PKV: No contracts during pregnancy?



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No private health insurance contracts for pregnant women?

Pregnant women apparently have problems getting a private health insurance (PKV) tariff. This was reported by a current radio magazine from Deutschlandfunk. Many providers explicitly ask in their application for admission that they are pregnant. According to industry experts, insurers may violate the Equal Treatment Act for insurance companies.

Many private health insurance providers exclude pregnant women Finding private health insurance could be difficult for pregnant women. According to media reports, numerous private health insurance providers exclude the admission of pregnant women. This exclusion is not only immoral, but also violates the "Equal Treatment Act for Insurance" in the opinion of financial experts. It states that the "costs related to pregnancy and maternity must not lead to different premiums and benefits". Therefore, the question of an existing pregnancy alone could be legally questionable. In any case, the Federal Association of Consumer Centers (vzbv) criticizes this. The consumer protection and expert Lars Gatschke told Deutschlandfunk: "In our opinion, such a question is not in line with the General Equal Treatment Act, because in our opinion this question does not refer to the pure costs of pregnancy, but also to the question of Conclusion of contract. "

Applications with questions about pregnancy
In the opinion of the insurance broker Ozan Sözeri from the online comparison portal "Widge.de", consequences could follow for the applicant if the question about an existing pregnancy remains unanswered in the application form. Many providers reject an application if they have been pregnant for more than three months. Accordingly, many of those affected no longer have the option of taking out private insurance from this point on. Most PKV providers state that the cost of giving birth to the child is too high or that the child's follow-up insurance does not correspond to the contract. If the affected person has already had one or two abortions, numerous insurance companies require a so-called risk premium. But that is illegal, as the PKV expert Sözeri told the DLF. Because an abortion (miscarriage) is not a previous illness that allows such a risk premium. Pregnancy-related illnesses such as pregnancy depression or gestational diabetes are not considered to be pre-existing diseases. Obviously, however, those affected have to pay higher contributions, some of which are more than ten percent higher than comparable premiums. Such a premium would then have to be paid for a lifetime. This is no longer legal equal treatment, as the insurance expert rightly criticized.

PKV speaks of individual cases
In this context, the Federal Association of Private Health Insurance (PKV) speaks of "individual cases". A spokesman told Deutschlandfunk that men and women were treated according to the same rights and obligations. The cost of pregnancy is usually covered. However, providers also have to have a pregnant woman's health check, no exception is made here.

Women should switch to private health insurance before pregnancy if possible, as independent insurance experts advise. If it is already too late, an intermediary could make an anonymous preliminary request to question the premiums and conditions. Statutory health insurance companies pose even fewer problems. There is sufficient health protection for mother and child without raising the tariffs, since the contributions are based on income. (sb)

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Image: Kai Niemeyer / pixelio.de

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