New Additional Benefits Effective August 15, 2026: Higher Dental Coverage, Sports Medicine with No Cap, New Preventive Care

Key Points at a Glance

• On August 15, 2026, the 61st amendment to our bylaws will take effect. It modifies our additional benefits in § 12, Paragraph VIII, and primary prevention in § 12a.
• The budget for dental services is increasing to €150 per calendar year. We reimburse up to €100 per treatment.
• Going forward, we will reimburse 100% of the cost of a sports medicine examination once per calendar year. The previous cap of €250 has been eliminated.
• You may bring any support person with you to the childbirth preparation class. The restriction to the husband no longer applies.
• An additional fee of up to €300 applies for on-call services provided by a midwife. Combined with the pregnancy budget, this can total up to €600.
• New developments in preventive healthcare: early detection of testicular cancer and early detection of vitamin D deficiency.
• The subsidy for alternative medicine products is increasing from €130 to €150 per year.

What’s Changing and When

Our Board of Directors approved the 61st amendment on July 16, 2026. The Federal Social Security Office approved it on August 6, 2026. The legal basis is Section 195(1) of Book V of the Social Code (SGB V) in conjunction with Section 90(1) of Book IV of the Social Code (SGB IV).

The amendment will take effect on August 15, 2026.

Additional benefits are benefits provided under the bylaws. We offer them voluntarily and in addition to the legally mandated benefits. This is precisely where health insurance plans actually differ from one another—not just in terms of the additional premium.

An Overview of All Budgets

Dental budget: €150 per year, €100 per treatment

The dental coverage limit will be €150 per calendar year per insured person. We will reimburse a maximum of €100 per treatment.

This is how the two amounts are related

The €100 is a maximum amount per treatment. It does not limit the number of treatments.

You can submit claims for multiple treatments until the annual budget is exhausted. For example, five treatments at €30 each add up to the full €150. Another option is one treatment costing €100 and another costing €50.

These nine services are eligible for reimbursement

In a nutshell: A DVT (digital volume tomography) is a 3D X-ray of the jaw. A smooth-surface sealant is a protective coating applied to the smooth surfaces of the teeth. Caries infiltration treats early-stage cavities without drilling.

The front tooth retainer has its own requirements

A retainer keeps the front teeth in place after orthodontic treatment. We will reimburse the cost only under the following conditions:

• Orthodontic treatment has been successfully completed.
• At the start of treatment, they had not yet turned 18.
• You are insured with us at the time the retainer is fitted.
• The retainer shall be issued no later than twelve months after the date of issuance of the final confirmation.

Repairs are included.

Pregnancy Budget

The biggest changes are to the pregnancy budget. Going forward, you’ll be free to choose your birth companion, and up to €300 will be added for on-call midwife services.

Five screening tests—only for those at increased risk of infection

In the future, the tests will be listed individually in the bylaws. All of them involve an increased risk of infection:

This entitlement is intended to prevent any risk to the child’s healthy development. It also applies if a deterioration in your health is likely to lead to an illness.

The examination must be conducted in accordance with quality assurance standards. The service provider must either be part of the network of physicians under contract or be authorized under Section 13(4) of SGB V.

Childbirth Preparation Class: Any support person is welcome

Previously, we only reimbursed the course fee for the accompanying person if that person was the spouse and was also insured with us. Both of these requirements have been eliminated. Going forward, you are free to choose your own accompanying person.

One condition remains: The midwife must be authorized to provide services under Section 13(4) of SGB V or Section 134a(2) of SGB V.

Submit the certificate of participation and the itemized invoice from the midwife. “Itemized” means that the invoice lists each service and amount separately.

Midwife On-Call Service: Up to an Additional 300 €

For items a–f of the Pregnancy Budget, a maximum amount of 300 € per pregnancy applies.

In addition, we contribute up to €300 toward the on-call services of a midwife during weeks 30 through 42 of pregnancy. This brings the total contribution to up to €600.

In this case as well, the midwife must be authorized to provide the service. Please submit the itemized invoice.

How to Get Your Refund

A fixed application deadline applies to all additional benefits under Section 12, Paragraph VIII. As of August 15, the bylaws for the pregnancy budget now explicitly stipulate what happens when the deadline expires.

Please submit your receipts to us by March 31 of the following calendar year. This applies to every budget—for dental care as well as for preventive medical care. We cannot accept receipts submitted after this date.

So be sure to start collecting your receipts during your pregnancy. That way, you’ll have everything ready by the end of the year.

For the Pregnancy Budget, this provision has been explicitly included in the bylaws since August 15. If reimbursement is not requested on time, the entitlement expires. The deadline itself remains unchanged—it was in effect previously, and it applies to all budgets.

Sports medicine examination: 100% reimbursement

Until now, we have reimbursed a maximum of 250 € for sports medicine examinations. This cap has been removed.

Going forward, we will reimburse 100% of the invoice amount on a calendar-year basis. To do so, we require a doctor’s note and an itemized invoice.

Two requirements remain: The examination must take place before you begin participating in sports. And it must be conducted by a doctor with a specialty in “sports medicine.” Be sure to ask about this at the doctor’s office in advance.

Another requirement is the presence of at least one of the following eight risk factors:

• excess weight
• high blood pressure
• pre-existing cardiovascular conditions
• Respiratory Diseases
• Pre-existing skeletal conditions, such as scoliosis
• Diabetes
• Smoking
• Alcohol Abuse

Budget for Alternative Medicine

The subsidy for homeopathic, herbal, and anthroposophic medicines will increase from €130 to €150 per year.

The reimbursement for osteopathy remains unchanged at €360 per year.

Preventive Health Care: Two New Screenings

Starting August 15, we will also cover the cost of early detection of testicular cancer via ultrasound and early detection of vitamin D deficiency.

As a result, preventive medical care under Section 23 of SGB V now includes nine services:

1. Annual skin cancer screening, including reflected-light microscopy, provided that the patient is not eligible for standard care coverage during the calendar year
2. Glaucoma Screening for People with Risk Factors
3. Mammography before the age of 50, or a manual examination performed by qualified blind or visually impaired examiners
4. Breast Ultrasound for Patients with Risk Factors
5. Health Checkup Before Turning 35 If Risk Factors Are Present
6. Bone density testing starting at age 55 in cases of justified suspicion of osteoporosis—no more than once a year, with a repeat test no sooner than two years later, requiring a doctor’s prescription and only if there is no entitlement under standard coverage
7. Colorectal Cancer Screening for Individuals with a Family History or Genetic Predisposition
8. Early Detection of Testicular Cancer (Ultrasound)
9. Early Detection of Vitamin D Deficiency

These terms and conditions apply to all nine services:

• You are at least 18 years old.
• There are already risk factors—such as a family history—that indicate a decline in health or an impending illness. The entitlement applies even if this helps prevent the worsening of an existing condition.
• The examination is performed by a physician enrolled in the statutory health insurance system—or by a physician authorized under Section 13(4) of SGB V.

You are free to choose which of these nine services you would like to use. A total of €50 per insured person per calendar year is available for preventive medical care.

Additional Protective Equipment: Ear Protection for Children and Adolescents

Starting August 15, we will reimburse the cost of custom-fit earplugs for swimming. These are custom-made earplugs that prevent water from entering the ear canal.

• for insured persons up to age 18
• up to 50 € per ear
• Prerequisite: You have a tympanostomy tube, that is, a small tube in your eardrum
• Buy ear protection from a hearing aid specialist

The coverage for hypoallergenic mattress, pillow, and blanket covers remains unchanged. All insured individuals are eligible for this coverage once every ten years, provided it is medically necessary and prescribed by a doctor.

To receive a refund, please submit the itemized invoice.

Primary Prevention under Section 12a

In the future, the areas of action will be aligned with the Prevention Guidelines:

• Physical Activity Habits – Reducing Sedentary Behavior, Preventing Risks Through Targeted Exercise Programs
• Nutrition – Preventing and Reducing Excess Weight, Preventing Nutritional Deficiencies and Malnutrition
• Stress and Resource Management – Promoting Multimodal Programs, Relaxation, and Recovery
• Substance Use – Promoting Smoking Cessation, Low-Risk Alcohol Use

You can take our in-house health classes at no cost to you.

We will reimburse the full cost of courses offered by third-party providers if they meet the statutory quality criteria. The maximum amount is €600 per calendar year. Please submit your certificate of attendance to receive reimbursement.

Also new: Your right to receive information about your benefits

With the 60th amendment to the bylaws, we are adding a new Section 18 to the bylaws.

You may request information from us regarding which services you have used and how much they cost. Upon request, you will also receive information about approved service providers, as well as services that can be prescribed and where to obtain them. This is based on Section 305 of SGB V.

We will provide the information verbally or in writing. There is no cost to you.

The 60th Supplement was published on August 6, 2026. It takes effect the following day, August 7, 2026—and thus before the benefit changes in the 61st Supplement.

What documents you need to submit

How to Submit Your Receipts

You have several options to choose from:

• Online Office (OGS) – Upload your documents directly in your personal account
• Email – Please send us your receipts as scans or photos
• Post – BKK WIRTSCHAFT & FINANZEN, Bahnhofstraße 19, 34212 Melsungen

If you have any questions about a specific service, please contact us through your personal contact person.

Legal Basis and Status

The reimbursements listed here are benefits provided under the bylaws (additional benefits pursuant to Section 12, Paragraph VIII of our bylaws). We provide them voluntarily and in addition to the statutory benefits.

The benefit information provided under the new Section 18 is not an additional service. It implements the statutory right to information under Section 305 of SGB V as set forth in our bylaws.

Our Board of Directors approved both amendments on July 16, 2026. The Federal Social Security Office approved both on August 6, 2026, in accordance with Section 195(1) of Book V of the Social Code (SGB V) in conjunction with Section 90(1) of Book IV of the Social Code (SGB IV).

All amounts are current as of August 15, 2026, and are subject to change due to subsequent amendments to the bylaws.

This article provides information about benefit entitlements. It is not a substitute for medical advice, diagnosis, or treatment. If you have any health-related questions, please consult your doctor.