bKV from SDK Süddeutsche Krankenversicherung: Plans, Benefits & Costs

The supplementary health insurance (bKV) plan offered by Süddeutsche Krankenversicherung is structured as a budget model and consists of two separate coverage plans: AmbulantBudget for outpatient care and ZahnBudget for dental services. Both plans can be purchased independently of one another in three budget tiers of 500, 1,000, or 1,500 euros per year, allowing employers to tailor coverage to the budget available per employee. A total of six plan options are available, offering varying levels of coverage depending on the selected combination of AmbulantBudget and ZahnBudget.

In the outpatient sector, services such as treatments by alternative practitioners, naturopathic therapies, osteopathy, medications, bandages, medical devices, and assistive devices, as well as vaccinations, are reimbursed from the respective annual budget. Naturopathic therapies provided by a physician or alternative practitioner are covered at 100 percent, with the exception of psychotherapy. A sublimit applies to vision aids within the health budget, meaning that only a limited portion of the total budget is available for this purpose. Advance payment by the statutory health insurance provider is not required for reimbursement; the services are paid directly from the module’s budget.

For dental care, the ZahnBudget plan covers, among other things, professional teeth cleaning and preventive checkups, including preventive care courses. Optional hospital services are covered differently depending on the selected plan; a daily hospital allowance is not included in the coverage. The insurance coverage is supplemented by digital health services: Through the provider Medgate, insured individuals have access to video consultations for digital doctor’s visits via app or video, including private prescriptions and sick leave certificates, as well as direct billing between SDK and Medgate, which is free of charge for bKV policyholders. In addition, there is a specialist appointment service and a medical hotline.

From an organizational standpoint, this plan is available to companies with five or more employees. A medical examination is not required for enrollment, and there are no waiting periods under the outpatient plan, meaning that coverage is available from the start of the contract. This makes it relatively straightforward to set up the bKV for the workforce without an individual risk assessment.

Family coverage and the continuation of coverage upon leaving the company are governed by the specific plan, meaning that the exact terms depend on the plan option selected within AmbulantBudget or ZahnBudget.

Thanks to the clear distinction between the outpatient module and the dental module—each with three scalable budget tiers—this plan is particularly well-suited for companies that wish to introduce flexible, easy-to-administer basic coverage without a medical exam and want to tailor the scope of benefits specifically to outpatient care, dental care, or both. The IVFP rating system classified this plan as “excellent,” while Morgen & Morgen rated it as “average.”

• AmbulantBudget (AB1O/AB2O/AB3O) (Budget Plan): Budget tiers 500 / 1,000 / 1,500 EUR/year · 3 plan options · for organizations with 5 or more employees
• ZahnBudget (ZB1O/ZB2O/ZB3O) (Budget Plan): Budget tiers: 500 / 1,000 / 1,500 EUR/year · 3 plan options · for companies with 5 or more employees

• Screening exams: Yes, including prevention courses
• Alternative practitioners: Yes (within the budget)
• Alternative Medicine: Yes, 100% (physician/alternative practitioner, excluding psychotherapy)
• Osteopathy: included
• Medicines and medical supplies: Yes
• Remedy: Yes
• Resources: Yes
• Vaccinations: included
• Vision aids: with a sub-limit within the health care budget
• Professional teeth cleaning: included
• Daily Hospitalization Benefit: No
• Optional services in hospitals: regulations vary depending on the plan
• Digital Health Services: Video Consultations (Yes, Medgate—digital doctor visits via app/video, private prescriptions, and sick leave certificates; direct billing through SDK–Medgate (free for those with supplementary health insurance)) · Specialist Appointment Service · Medical Hotline
• Budget carryover: No, maximum reimbursement amount per person per calendar year; no carryover
• Upon leaving the company: regulations vary depending on the collective bargaining agreement
• Family Coverage: Rules Vary Depending on the Plan

The premium for the supplementary health insurance (bKV) offered by Süddeutsche Krankenversicherung is based on the selected budget level under the AmbulantBudget and ZahnBudget plans, each of which is available in levels of 500, 1,000, or 1,500 euros per year. Since both plans can be selected independently of one another, the total premium is calculated based on the combination of the two selected budget levels.

The annual health care budget serves as the maximum reimbursement amount per insured person per calendar year. Within this limit, the benefits covered under the respective plan are reimbursed, although an additional sublimit within the overall budget applies to certain items, such as vision aids.

Unused amounts expire at the end of the year: There is no provision for carrying over unused budget to the following year. Employers and employees should therefore set the budget amount to match expected needs, as any excess budget cannot be saved.

• Morgen & Morgen: Average (3/5) · 2025 — Rating
• IVFP: Excellent · 2024 — Rating