Hartz IV: No statutory health insurance for ex-self-employed

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Formerly self-employed are not entitled to switch to statutory health insurance during Hartz IV benefits if they previously belonged to a private health insurance company.

Former Hartz IV self-employed persons who were previously insured with a private health insurance company are not entitled to switch to the statutory health insurance fund. This was decided by the State Social Court in North Rhine-Westphalia (NRW).

The State Social Court of North Rhine-Westphalia ruled in an urgent procedure with the file number Az: L 16 KR 329/10 B ER that ex-self-employed are not entitled to switch to statutory health insurance during the period of unemployment if they previously belonged to a private health insurance company.

In the present case, a plaintiff from Hamm had not made his private health insurance contributions and was therefore terminated by the insurance company in 2007. After that, the man was no longer insured. When the plaintiff became unemployed, he applied to be admitted to the statutory health insurance (GKV). However, the health insurance company refused on the grounds that the private health insurance had priority over the statutory health insurance. Anyone who is in the Hartz 4 reference will only be reimbursed by the employment agency that would also be paid for the SHI. Since the PKV contributions are usually higher, those affected must pay the difference from the standard rate.

Basically, Hartz IV recipients are included in the statutory health insurance. Because every person, whether unemployed or not, is subject to compulsory insurance. However, this does not apply if someone previously belonged to a private health insurance or no health insurance company. The PKV takes precedence here. The state social court pointed out that by creating the compulsory insurance, private health insurers have to offer a basic tariff. This tariff is offered regardless of the general health of the insured. The benefits roughly correspond to statutory health insurance.

The applicant had argued that he had given up self-employment shortly before receiving unemployment benefit II benefits. However, the social judges did not accept this argument. The status before receiving the benefit is crucial. The plaintiff had clearly pursued a self-employed activity before moving on to Hartz IV. (10/19/2010, sb)

Also read:
Arge must pay PKV contributions to Hartz IV
Solution for private health insured at Hartz IV?
Study: fear of Hartz IV makes you sick

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