PKV: 150,000 insured in the debt trap



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PKV: More and more people can no longer afford their private health insurance. The industry estimates the default payments at 300 million euros annually.

Around 8.8 million people are currently covered by private health insurance (PKV). According to the associations, there are around 150,000 insured who can no longer afford the private health insurance contributions. The annual sum of all defaulting contributors is estimated at 300 million euros.

Particularly affected: Unsuccessful self-employed. Above all in this group are former self-employed people who became unemployed due to a failed business model. The job centers only paid those affected the minimum rate of the statutory health insurance (GKV). The unemployed had to pay the difference themselves from the standard rate. A new ruling by the Federal Social Court in Kassel now obliged the job centers to assume the full cost of an appropriate basic tariff. However, the verdict has received numerous criticisms because it not only relieved the victims but also the private health insurance. So far, as with the SHI, this has so far refused to introduce a reduced social tariff if unemployment is present.

Switching to statutory health insurance is not possible The judgment is also problematic because it is not possible for those affected to switch to statutory health insurance. It is also not possible for private insurance companies to exclude a defaulter from health insurance. Health insurance has been compulsory in Germany since January 1, 2009, after every resident in Germany must have adequate health insurance coverage. Private health insurance companies may not reject a non-insured person because of a risk assessment, but must offer at least a basic tariff.

Health insurance benefits are reduced in the event of debts. If the insured cannot pay their contributions in full or not at all over a longer period of time, most providers respond by restricting the benefit framework (ELP). If this restriction does not result in the payment behavior of the debtor improving within a year, the person concerned is downgraded to the benefits of a basic tariff. The health benefits are then similar to those of the statutory health insurance companies. Insurance companies are currently considering further limiting benefits in the event of months of non-payment. In extreme cases, only emergency services should then be paid. However, it can be doubted whether this variant complies with the law.

Basic tariff offers no way out If insured persons are deported to the basic tariff, this does not mean that the debt of the contributor is reduced. Because in most cases this downgrade only means an improvement for the PKV provider. Because the insurance company then has to pay less for the services of the policyholder, the premiums are mostly similar to "normal" tariffs. The financial burden is generally not reduced for those affected.

PKV lock offers are complicit in this situation, the PKV should not be completely innocent. In the beginning, young people in particular are lured with sometimes ludicrous lures. The premiums and / or the life situation of the insured person gradually increase. In the end, the insured person falls into a debt trap because he can no longer pay the high premiums. The lucky winners of this game are often unscrupulous insurance brokers who earn horrific three and four-digit commissions when they get a contract. If you still want to switch to private health insurance, you should inform yourself beforehand precisely and independently. The consumer advice centers also provide appropriate advice. (sb)

Also read:
Contributions from the private health insurance are increasing
PKV map report 2011: Debeka wins the test
PKV: Services and quality a reason for changing?
Basic PKV tariff is increased
Job centers have to reimburse contributions for private health insurance

Image: Stephanie Hofschlaeger / pixelio.de

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