BKK Health Professions What insured people should pay attention to

Closure of the BKK for Health Professions: What insured persons should pay attention to

08/11/2011

The company health insurance BKK for health professionals will be closed at the end of the year. According to the cash register, the insured persons were already informed about the closure by means of a membership circular. Those affected must now look for a new health insurance. Here, some not insignificant aspects should be considered.

This year, the second health insurance now closes its doors due to insufficient funds and a bankruptcy before. Until recently, the board of BKK for health professionals had sought a solvent fusion partner. The Federal Insurance Office (BVA) had promised the fund a continued operation only in the event of a merger. Since all attempts failed in this direction, an end of the operating license was no longer averted. Scenarios such as after the closure of City BKK should not be repeated, according to the Federal Ministry of Health and the Kassenverbände. Individual health insurance companies such as the AOK or the DAK have already announced that they will be accepting former health insurance fund members of the BKK without any problems. However, insured persons should carefully check their health insurance promises before changing them.

If a health insurance fund closes, insured persons must look for a new health insurance provider. According to the current legal situation, all POS providers must accept new members as well as their co-insured partners or children. An examination of the state of health as with the private health insurance is prohibited. However, as the City closed BKK in the summer, individual funds still tried to get rid of membership applications on the phone. In doing so, they often resorted to flimsy and unlawful arguments. For example, the cash register was said „xyz“ do not have certain therapies in their repertoire or supposedly do not take them completely. If such a conversation can be proven, the cash register faces severe fines. From the first of January, the Ministry of Health intends to punish such illegal practice with up to 50,000 euros. Also, the Federal Insurance Office has announced any violation in this direction „all available resources“ to sanction. Some health insurance funds as well as the Federal association of the legal health insurance companies (GKV) have asserted that such a situation will not occur again as in the times of the City BKK. It remains to be seen, however, whether lip service will actually work in practice. Who still on the phone „abgewimmelt“ should complain directly to the Federal Insurance Office. In such a case, it is important to note down the name of the employee, the time, the day and the content of the conversation.

Insured people have to look for a new health insurance fund
As of 31 December 2011, the BKK closes for health professionals. By January 14, 2012, all former members must have received a confirmation of admission from the new health insurance. Those who can not independently take care of a new admission will be looking for a new health insurance because there is a legal obligation to take out health insurance in Germany. The employer, the job center or the pension insurance institution orients itself to the pre-insurance (§ 175 para. 3 sentence 2 SGB V). If no pre-insurance can be determined, any other health insurance will be chosen. This measure should ensure that there are no insurance downtime. Those affected should not let the scepter out of their hands and seek a new health insurance as independently as possible. Until the day of closure, all current health care will be paid until the change from the BKK for health professionals.

Unlike in the free market, all claims and liabilities of the BKK for health professionals must be made to providers (such as doctors, clinics, pharmacies) until closure. This means that insurance cover exists until a bill of exchange has been made. In principle, the following applies: If health services were provided, the contractual partners would also be reimbursed. This also applies to all settlements after the closure. For the costs is the community of health insurance companies.

The health insurance companies are currently trying to brighten their image in the public positively. Many cash desk managers emphasize a smooth process. As the spokeswoman for the BKK Federal Association Christine Richter told the consumer portal „test“: „For us it goes without saying that the insured members of the BKK are welcome for health care professions at the other company health insurance funds!“ Similar comments were heard from the chairman of the board of the AOK Bundesverband as well as the association of the Ersatzkassen. Richter urged the affected members of the cash register to seek a new fund as soon as possible, so that the transition can proceed without any problems.

Health insurance selection should be made wisely
With the health insurance selection BKK-Heilberufe members should pay particular attention to the service, additional offers such as premiums and additional contributions. Only in these points mentioned the cash registers differ. It should be noted that 133 of the 156 health insurance company currently require no additional contribution from their insured. Some of them, such as BKK Gesundheit, DAK and BKK Axel Springer, want to forego the additional premium that is currently levied from the second quarter of 2012 following a completed merger. However, it is still unclear whether the announcement is realistic because the BVA has not yet given its approval. A concrete decision is expected in January. Admittedly, the DAK already advertises with the argument that the cash register is soon „Additional contribution free“, however, DAK can only issue this with a guarantee if the supervisory authority has given its full consent. Who still emerged in the new „DAK health“ should note that there is no special right to cancel, if the additional contribution as announced but not abolished. Then it's eighteen months to wait for the regular right of termination to take effect. Currently, the DAK requires in addition to the regular contributions an additional contribution of eight euros per month. It is also unclear what the newly merged DAK Health will do for additional services. Again, the BVA has yet to agree.

Additional contribution, service and bonuses
The additional contribution should not be the sole criterion for the choice of the new fund. Although about 95 percent of the health services of the providers are the same, because these are laid down in the catalog of benefits, but there are differences in service, premiums and additional offers. Special additional benefits include bonus programs, patient training, diet courses, offers for the chronically ill or optional fares. (Sb)

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Picture: Pauline