The federal government for insured persons (BdV) warns of a hasty change of insurance to private health insurance: a change to private health insurance should be considered carefully.
The federal government for insured persons warns: "Nobody should now go into private full insurance without consideration, perhaps only because they are earning well", emphasized the chairman of the largest German consumer protection organization for insured persons, Thorsten Rudnik. The following still applies: “The step into private health insurance (PKV) is the beginning of a lifelong commitment. There is hardly anyone back in the legal system. ”Although the private health insurance company offers many short-term advantages, such as lower premiums and better benefits, the disadvantages for the insured could outweigh the long-term, the BdV warned. "There is a risk of adversity if you only see the short-term savings and don't really know what the long-term consequences are," explained Thorsten Rudnik.
Changing health insurance is simplified
The background to the current warning from the BdV are the decisions of the black and yellow federal government on health reform that will come into effect on January 1, 2011, which will make switching to private health insurance considerably easier and, due to the simultaneous increase in premiums to 15.5 percent of income from statutory health insurance ( GKV) appears extremely attractive in the short term. In the coming year, the compulsory insurance limit, i.e. the gross income from which the employee is no longer compulsorily insured in statutory health insurance, will be reduced to 4,125 euros per month (49,500 euros annually). In addition, employees only have to reach this limit in a single year in order to be able to switch to private health insurance, not in three consecutive years as before. This means that considerably more workers can switch to private health insurance than before, but the change can also have disadvantages, the warning from the Confederation of Insureds.
Caution required when changing insurance policies While most private health insurance providers offer particularly low tariffs, especially for newcomers, customers must expect massive premium increases in the long term. Since a switch back to the GKV is almost impossible, everyone should carefully consider which insurance also seems best suited to them personally in the long term, the BdV explained. The individual situation of the insured is decisive for which system is the better choice. For example, it can generally be found that private insurance is rather unfavorable for people who will have children later and are likely to want to insure them with them, according to the BdV. While family insurance automatically takes effect in GKV and provides children with insurance protection, in PKV individual contributions have to be paid for each family member, explained Thorsten Rudnik and therefore cautioned when changing insurance, especially if the family situation has not yet been clarified.
Private health insurance providers should provide honest and transparent information about tariffs. While young, healthy insureds can save a lot of money with private health insurance, there are almost no limits to the increase in premiums in the rest of their lives. The affordable entry-level tariffs are continuously adapted to the health of those affected and become more and more expensive with increasing age. According to the BdV, even for healthy customers, it is not guaranteed for a lifetime that the financial benefits of the PKV outweigh them. In view of the sometimes massive premium increases, the BdV urged private insurers to provide transparent and honest information about alternative tariffs. "Older insureds often do not know how to pay their renewed tariff increase these days," and private health insurers inform their more than eight million members "by far not enough about existing switch options," explained Rudnik. With the annually announced premium adjustments, the privately insured have the opportunity to switch to another cheaper insurance tariff, said the chairman of the BdV.
Partly massive premium increases in the private health insurance system At the moment, the Confederation of Insureds is receiving “an infinite number of letters” from insured persons, to whom substantial premium increases were announced on January 1, 2011. "Many premiums are in double digits, some at 33 or 35 percent," said BdV chairman Rudnik. One of the reasons for the wave of increases is that health insurance balance sheets will be burdened by low market interest rates, Rudnik continued. With the recommendation of many private health insurance companies to their financially overwhelmed members to simply switch to the low-cost basic tariff, the insured was not helped, according to the position of the BdV. "Because the services there have nothing to do with what patients imagine under private medical protection," emphasized Thorsten Rudnik. The basic tariff has recently been heavily criticized, since the pension entitlements in practice were in some cases considerably worse than the statutory standard pension. According to the BdV chairman, the painful insight for many privately insured people follows: "Those who want to keep their comprehensive protection often find no alternative to their expensive tariff, especially in old age." To save, insured people only have to think about which benefits they can possibly do without. Therefore, "nobody (...) should simply change because of a contribution advantage," warned Thorsten Rudnik.
Better entitlement to care in private health insurance The private health insurance company still offers clear advantages in terms of benefits. The pension claims and the service are considerably better for the privately insured than with the GKV. Privately insured persons have to put up with fewer waiting times at the doctor and are entitled to additional services such as chief medical treatment, single room in the hospital, exemption from additional payments for medication, reimbursement of dental treatment, new treatment methods or visits to alternative practitioners, which are covered by the insurance. The GKV's range of services cannot keep up here, but the contributions of private insurance companies also increase with each additional benefit covered. The following applies: the more extensive the entitlement to care, the more expensive private health insurance. In addition, the private health insurance company only reimburses "medically necessary" services, although the ideas about the necessity for patients and insurance companies are sometimes very different. Ombudsman Helmut Müller, who is responsible for arbitration between customers and private health insurance companies, said: "The discussion about medical necessities is the most common complaint we have", because "insurance companies look more closely at invoices than before, and customers are demanding more and more . ”The general presumption of a better range of services offered by private health insurance is no longer entirely unreserved. For some benefits, such as sickness benefits for children who are ill, maternity benefits, the financing of domestic help in the event of illness, reimbursements for psychotherapy and aids such as crutches, the SHI even offer better benefits than private health insurance. (fp)
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