What to do about rising PKV contributions?

Strategies against a drastic increase in contributions in private health insurance

02/01/2014

Numerous private health insurance companies (PKV) have again increased their contributions at the turn of the year. Although a change back to the statutory health insurance (SHI) is usually not possible, the person affected various options remain to escape the contribution increase. In case of doubt, the so-called base rate applies, which, however, offers only a very limited insurance coverage.

Unlike the statutory health insurance, the adjustment of tariffs to the actual structure of expenditure is common in private health insurance. As a result, rising health care spending is leading to a significant increase in contributions. According to media reports, some PKV tariffs have increased by up to 41 percent in 2014. In recent years, the drastic increase in private health insurance premiums has often been criticized, as more and more private insured persons were no longer able to pay them. He was only a change in the base rate, which, however, brought significant losses in performance entitlement.

Special right to cancel contributions
Private health insurance companies have been able to attract many new members in recent years, with lucrative offers for young, healthy, well-paid people. However, the insured often forget that the initially low premiums in the future can increase drastically and thereby reach a multiple of the maximum rate in the statutory health insurance. They are faced with unexpected premium increases, but they do not have the opportunity to switch back to SHI. However, according to the press officer of the Association of Private Health Insurance, Dirk Lullies, they have three main options if they do not want to participate in the premium increase. First of all, insured persons are generally granted a special right of termination in the event of a premium increase. You have the option to terminate your contract and switch to another insurer.

Tariff change within an insurance company
However, anyone who had been privately insured before 2009 loses all established retirement provisions in the event of an insurance change, which can amount to quite a considerable amount. Even after the year 2009 members of the PKV have been allowed to transfer their retirement provisions only to the amount of the basic rate to their new insurance. Thus: „The longer one is privately insured, the greater the loss of retirement provision“, explained Lullies. In order to avoid this loss of the retirement provision, however, the insured may also switch to another tariff in their previous private insurance. In principle, this option is available throughout the year, and the person concerned will in this case retain all its provisions, explained Lullies. If no new benefits are provided for in the new tariff beyond the previous level, no new health check will be required, according to the Press Officer of the Association of Private Health Insurance. Here pay „it is always to inquire about other rates.“

Base rate as an alternative?
For insured persons who were already privately insured before the deadline of the first of January 2009, there is often the option to switch to the standard rate when changing the internal tariff. Otherwise, the base rate remains as the last option. In this, the contributions may not be higher than the maximum rate of SHI (currently 630 €). However, the base rate includes only a very limited catalog of benefits, in which the insured are usually in the opinion of consumer organizations better secured than in the GKV. A change in the base rate can therefore represent a significant financial relief, but it loses all benefits in the claim for benefits. However, insured persons still have at least their age reserves retained. If the insurance companies in a desired change uneven, recommends Bianca Boss of the Confederation of insured in Henstedt-Ulzburg opposite the news agency „dpa“ to seek urgently independent assistance. Complaints can be submitted to the Ombudsman for private health insurance.

Performance waiver and increased deductible
In order to avoid a drastic increase in contributions, private insured persons can also do without specific services, explained Peter Grieble of the Consumer Affairs Center Baden-Württemberg in Stuttgart in an interview with the „dpa“. In particular insured with a tariff of „Luxury variant can make this relatively easy“, Grieble continues. For example, it would be possible to waive the daily allowance or the right to a single room in case of hospitalization. However, such benefit cuts should be well considered, as you can „usually privately insured to be better insured than the legally insured“, stressed Bianca Boss. With the benefit reduction, this advantage is finally lost again. Alternatively, an increased deductible of the insured for necessary treatments can be provided to avoid the contribution increases. However, this is also a double-edged sword. Because in case of doubt can be extremely high additional costs. Whether an increase in the deductible makes sense, „depends on the state of health“ and should be decided individually by each, Lullies explained. For private insured persons, who are often ill, such an increase in the deductible makes no sense anyway.

In general, when concluding private health insurance, consumers should be aware of the fact that significant increases in contributions are likely to occur in the future, and that this should be included in their considerations beforehand, emphasized Peter Grieble. It is also advisable to create appropriate reserves in the event of a contribution increase. Grieble is convinced that drastic increases in private health insurance premiums are expected in the future. (Fp)