Are employees required to undergo a medical examination?

In traditional private supplemental health insurance plans, a medical underwriting process is standard—the insurer reviews pre-existing conditions and past treatments and, based on this information, decides whether to accept the applicant, impose a risk surcharge, or exclude them. In modern group supplemental health insurance plans, this underwriting process is eliminated in almost all cases.

Why the bKV does not require a medical exam

The insurer does not calculate the individual risk for each employee, but rather the collective risk of the entire workforce. Thanks to the minimum participation rate and group-based pricing, young, healthy employees and older employees or those with pre-existing conditions balance each other out statistically—individual selection is not necessary.

What requirements must be met

  • Insurer's minimum number of participants (typically 3 to 20 employees)
  • Primarily or entirely employer-funded
  • Enrollment within the defined enrollment window upon implementation or commencement of operations

When an examination is required

In a few situations, a health assessment—usually a simplified one—is used after all:

  • Very small groups (often fewer than 10 employees) at some insurance companies
  • Family members after the application window has closed
  • Joining after the individual onboarding window has closed
  • Very high rates, with annual budgets exceeding 2,000 euros at some providers

Privacy Policy

Important: Even if a simplified health declaration is required, the responses are sent exclusively to the insurer—not to the employer. At no time does the employer receive information about diagnoses, pre-existing conditions, or claims filed by individual employees.

Who benefits the most

For employees with chronic illnesses, mental health diagnoses, or a history of serious medical treatments, supplementary health insurance is often the only realistic way to access private healthcare services—they would frequently be denied coverage under individual private health insurance or face high risk surcharges.

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Related terms

Can family members be covered under the supplementary health insurance plan?
Yes, most supplemental health insurance plans offer a family option that covers spouses, domestic partners, and children. During the enrollment window (typically 3 to 12 months after the policy begins), coverage can be added without a medical exam. Depending on the plan, premiums for family members are paid by the employer, the employee, or shared between the two.
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What happens to your supplemental health insurance when you change jobs?
When employees leave the company, they can generally transfer their supplementary health insurance to an individual policy with the same insurer without undergoing a new medical examination. Their coverage remains in effect, and the employee is then responsible for paying the premium. The deadline for this transfer is typically 2 to 6 months after the contract ends.
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What is a company health insurance plan (bKV)?
Employer-sponsored health insurance (bKV) is a supplementary insurance plan funded by the employer for employees covered by statutory health insurance. It covers services that statutory health insurance (GKV) does not reimburse, or only reimburses to a limited extent—such as dental prosthetics, eyeglasses, alternative practitioners, or advanced preventive care. Up to 50 euros per month, it is exempt from taxes and social security contributions.
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