PKV For non-payers only emergency care

Non-payer tariff for private health insurance?

10/03/2012

Private health insurance companies (PKV) have been thinking about introducing an extra tariff for insured persons who are not paying their contributions. According to media reports for defaulting contributors only the costs of medical emergencies are taken over.

By the non-payer, the private health insurance claims to have already incurred a damage in the amount of 550 million euros. In order to limit this, according to the plans of the private insurers, a non-tariff is apparently introduced, which covers exclusively the supply of emergencies.

Only provided for medical emergencies?
On Wednesday in the health committee of the Bundestag an expert meeting took place, in which the private health insurance association, according to media reports, also discussed the introduction of a non-tariff rate. Accordingly, the defaulting contributors are to be accommodated in an extra tariff, which provides for a contribution of 100 euros per month only the supply of medical emergencies. On demand from „VIP News“ a spokesman for the PKV Association did not confirm these conversation details, but said that here „ongoing negotiations between the Health Ministry, the Ministry of Justice and our representatives“ occur. Also make the PKV Association no secret from the fact that in view of the nearly 144,000 defaulting contributors and the associated burden of 550 million euros, will be looking for alternatives in dealing with the non-payers. „We have to find a way how to deal with non-payers“, said the spokesman for the private health insurance association „VIP News“. Non-payers are those insured persons who have not paid their contributions for three months or more in 2011.

Extra PKV tariff planned for non-payers
Under the then Minister of Health Ulla Schmidt (SPD), the general compulsory insurance was introduced in 2009. Since then, private health insurance companies can no longer simply terminate their membership if they do not pay their contributions. Instead, the accommodation is provided in a so-called base rate. This is aligned to the benefits of the statutory health insurance (SHI), but may be associated with contributions up to the maximum contribution of the statutory health insurance. For the affected insured often also a non-affordable burden, so that the „PKV companies regularly write off this sum and from aging provisions“ The spokesperson of the PKV Association told „VIP News“. However, it remains „only a few insured permanent non-payer“, why a financial relief is also in the interest of defaulting contributors, said the association spokesman on. In this way, the outstanding amounts would remain manageable and those affected would have a real chance to reduce their debt on resumption of payments.

Critics see homemade problem
In addition, the restriction of insurance benefits to medical emergencies is generally permitted by the legislature, but it is necessary to look closely at the definition of the emergency. For example, there are good ones „Experience from the Asylum Seekers Benefits Act“, so the position of the PKV Association. Although the concern of the private insurance companies to introduce a non-tariff rate from a financial point of view quite understand, but critics see a home-made problem of private health insurance. For especially in the private health insurance companies, which have lured their customers massively with cheap deals, are today recorded significant contribution losses. Also, many private insured simply can not afford the annual contribution increases. The introduction of a non-tariff rate would also lead to the fact that almost 150,000 people will suddenly be supplied only in case of medical emergencies, so the criticism of the position of private health insurance.

Non-payers also at the GKV a problem
The problem of non-payers is increasingly in the statutory health insurance, so the statement of a speaker from the scientific institute of the AOK (WIdO) in the expert discussion in the health committee. Here, a damage of around one billion euros arose in the past year, with the GKV, in contrast to PKV in the cover, however, have no difficulties. The solidarity system would automatically compensate for the failures. By contrast, in the case of private health insurance, the loss of contributions must not be allocated to other insured persons, so that company funds must be used for compensation. Perhaps also an explanation for the special commitment of the private insurance companies in the search for alternatives in dealing with the defaulting contributors. (Fp)

Also read:
Health insurance: Non-payers cause losses
Private patients flee to the health insurance
Health insurance: additional contributions come again
Complaints about increase in PKV contributions
Health insurance: What will change in 2012?
Private health insurance may terminate

Picture credits: Ronny Richert