Private health insurance aids are paid by your tariff, not by one national list. With an open catalogue, every medically necessary aid is reimbursed. With a closed catalogue, only the products named in the tariff are covered. The reimbursement rate and the maximum amounts also decide how much of an invoice stays with you.
Key points at a glance
- Open catalogue: Everything that is medically necessary is reimbursed. Closed catalogue: Only what is explicitly listed is reimbursed.
- The statutory health insurance aids directory does not bind private insurers. The exception is the basic tariff.
- Common reimbursement rates are 75, 90 or 100 percent, often with maximum amounts. The exact figures are in the tariff conditions.
- Privately insured people pay the invoice first and then submit it to the insurer.
What counts as an aid in private health insurance?
Aids are items that secure a treatment, prevent a disability or compensate for one. Typical examples are insoles, compression stockings, walking aids, CPAP devices, prostheses and hearing aids.
Private health insurance does not follow one uniform list. What it reimburses is set by your contract. The contract states the type of catalogue, the reimbursement rate, the maximum amounts and, where relevant, the deadlines for a replacement. Two tariffs from the same insurer can differ considerably here. Glasses and contact lenses also count as aids, but they follow their own rules, which are explained in the article PKV and glasses (in German).
What does an open catalogue mean for private health insurance aids?
An open catalogue reimburses every aid that is medically necessary. The tariff does not list them one by one. What matters is whether the aid is required in your specific case. The insurer usually asks for a medical certificate to prove this.
The advantage: New products that did not exist when the contract was signed can also be reimbursable. Reimbursement remains tied to the reimbursement rate and to any maximum amounts.
What is a closed aids catalogue?
With a closed catalogue, the tariff names the reimbursable aids individually. The insurer does not reimburse anything that is not on the list, even if your doctor considers it sensible. The same applies to products that come onto the market only after the contract was signed.
A closed catalogue is not automatically bad. If the list covers the aids you realistically need and the reimbursement rate fits, the tariff can be a good match. What matters is that you know the list before you sign.
Open catalogue, closed catalogue and statutory insurance compared
| Feature | Open catalogue (PKV) | Closed catalogue (PKV) | Statutory health insurance |
|---|---|---|---|
| Basic principle | All medically necessary aids | Only aids explicitly listed | Aids that are required in the individual case |
| Basis | Tariff conditions | Tariff conditions with a list | Act and aids directory of the GKV Federal Association |
| New products | Generally reimbursable when necessary | Only if they are on the list | Checked case by case |
| Your share | Difference to the reimbursement rate and the part above the maximum amount | Difference to the reimbursement rate, unlisted products in full | Co-payment, extra costs beyond what is necessary |
How is reimbursement calculated? An example
Example with assumed figures: Jonas, 24, is prescribed custom insoles (€120). His orthopaedist also recommends a therapy device for €300 that is not on any standard list. The total cost is €420. Tariff A has an open catalogue with 90 percent reimbursement and no maximum amount. Tariff B has a closed catalogue with 100 percent reimbursement, in which the insoles are listed but the therapy device is not. The figures are invented and only show how the type of catalogue and the reimbursement rate interact.
| Item | Cost | Tariff A (open, 90 percent) | Tariff B (closed, 100 percent) |
|---|---|---|---|
| Custom insoles | €120 | €108 reimbursed | €120 reimbursed |
| Therapy device | €300 | €270 reimbursed | €0 reimbursed |
| Total reimbursement | €420 | €378 | €120 |
| Your share | €42 | €300 |
Tariff B reimburses more for the insoles because its rate is higher. For the therapy device, the price of a closed catalogue becomes clear. How much this adds up to over the years depends on which aids you actually need.
What does statutory health insurance pay for aids?
Statutory health insurance pays for aids that are required in the individual case to secure a treatment, prevent a disability or compensate for one. You bear any extra costs beyond what is necessary yourself. From the age of 18, a co-payment applies, which is set by law. In private health insurance, the tariff determines your share. What counts is the reimbursement rate, the maximum amounts and, where applicable, a deductible. If you pay very high co-payments in a year, you can be exempted once you reach the exemption limit. The Verbraucherzentrale explains the rules.
Hearing aids and orthopaedic aids: what matters in the tariff
Hearing aids in private health insurance
Hearing aids are among the most expensive everyday aids. In private health insurance, the tariff decides how much is reimbursed. Check whether a maximum amount applies and how often a replacement is reimbursed.
Orthopaedic aids in private health insurance
Insoles, orthoses, bandages and walking aids are the most common orthopaedic aids. Check whether the tariff also reimburses custom-made items and higher-quality versions or only a standard supply. This is set out in the aids clause of the tariff conditions.
Reimbursement: how to submit your claim
There is no direct contractual relationship between the medical supply shop or doctor and the insurer. You pay the invoice and submit it. The deadline for submitting is three years from the end of the year in which the invoice was issued. For expensive aids, clarify cost coverage before you buy, so that there are no surprises.
What to check in the tariff conditions
- Type of catalogue: Is the aids catalogue open or closed, and where does this appear in the conditions?
- Reimbursement rate: Is it 75, 90 or 100 percent, and does it apply equally to all aids?
- Maximum amounts: Are there limits per aid, per year or per period?
- Replacement and repair: When does the tariff reimburse a new aid, and are repairs included?
- Proof: Which medical prescription or justification does the insurer require?
Compare at least two tariffs using these points, not only the monthly premium. For an overview of other benefits, see the PKV benefits for students at a glance (in German).
Frequently asked questions
What does an open aids catalogue mean?
The tariff reimburses every aid that is medically necessary, without naming them individually. What matters is the necessity in the individual case, usually proven by a doctor’s prescription. The reimbursement rate and maximum amounts of the tariff still apply.
Open or closed aids catalogue: which one suits me?
The open catalogue is more flexible, because it also covers new products as long as they are medically necessary. A closed catalogue can suit you if the list covers your realistic needs and the reimbursement rate is right. Compare the type of catalogue, the reimbursement rate and the maximum amounts together.
Does private health insurance pay for every aid?
No. What is reimbursed depends on the tariff. Even with an open catalogue, the aid must be medically necessary. Pure comfort products without medical necessity are generally not covered.
Does the statutory aids directory also apply in private health insurance?
No. The directory is maintained by the GKV Federal Association and does not bind private insurers. The exception is the basic tariff. In all other tariffs, the conditions of your contract apply.
What you should do now
- Look for the aids clause in the conditions of your tariff or of the tariff you are considering.
- Note the type of catalogue, the reimbursement rate and the maximum amounts, and compare at least two tariffs.
- Consider which aids you are likely to need in the coming years, for example insoles or a hearing aid.
- For expensive aids, clarify cost coverage before you buy, and keep the prescription and the invoice.
- Submit invoices within the deadline.
Related articles
- PKV benefits for students: the overview (in German)
- PKV and glasses: what private health insurance pays (in German)
- Vaccinations in private health insurance (in German)
- Studying at 30 and over: opportunities, financing and everyday life (in German)
Sources
- Gesetze im Internet: § 33 SGB V, aids (in German)
- GKV Federal Association: aids directory (in German)
- Verbraucherzentrale: co-payments and exemption (in German)
Information, not individual advice.
Editorial team: Academycon · Last updated: October 2026. This guide is general information, not individual advice. The German version is authoritative.
Want to go through your tariff? You can find the Academycon online check on our website.
