Detailed list of benefits

Here you will find a detailed list of benefits provided by EDUCARE24.

• Health insurance
• Liability insurance
• Accident insurance
• Deportation costs insurance

Health insurance benefits

Insurance cover – where medically necessary – is provided for:

• Outpatient medical treatment. To see which benefits are reimbursable, see the fee schedules (valid for Germany) described below.
• Inpatient medical treatment including operations for the general care level without optional services. Expenses for separately billable treatment by an attending physician equivalent to outpatient medical treatment are reimbursable according to the fee schedules (valid for Germany) described below.
• Medically necessary rehabilitation measures (subsequent to a previous medical treatment).
• Medically prescribed medicine and dressing material.
• Medically prescribed remedies up to a maximum of €250 during the entire insurance period.
• Medically prescribed medical appliances that become necessary due to an accident and provide help for the medical treatment of the consequences of an accident.
• Examination and treatment due to pregnancy and childbirth, if the pregnancy was conceived after the start of insurance coverage.
• Treatment of mental illness (also inpatient) except psychoanalysis, psychotherapy and hypnosis. In case of an acute psychological or mental disorder the latterly mentioned benefits shall also be covered for one case during the whole insurance period up to a maximum of €500.
• Dental treatment for pain relief. To see which benefits are reimbursable, see the fee schedules (valid for Germany) described below. Within the policy EDUCARE24 S and EDUCARE24 M, benefits for dental treatment are limited to €500 during the entire insurance period.
• Simple repair of existing dentures up to an amount of €200 (products EDUCARE24 L and XL).
• Dentures due to an accident up to an amount of €2,000 (products EDUCARE24 L and XL).
• Medically necessary transport of patients for purposes of inpatient treatment and treatment by an emergency physician.
• Medically necessary and prescribed return transport of an ill insured person from abroad to his/her home country, if the type of illness and its seriousness would require more than 14 days of inpatient treatment.
• Repatriation of an insured person’s remains to his/her home country or funeral expenses in Germany up to €30,000.
• Only for EDUCARE24 XL: Preventive medical examinations (for example at the dentist and gynaecologist) under statutory schemes, adult and child health examinations under statutory schemes, vaccinations (e.g. tetanus). The total benefit is limited to a total of € 500 per insurance year.

You will find a full description of benefits and benefit exclusions in the General Insurance Conditions (German).

Physician and Dentist Fee Schedules

The following benefits are reimbursable: expenses for outpatient medical and dental treatment up to the following rate of either the Physician Fee Schedule (GOÄ) or Dentist Fee Schedule (GOZ) valid in Germany.

• The following benefits are reimbursable: expenses for outpatient medical and dental treatment up to 2,3 times the rate of either the Physician Fee Schedule (GOÄ)–in case of benefits pursuant to paragraphs A, E or O of the GOÄ up to 1,8 times the rate, in case of benefits pursuant to paragraph M and number 437 of the GOÄ up to 1,15 times the rate – and up tp 2,3 times the rate of the GOZ.

Important advice with regard to tuberculosis in foreign visitors!

Throughout the past years, there has been a sharp increase in tuberculosis, in particular in eastern European states. Please make sure, in the public interest, to undergo a tuberculosis test (X-ray or or intradermal test/Mendel-Mantoux test) prior to your entry into Germany. This test should not be older than three months. It protects you from the risk of a pre-existing infection.

Apart from the health risk, you otherwise also take a high financial risk since no pre-existing medical conditions (prior to entering Germany), including tuberculosis, are covered by the insurance policy.

Benefits based on prior agreement or approval

In some cases, a medical costs projection is a necessary precondition for a 100% reimbursement of the reimbursable treatment expenses. You must provide us with a medical costs projection prior to the planned treatment in the following cases:

Outpatient treatment:

• diagnostic radiology methods that exceed the scope of conventional X-ray diagnostics (such as computed tomography, magnetic resonance imaging and scintigraphy as well as Gastroscopy and colonoscopy);
• allergy tests.

Dental treatment:

• treatment of more than two teeth during the insurance period;
• periodontal treatment;
• treatments with an estimated cost range of more than €250.

Without our written approval of the medical costs projection, the reimbursement of the above named benefits is limited to 50% of the reimbursable costs.

Liability insurance benefits

EDUCARE24 M, L and XL include full personal liability insurance. In addition to bodily injury and property damage, the policy also covers damage to rented property. Damage to rented property is damage that is caused to a rented apartment. It has become popular with landlords to demand that such damage is covered.

Personal liability insurance coverage only applies if the insured person is not sufficiently covered by other insurance policies (subsidiary coverage). Damage caused by the use of a motor vehicle is not insured. This includes both personal injury and damage to property.

Sums insured in liability insurance

You will find a full description of benefits and benefit exclusions in the Liability Insurance Conditions (German).

Accident insurance benefits

EDUCARE24 provides the following accident insurance benefits:

Sums insured in accident insurance

You will find a full description of benefits and benefit exclusions in the Accident Insurance Conditions (German).

Deportation costs insurance benefits

In case of an officially ordered deportation of the visitor, the insurance policy covers the incurring costs up to €4,000 if claims are made against the host.

Deportation costs policy also provides coverage after the expiration of insurance if the visitor, against all expectations, has not left the Federal Republic of Germany.