Health insurance withdraws from eligibility

Electoral tariffs before the end: The Techniker health insurance sets the TK private practice tariff at the end of the year.

(24.08.2010) The Techniker Krankenkasse (TK) is the first of the statutory health insurance companies to introduce one of their optional tariffs. At the end of 2010, the tariff will run for 7,000 insured „TK-private practice“ which was originally intended to help acquire new customers or keep top earners.

The elective rate „TK-private practice“ offered the insured the opportunity to bill their doctor's visits in much the same way as private patients and thereby enjoy any advantages for the doctors. The insured people paid their bills for the time being and then received the funds paid by the Techniker Krankenkasse, whereby a maximum of 3.5 times the simple rates of the fee schedule could be charged. With the introduction of electoral tariffs for the statutory health insurance companies in 2007, the legislation wanted to provide the statutory health insurance funds with an additional means to compete with private insurance companies. However, it has also been decided that they have to pay themselves financially. However, since the statutory insurance companies can not make a similar selection of their customers, such as private health insurance, d. H. The sometimes very attractive optional tariff is accessible to everyone, sometimes incurring considerable costs, which can not be covered by the tariff alone.

The private health insurance (PKV), which saw itself in the course of the introduction of electoral tariffs, a significantly increased pressure from competition by the statutory health insurance companies, the attitude of the electoral tariffs is very accommodating. "The failure of the 'private patient' election tariff of the Techniker Krankenkasse shows that such optional tariffs are a foreign body in the statutory health insurance," said the director of the Association of Private Health Insurance, Volker Leienbach. He further stated that "Electoral and supplementary tariffs (...) in a state-subsidized social insurance have nothing to look for“ and „According to him, the system could not work because the statutory insurance may not demand risk-commensurate premiums from its policyholders.

However, the fact that the competition between private and public health insurance companies is developing even more in favor of the private sector is problematic for the healthcare system as a whole. For anyway, more and more well-off insured leave the public health insurance in the direction of private health insurance. Thus, the idea of ​​solidarity, which is the basis of the health system, practically overridden, as the „strong shoulders“ who should bear a large part of the burden in the statutory insurance system, increasingly turn their backs on this. In addition, the Federal Government's efforts to facilitate the change between statutory and private insurance as well as the general abolishment of electoral tariffs have already weakened the statutory health insurance funds.

In the case of the existing optional tariffs, models with a premium refund have so far been of particular interest to insured persons. Insured persons receive up to a maximum of one monthly contribution here if they do not go to the doctor for a full year or pay their own bills there. "The insured here has no financial risk, because he pays for no higher contribution and the fund carries in case of illness, the costs," said the financial expert of the consumer center North Rhine-Westphalia, Kai bird. However, the model becomes problematic when seriously ill patients forego the visit to the doctor to get a monthly contribution at the end of the year. (Fp)

Also read:
Chefarztbehandlung only possible with PKV?
Health insurance additional contributions also in 2011
Health insurance companies criticize restriction Wahltarife
Around 1 million refuse additional contribution