AXA Health Insurance's bKV: Plans, Benefits, and Costs

AXA Health Insurance organizes its employer-sponsored offerings into three rate structures, each reflecting different access models and pricing logic. FlexMed easy Plus and FlexMed easy Premium are budget-based plans: The employer sets a budget level between 300 and 1,500 euros per year, resulting in five plan options per structure. In addition, FlexMed Privat Premium is a compact plan with two options that defines benefits as a flat rate rather than through a freely selectable budget. In total, twelve plan options—including combinations of coverage modules—are available, allowing companies to tailor coverage to their budget and workforce size.

Within the budget plans, the selected tier also represents the maximum reimbursement amount for the plan’s outpatient services. Once this limit is reached during the current insurance year, no further reimbursement will be provided, regardless of which specific service caused it. Within this framework, additional sublimits apply to certain types of services, such as treatments by alternative practitioners—including medications prescribed by them—as well as vision aids. Depending on the plan, an advance payment from statutory health insurance is also required before AXA Health Insurance covers the costs exceeding that amount—for outpatient care, it primarily covers the difference between the statutory health insurance reimbursement and the full invoice amount rather than reimbursing the full invoice amount.

For inpatient care, the insurer reimburses the remaining eligible costs for medically necessary treatments in hospitals that bill according to statutory fee schedules, after the statutory health insurance has made an advance payment; optional services in the hospital vary depending on the plan. For dental care, professional teeth cleaning is included in all plans, while teeth whitening depends on the selected plan. The range of benefits is supplemented by digital services: A video consultation with a physician is available as an included service without being counted toward the budget and can also be used by co-insured family members; in addition, there is a service for scheduling appointments with specialists, a medical hotline, and the option to obtain a second medical opinion.

It is important for employers to note that the minimum number of employees varies depending on the plan: FlexMed easy Premium is available for companies with as few as five employees, while FlexMed easy Plus and FlexMed Privat Premium require a minimum of ten employees. The agreed-upon premiums are guaranteed through January 1, 2027. Group insurance policies typically do not require medical underwriting for individual employees; for newborns, coverage even takes effect without risk surcharges or a waiting period, provided that one parent has been insured for at least three months at the time of birth and the enrollment is submitted retroactively no later than two months after the birth.

Family members—spouses, children, and persons legally equivalent to them—may be included in the coverage, provided that the respective framework agreement allows for this and they themselves are either members of or covered under family coverage in the statutory health insurance system. The insured person’s coverage automatically ends at the end of the month as soon as a requirement for eligibility is no longer met; the employer or the insured person entitled to benefits must notify the insurer of such a change immediately. The specific terms that apply upon leaving the company vary depending on the selected plan.

Thanks to its tiered pricing structure and the option to enroll with as few as five employees, AXA Health Insurance’s plan is suitable for both smaller businesses and companies that wish to move up to higher price tiers as their workforce grows. Externally, AXA Health Insurance’s group health insurance plan was rated “Very Good” (4 out of 5) by Morgen & Morgen in 2025 and “Excellent” by the IVFP in 2024, which supports its classification as a solidly structured group insurance offering.

• FlexMed easy Plus (Budget Plan): Budget tiers 300 / 600 / 900 / 1,200 / 1,500 EUR/year · 5 plan options · for companies with 10 or more employees
• FlexMed easy Premium (Budget Plan): Budget tiers 300 / 600 / 900 / 1,200 / 1,500 EUR/year · 5 plan options · for businesses with 5 or more employees
• FlexMed Private Premium (Compact Plan) · 2 plan options · for companies with 10 or more employees

• Preventive screenings: covered differently depending on the plan
• Alternative practitioners: regulations vary depending on the insurance plan
• Alternative Medicine: Regulations Vary Depending on the Plan
• Medications and medical supplies: covered differently depending on the plan
• Medications: Regulations vary depending on the plan
• Assistive devices: Regulations vary depending on the plan
• Vaccinations: included depending on the plan
• Travel vaccinations: included depending on the plan
• Vision aids: with a sub-limit within the health care budget
• Professional teeth cleaning: included
• Teeth Whitening: Included depending on the plan
• Daily Hospitalization Benefit: Rules Vary by Plan
• Optional services in hospitals: regulations vary depending on the plan
• Digital Health Services: Video Consultations (Yes, “Online Doctor” (medical video consultation) as an included service with no out-of-pocket cost, also available to family members; provider name not officially listed; Yes, “Online Doctor” (medical video consultation) as an included service, also available to family members; provider name not officially listed) · Specialist Appointment Service · Medical Hotline · Second Medical Opinion
• Budget Carryover: No, maximum reimbursement amount per insurance year; no carryover
• Upon leaving the company: regulations vary depending on the collective bargaining agreement
• Services for Family Members: Regulations Vary Depending on the Plan
• Family Coverage: Rules Vary Depending on the Plan

Premiums for AXA Health Insurance’s supplementary health insurance (bKV) are primarily based on the selected budget level: With FlexMed easy Plus and FlexMed easy Premium, the employer selects a level between 300 and 1,500 euros per year, which also defines the maximum reimbursement amount for the insured person’s outpatient services. The higher the budget level, the more extensive the potential reimbursement—and, as a rule, the higher the premium.

The outpatient services defined in the respective plan are charged against this budget, although individual types of services may also have their own sublimits, such as for vision aids or treatments by alternative practitioners. If the maximum reimbursement amount is exhausted within an insurance year, reimbursement for the relevant services ceases until the start of the next insurance year.

Unused budget funds expire at the end of the year: There is expressly no provision for carrying them over to the following year, as the maximum reimbursement amount is reset annually. In addition, the agreed-upon contributions are guaranteed through January 1, 2027, which provides employers with planning certainty regarding additional personnel costs over this period.

• Morgen & Morgen: Very Good (4/5) · 2025 — Rating
• IVFP: Excellent · 2024 — Rating