts. You then wait 3 more months until the 6-month waiting period ends. After that, you can claim for check-ups and the delivery.
Neither plan covers post-natal care or additional midwife services.
Where does Expat health insurance cover me when I travel?
Expat health insurance covers the same medical treatment when you travel as it does at home. That applies in the following places:
The European Union and the Schengen Area
Andorra, Monaco, San Marino, and Vatican City
The United Kingdom is excluded. Each trip can last up to 90 days, and there’s no limit on the number of trips per year.
After 12 months on the policy, you’re also covered for up to 6 weeks of travel per year to your home country. Your home country is the country where you last lived, as you declared at sign-up. You get the same level of coverage there.
Are sports accidents covered by Expat health insurance?
Expat health insurance covers accidents that happen while you practice a sport as a hobby. The same terms apply as for any other accident, and this includes mountain sports and winter sports, such as skiing and snowboarding.
Outpatient and inpatient treatment after a sports accident is covered. Ambulance transport and air lifting after the accident follow the rule for all ambulance transport: they’re covered only if they lead to an admission and an inpatient stay.
Accidents from practicing a sport professionally are not covered. Professional athletes cannot take out Expat health insurance.
What is not covered by Expat health insurance?
Neither Basic Cover nor Premium Cover pays for the following:
Conditions that existed or were known before your policy start date (pre-existing conditions) are not covered.
Preventive and prophylactic treatments are not covered unless they’re explicitly listed as covered.
General vaccinations are not covered, including vaccinations given during the U1–U9 child check-ups. The only exceptions are the travel and COVID vaccinations that Premium Cover includes.
Psychoanalytical and psychotherapeutic treatments are not covered.
Vitamins and nutritional supplements are not covered, even when a doctor prescribes them.
Treatment for addictive disorders is not covered.
Ambulance transport is not covered if it doesn’t result in inpatient hospital admission or if it relates to a pre-existing condition.
Allied-health, holistic, and alternative treatments are not covered, except medically prescribed physiotherapy. This includes chiropractic treatment, osteopathy, occupational therapy, podiatry (medical foot care), dietetics and nutritional counseling, speech therapy, acupuncture, traditional Chinese medicine, and naturopathy.
Self-harm and self-inflicted injuries are not covered.
Fertility and sterility treatments are not covered.
Medical certificates that aren’t medically necessary are not covered. Examples are sick notes, medical check-ups for your visa, and medical clearance for sports.
Accidents from practicing a sport professionally are not covered.