Percentage Reimbursement Tariff (Quotentarif)

Concept

A percentage reimbursement tariff is a health insurance tariff under which the insurer reimburses the medical treatment costs actually incurred not in full, but only up to a percentage agreed in advance, while the insured bears the remaining share themselves. The reimbursement percentage is fixed at policy inception and generally remains unchanged for the duration of the contract.

Typical Use Case

Percentage reimbursement tariffs are regularly used to supplement an existing basic coverage, for example where an employer or civil-service authority already covers a certain share of treatment costs under a subsidy scheme (Beihilfe), and the private health insurance policy merely closes the remaining coverage gap up to a specified percentage of total costs.

Distinction from Full-Cost Insurance

Unlike full-cost insurance, which reimburses all treatment costs incurred within the agreed terms, a percentage reimbursement tariff regularly results in a lower premium, since the insured bears part of the cost risk themselves; it is therefore particularly suitable for groups whose basic coverage already covers a significant share of costs and for whom full duplicate coverage would not be economically sensible.