Information for International Professionals

How the Health App Works

As a Gothaer Health Insurance customer, you can use the Health App free:

• Download the App
• Register once
• Access services related to your health insurance and health

Download in Google Play Store

Download in Apple App Store

Gothaer Health App Registration

To use the Gothaer Health App, you need a digital user account with Gothaer. Register once in the app for a digital user account with your customer and contact information:

• First and last name (Vor- und Nachname)
• Insurance number (Versicherungsnummer - can be found, for example, on your insurance policy or insurance card number)
• Your date of birth (Geburtsdatum)
• E-mail address (will be your username)
• Mobile phone number

You will need to confirm your mobile phone number and e-mail address during the registration process via SMS code or con­fir­ma­tion email. If you do not send a confirmation, you will not be able to use the Gothaer Health App.

Once you have created a digital user account, you can simply log in to the Gothaer Health app with your username and password. In a final step, create a PIN to protect the data stored in the app (e.g. photographed receipts). This will be your login for the app in the future. You can easily replace it with fingerprint or facial recog­ni­tion.

How the invoice submission works:

How do private health insurers pay for medical services?

The billing of services is a matter between your doctor and you. This means that the medical invoice will be issued directly to you and must be paid within the specified time period.

The private health insurance com­pa­ny will reimburse you ac­cord­ing to the plan, considering the cho­sen deductible. To receive re­im­burse­ment, you have to sub­mit your medical bills, dental bills, prescriptions and estimates.

There are four ways to do this:

1. Gothaer Health App

Once you have downloaded the Gothaer Health App and reg­is­tered for your digital account, you can submit your invoices through the app. Use the "Meine Belege" app menu item to access this feature.

• Simply take a picture of your invoices.
• When taking a photo, make sure the invoice is within the app's designated frame.
• Use your finger to straighten the marked corners to correct any trapezoidal errors (Trapezfehler).
• If there is information on the back of the document (e.g. prescription), remember to photograph the back as well.

Our tipps for you:

• Smooth out any paper wrinkles before taking the photo.
• Make sure you have adequate lighting when taking photos.
• If possible, use the flash when taking photos.

For a video tutorial on how to submit invoices using the app, click here.

In the "Historie"(history) menu item, you will find an overview of the invoices that you have sub­mit­ted via app. As a pol­i­cy­hold­er, you will be able to view ad­di­tion­al information about your billed invoices, doctor visits, and treatments in your history after you activate your code*.

*The activation code mailed to you after you registered for your digital user account.

2. Online Portal "My Gothaer"

Another option for submitting invoices to Gothaer Health In­sur­ance is the online portal "My Gothaer" (Meine Gothaer). Here you can easily upload your in­voic­es via the mailbox and sub­mit them digitally.

To use the „My Gothaer” online portal, you need to have a digital user account with Gothaer

Sign up now

3. E-Mail

Alternatively, you can email your invoice to the following address: kv_leistung@gothaer.de. Please be sure to include your insurance number and the subject line "Rechnungseinreichung” (Invoice Submission).

4. Mail

You may also submit your invoices by mail. Please send them to the address below:

Gothaer Krankenversicherung AG
Kundenservice Leistung
50598 Köln

This is how online booking works with Doctolib:

• Open the Website
• Register once
• Search for a doctor or specialty
• Book an appointment
• Receive appointment confirmation

Our tip for you:

• Use the location feature to find doctors in your area.
• Change the "Public" filter to "Private".
• Use the "More Filters" button to select a spoken language preference and filter for a video consultation.

How TeleClinic works:

More than 100 general prac­ti­tion­ers and medical spe­cial­ist are available in Ger­many. You can also upload medical docu­ments, such as a photo of a rash, via TeleClinic to share with your doctor. According to modern standards, the data is encrypted several times.

When you contact TeleClinic, you will first speak to a TeleClinic medical assistant. They will take your request and select a suitable doctor. Please make sure you have your Gothaer Health In­sur­ance Number ready.

The use of TeleClinic is free for all insured persons of Gothaer Health Insurance. As with in-person con­sul­ta­tions, billing for services is between the doctor and you. If you have a private health insurance, the costs will be reimbursed within the limits of your plan, taking into account your chosen deductible.

Note: The TeleClinic website and registration are only available in German. The medical consultations are also available in English. You can indicate your language preference on the medical questionnaire when you request treatment.

Here is how it works:

• Download the app for free
• Unlock it with your Gothaer insurance number
• Create your personal nutrition profile for you and your family
• Scan the barcode (EAN code) of a product
• Receive a personal evaluation instantly

Overview of important insurance documents

The Insurance Policy (Versicherungsschein)
... is your guarantee that you are insured with Gothaer Health Insurance. The certificate contains important information about your coverage and serves as written proof of your insurance. Please check the insurance policy for accuracy and keep this document in a safe place.

The Employer's Contribution Certificate (Bescheinigung für den Arbeitgeberzuschuss)
... is enclosed if you are covered by private health insurance as an employee. Please submit the certificate to your Human Resources Department to receive your employer's contribution.

The Tax Certificate (Steuerbescheinigung)
.. indicates your contributions that are fully tax-deductible. Please also submit this to your human resources department so that you can claim the tax benefit directly. Are you self-employed? Use the certificate as proof for the tax office for advance income tax payments.

The General terms and conditions of insurance (Allgemeinen Versicherungsbedingungen - AVB)
... inform you about your plan and your rights and obligations under your policy.

The Insurance Product Information Sheet (Produktinformationsblatt) and the Consumer Information (Verbraucherinformationen)
... give you with a comprehensive overview of the most important information regarding your coverage.

The Insurance Card - Gothaer Card (Versicherungskarte)
... identifies you as a privately insured person at the hospital and guarantees the settlement of accommodation costs between the hospital and Gothaer.

Information about the deductible

What is a deductible?

The deductible (Selbstbeteiligung) is the amount that you, as the insured person, have to pay in the event of an insurance case. The health insurance company will cover any additional costs. The amount of the deductible is specified in the plan and is contractually agreed per person and per calendar year.

How does the deductible affect the cost of my plan?

A higher deductible has a positive effect on the monthly premium, i.e. the higher the deductible, the lower the monthly premium. In addition, as an insured person, you will be reimbursed for the costs you save by not claiming benefits in the form of a premium refund, which you can use to further, reduce your own costs.

More information about the premium refund

What is a premium refund?

If you have not claimed any benefits or have paid for minor medical expenses yourself, this will have a positive effect on administrative costs. As a result, the number of claims that are processed in a calendar year will be reduced. For many years, Gothaer Health Insurance has passed on the cost savings to their insured persons in the form of premium refunds (Beitragsrückerstattung).

We differentiate between performance-based and non-performance-based (guaranteed) premium refunds:

• The performance-based premium refund is a voluntary benefit provided by the health insurer. Each year, the Gothaer Health Insurance management board determines which plans receive a premium refund and the amount of the refund.
• The amount of the non-performance-related or guaranteed premium refund is a fixed benefit. If you meet certain requirements, you will receive a guaranteed premium refund.

When and how is the premium refund paid?

In August of the following year, you will be notified of the amount of your premium refund for the previous calendar year. A few days after this notification, the premium refund will be transferred to your account.

Do I need to apply for a premium refund?

You do not need to do anything at all. Each year, the Gothaer Health Insurance checks whether you have meet the conditions for a premium refund. If the conditions are met, the premium refund will automatically be credited to your account.

More information about the premium adjustment

With your private health insurance, you have chosen the best medical care, benefiting from medical advances and rapid access to medical specialists. The German health care system is one of the best and most advanced in the world.

Fortunately, constant advances in medicine (e.g., new drugs, improved therapies) are curing diseases and improving quality of life and life expectancy.

As a person with private health insurance, you can use the new methods at any time. You and your health will benefit greatly from this, as the costs will be covered to the extent agreed in your tariff.

Influence on the premium amount:

On the one hand, we guarantee you permanently unchanged insurance cover. On the other hand, we have to regularly check - as stipulated by law - whether the premiums are sufficient for the guaranteed insurance cover.

And that is precisely the point: insurance benefits are subject to the following influencing factors, among others:

• rising medical and nursing costs
• medical progress
• inflation and interest rates
• changes to the legal framework.

Even though we use actuarial knowledge and statistics to calculate premiums, no one can look into the future and predict how all the influencing factors described above will affect premiums in the future.

What is untouchable is the level of coverage you have with us. You can rest assured that we will continue to deliver on our service promise. This is especially true in light of the fact that in the past, the public health insurance system has reduced benefits while increasing contributions. This will also be possible in the future.

Important: We try to limit contribution increases every year and use considerable financial resources for this purpose.