Many people think that a policy covers absolutely everything. But there is a list of exceptions that are important to know about before taking out insurance to avoid unpleasant surprises.
What does DKV health insurance NOT cover?
1️⃣ Illnesses, injuries, or health conditions that already existed before the policy was issued are not covered.
What does this mean? If a client has a medical condition, we note this in the health declaration when the policy is issued. After that, the insurance company's risk department makes a decision:
– or not cover anything related to this disease at all,
– or partially cover (e.g. consultations), but not procedures or surgeries.
2️⃣ Consequences of acts of violence, epidemics, disasters, as well as nuclear or radioactive incidents.
3️⃣ Injuries and illnesses related to professional sports or extreme activities.
4️⃣Aesthetic surgery and any procedures for cosmetic purposes.
5️⃣Reproductive medicine (artificial insemination, insemination, etc.) - not included in the standard package. Covered only in the DKV Mundisalud policy (under certain conditions).
5️⃣ Methods that are not officially recognized and have no scientific basis (in particular, RedETS in Spain).
6️⃣Medical care for chronic alcoholism, drug addiction,
as well as in cases of injuries sustained while under the influence of alcohol or drugs.
7️⃣ Treatment in clinics that are not part of the DKV network
— in the standard package (DKV Integral or Selección) such treatment is not covered.
8️⃣ Medications are not covered by standard policies.
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However!
The DKV Mundisalud (Reembolso) policy, in addition to coverage at any clinic, also includes reimbursement of the cost of medications (up to 50% up to €100 per year), as well as vaccinations up to €150 per year.
Importantly: The specific list of exceptions depends on the type of policy.
Always check the terms before signing the contract.
If you are unsure whether your situation will be covered, it is best to clarify this before using the service.
Want to know more? For details about the cost and terms of insurance, please contact me directly — I will be happy to answer all your questions! 💌