PKV and children change should be well considered

PKV and children: Parents who want to switch to private health insurance in the future should pay attention to important aspects. A change from statutory health insurance to private health insurance can quickly turn into a cost trap.

(28.10.2010) Anyone planning or raising children should consider carefully whether switching to private health insurance makes sense. For in private health insurance, children must be individually insured. Family insurance does not know PKV, in contrast to the statutory health insurance.

Young, dynamic and successful: this is often the starting point for many people if they want to switch to private health insurance. Because health insurance PKV lure, especially in young, healthy people with low contributions - much lower than the statutory health insurance (SHI). Due to the health care reform of the federal government, it will be much easier for employees from 2011 to switch from statutory health insurance to private health insurance. Instead of the three-year regulation now enters the „One-year scheme“ in force. This means that employees only need to earn gross gross premiums of € 49,500 once in order to switch jobs. The Association of Private Health Insurance estimates that around 16,000 workers will be able to change jobs next year. Still one shows oneself with the PKV less optimistic, immediately one hopes of course on new policyholders.

Change in the PKV should be well considered
But the step should be well considered. Because ultimately it depends on how you plan your own life situation. Whether or not a change really pays off depends on whether you have children of your own, for whom you have to pay or if you are planning a family for the future. It is also crucial whether the spouse is working or not. While non-working spouses and children are automatically insured in the statutory health insurance, private health insurance for children and spouses must be provided separately. Separate insurance policies must be taken out for each individual child and for the partner.

A partner in the GKV, a partner in the PKV: Can the child be insured for a family??
If both couples work and one parent is insured by the statutory health insurance, it gets even more complicated. Many now assume that the parent who is in the GKV can also insure the children. However, this only works if the GKV insured earns less than the parent who is insured in private health insurance. That is likely to apply only in the rarest cases. An exception applies only to unmarried couples. If a parent changes into the private health insurance, children can be co-insured with the other parent in the GKV free of charge. Even if there are no children in the game, this step should be carefully considered, because no one can say to one hundred percent what their own life planning in a few years looks like.

Both parents in the private health insurance
If both partners (married or non-marital) are privately insured, the child must either „voluntarily by law“ be insured or a PKV contract be concluded. Here it applies that the PKV neonates must insure health insurance independent of the health condition. The PKV may also not have a health check, as this has been established by the legislator. This is true even if it is known shortly after birth that the newborn child suffers from significant health restrictions. Newborns thus occupy a legally protected special status. The PKV must offer full protection and may not demand higher contributions even in special cases. Parents should definitely comply with the statutory deadline. After the birth of the child, parents have exactly two months from the child's birthday to register their child with a private health insurance. But here too, it should be remembered that the children are not receiving higher health benefits on better terms than the parents themselves. The best benefits are therefore only given to the children if the parents themselves are well insured.

For this reason, parents should pay close attention to what they have done themselves. Here, consumers should look closely into their terms and conditions, which benefits were set out in their own contract and what deductible is granted. Important additional services include dentures, orthodontic treatments, psychotherapy and medical aids such as visual aids or hearing aids. But especially young and healthy adults at the beginning of a private health insurance tend to choose low cost fares with very few benefits and a high deductible. This can clearly go back at the birth of a child.

PKV insurance for older children
If older children need to be insured for private health insurance, insurance providers have the same right as adults to refuse admission. The PKV also has the right to demand so-called risk premiums for children's health restrictions. Although there are some private health insurance rates that offer low-cost contributions with a family doctor principle, however, the straight free choice of the doctor is a major advantage of private funds. Since the beginning of the year, however, PKV contributions for children can be claimed for tax purposes. However, there must be a statutory minimum protection for the insurance, which is stored similar to the GKV. (Sb)

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Picture: Gerd Altmann