New special rules for PKV change

Change to private health insurance was facilitated by special regulations

15/01/2011

Since the beginning of the year, a switch to private health insurance has been significantly simplified. A change does not always make sense, since the costs of a private health insurance can quickly maximize.

Changing conditions significantly simplified
The change to private health insurance (PHI) has been significantly simplified for employees and civil servants as part of health care reform. Instead of the three-year period now applies the one-year period in which a worker must earn at least 49,500 euros a year in order to switch from the statutory health insurance to private health insurance. But health economists warn who has once left the system of statutory health insurance, which is almost invariably denied the way back. For this reason, a change in advance should be considered carefully.

Special regulation accelerate change
So that the PKV can be taken even faster, the black-yellow coalition even created a special regulation. Anyone earning at least 4125 euros gross at the end of the year in December 2010 can change even faster and does not have to wait another year. The coalition's special purpose gel is intended to bring membership gains to private insurers as quickly as possible. This means in plain language that those affected can initiate an immediate change without having to wait another year.

Consumer advocates: A change in the PKV should be well considered
But before this change takes place, consumers should inform themselves accurately. Although privately insured persons benefit from numerous privileges such as preferential treatment with GPs and specialists, however, the PKV does not know many insurance benefits that are anchored in the statutory health insurance funds. The consumer centers in Germany, for example, advise themselves to think in advance about exactly what their own way of life will look like in the future. One example is the free family insurance in the GKV. While statutory children and unemployed partners are covered by health insurance for free, family members must be individually insured with a health check and their own health insurance policy. This circumstance could quickly maximize costs and may be higher than legal ones. However, there are also private health services that the GKV does not know. For example, costly dental prostheses are paid in full by PKV (depending on the tariff). Private insured persons can also benefit from claiming health services such as homeopathy and naturopathy treatments. It should be noted that it always depends on the fare selection. Because PKV works like a so-called „modular“. Depending on which services you would like to have in the future, the private health insurance tariffs can also be designed. Consumers should be careful to choose only the really important benefits, because the more benefits are chosen, the higher the later insurance contributions.

Some can save costs through the PKV
Anyone who has paid the maximum rate of the statutory health insurance, can save a few hundred euros a month by changing. Because so-called entry-level tariffs usually begin with a monthly contribution of around 150 euros. These tariffs are particularly suitable for young and healthy people, because the tariffs have a high deductible portion. But the tariffs are not tied to their own wage development, so that people earning more money. It should be noted that also the tariffs of private health insurance are not fixed for all eternity, but due to the general price increases in the health system and due to the age of the insured continue to rise. Private health insurance is also affected by societal demographic change, which is driving up the cost of health services. While the statutory health insurance funds receive numerous grants from the federal government, private health insurance companies, as an economically oriented company, have to cope with the cost increases themselves. In the opinion of some experts, this could potentially lead to enormous problems. However, representatives of private health insurance themselves point to the growing problem and are already rethinking new strategies.

Inform independently
So before actually taking advantage of the new exchange option, you should be fully informed and given independent advice. Correspondingly free consultations offer for example the consumer centers. It is best if you visit the consumer advocates with a previously obtained PKV offer and go through tariff options and contract terms. In most cases, an appointment must be made in advance. (Sb)

Also read:
Separation of private health insurance and GKV a discontinued model?
Private health insurance: that changes
The health care reform comes into force
Contributions of the private health insurance rise

Image: Barbara Eckholdt