All pre-existing conditions in the last 5 years are subject to insurance cover in the first two years of insurance.
Closed. If consultations, examinations, operations are not advised or carried out during the first two years of insurance, they are co-insured from the third year of insurance. Chronic diseases that have already existed at the time of application are permanently excluded.
Morgen Price’s health insurance is an annual contract that automatically extends for another year. Termination must be in writing at least one month before the end of the contract. Before the end of the insurance year, the customer receives the new contribution calculation and insurance conditions. It is then possible to change the tariff, the payment method and the deductible. Only when the “new” insurance contribution is received in full (after contribution adjustment) does it exist
insurer’s obligation to provide benefits.
Insurance cover can be extended to worldwide coverage, with and without USA and Asia exclusions: Health insurance / European health insurance (EU-KV) The EU/EEA health insurance only reimburses benefits if the contributions were paid by the customer according to the insurance certificate according to the insurance certificate and there are no arrears. If there is a backlog of contributions, there is no entitlement to benefits and the insurer can withdraw from insurance cover without giving reasons. The insurer will not inform the customer if his contract is in arrears and does not ask the customer to pay the outstanding contributions. The policyholder is responsible for this himself. In the event of non-payment, the contract automatically expires without further information from the insurer. As long as there is no receipt of money with the insurer, the insurance cover cannot be reactivated. If an insured event occurs during the period of non-payment, the policyholder must pay for the insured independently and the subsequent illnesses that may result from this at his own expense. The insurer is exempt from the obligation to pay.
- Medical bills are available according to max. 6 months. The reimbursement of the invoice is only carried out together with the reimbursement form (Claim Form), otherwise there is no entitlement to insurance benefits.
- Inpatient hospitalizations must be notified to the insurer within 48 hours, otherwise only 75 reimbursements.
- In the outpatient/inpatient and dental area, only the costs in the respective country are covered, which are not unnecessary, medically inappropriate or above the usual, normal and reasonable rate of the respective country.
- If the insurer is prohibited by law, or if he decides not to continue this type of insurance, the policyholder will be required to do so. 120 days before its next annual renewal date.
- The place of jurisdiction is the seat of the EEA/EU insurer.
- Pregnancy benefits: Pregnancy benefits are limited depending on society and tariff. Costs for preventive care, prenatal measures, birth and aftercare may not be covered by 100.
- The annual limit for outpatient/stationary/tooth in the respective tariff of the company is urgently observed, here there may be benefit restrictions and costs must be covered privately, as they are not covered by the maximum limits by the insurer.
- addictions (e.g. alcohol withdrawal) and their consequences; Accidents and illnesses caused or caused by alcohol and/or drug influence will not be refunded.
- Depending on the company’s tariff: renal failure and its consequences (e.g. outpatient dialysis); Body replacements in the form of external prostheses are max. 2,500 euros, all other body replacements are not paid by the insurer.
- eating/sleeping and behavioural disorders and their consequences (e.g. anorexia, sleep apnea and psychological treatments);
- HIV diseases (except through blood transfusion);
- Manual therapy, occupational therapy and speech therapy, med. Sports massages;
- extreme sports (e.g. martial arts, motorsport, skydiving);
- Accidents in professional and amateur sport, if the sport is a credit or a profession. The resulting illnesses will not be reimbursed;
- No performance entitlement is assumed for the following leisure activities, e.g. equestrian sports; Weightlifting; Hunting and shooting; Motorcycling (over 1000 cc), quad biking and kitesurfing;
- Dental area: 6 months waiting period, 10 additional payments per invoice, no benefit for gum disease/gingivitis and its consequences (e.g. periodontitis); the insurer’s list of material costs;
- Mobile aids (e.g. wheelchairs) are reimbursed up to 1,000/1,500/2,000 euros per year, depending on the tariff.
- Maximum annual reimbursement, such as physiotherapy or naturopathic services
- Exclusions of benefits: Please note the general terms and conditions (General Insurance Conditions) of the insurer in order to find out about deadlines and exclusions!
All MP contracts have a waiting period of 6 months (benefits only in case of accident or serious illness). Medical bills are available according to max. 6 months; The invoice is reimbursed exclusively via a separate cost
Refund form, otherwise a refund cannot be guaranteed. Inpatient hospitalizations must be notified to the insurer within 48 hours, otherwise only 75 reimbursements. In the outpatient/inpatient and dental area, only the costs in the respective country are covered, which are not unnecessary, medically inappropriate or above the usual normal
and reasonable rate of the respective country. Depending on the tariff, health insurance provides at least in the European economic sector. This European economic sector includes:
Germany. Morgan Price provides full german statutory or private health insurance in the event of illness. The customer was informed that the European health insurance does not meet the German insurance obligation and that it does not replace German statutory or private full health insurance.
Option right Reintegration German KV:
We currently offer our customers the option of existing framework contracts with German health insurance companies (PKV/GKV) for reintegration into the German health insurance system. The conditions for this are that the contributions to health insurance and private long-term care insurance are payable for at least paid for one year without late payment. Thereafter, a return to the German health insurance system is possible even without penalty contributions under certain conditions.
Private long-term care insurance
According to insurance conditions, the insurer provides compulsory care insurance in all five levels of care in the outpatient and inpatient areas, even without any advance payment of compulsory care insurance. This is explained in the insurer’s insurance conditions. Without classification of compulsory care insurance, the insurer would determine the need for care via the medical service of private health and long-term care insurance (Medicproof GmbH). The cost of determining whether a nursing classification exists must be borne by the customer. The long-term care insurance taken out is a basic insurance. The private long-term care insurance does not automatically completely close the care gaps in the case of need for care in the outpatient and inpatient areas, but, depending on the amount of the desired daily care allowance, only secures a part of the resulting care allowance. care costs.
Dental component -PERFORMANCE FEATURES
Dental treatment, prophylaxis / PZR: 75, observe the dental relay; 75 for general prophylaxis and prof. tooth cleaning. Dentures, inlays, implants: dentures 50, inlays 75, implants 50, incl. Bone structure; for all: Observe the tooth squadron. Orthodontics: 50 or according to possible GKV performance, 50 of the remaining costs (KIG 1-5), observe the dental squadron. Dental squadron: reimbursement for dental treatment, dentures and orthodontics max. EUR 1,000 in the 1st year; Max. EUR 2,000 in total in the 1. to 2nd year; Max. EUR 3,000 in total in the 1st to 3rd year; Max. EUR 4,000 in total in the 1. to 4th year; from the 5th year without dental squadron limit.
Fee order tooth: Without limit.
Healing and cost plan: No, does not have to be submitted. Duration of contract: At least 2 years, maximum admission age 64 years. Termination date: With a period of 3 months at the end of a calendar year. World standing: Yes, up to 2 months.