Private health insurance: is it worth changing?



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Can a switch to private health insurance for employees be worthwhile?

The planned health care reform will loosen the entry requirements for private health insurance (PKV). Instead of the three-year period, only a one-year period should apply in the future. Since 2007 it has been the case that employees have to have gross income of 49,950 euros over and above the compulsory insurance limit in order to be able to switch to private health insurance. The reform of the Federal Minister of Health Philipp Rösler (FDP) has now relaxed this regulation. From the first of January 2011, only the one-year period then applies. The question remains whether a switch from statutory to private health insurance can actually be worthwhile.

Healthcare reform makes it possible: The change from the GKV to the PKV is made easier
Because of the planned health reform of the federal government, private providers of health insurance can look forward to. Employees with a relatively high income can switch to private health insurance more easily from January 1, 2011. For this, employees must have a gross income of 49,950 euros per year. This limit must be breached at least once, after which an employee subject to social security contributions can choose whether he would rather stay in the statutory health insurance or switch to private health insurance. The offer can be tempting, especially for young and healthy people, since entry-level tariffs are inexpensive. Before that, however, the PKV uses a health check to check the general health of the insured. The rating of the contribution is then also measured by this.

A change can also be worthwhile due to the individual benefits of the PKV. The selectable services such as chief physician treatment, care in medical practices and clinics are more privileged than with the statutory health insurance. Tariff options such as reimbursements and premiums for non-use of health services can also be quite interesting, for example, if you have not used any benefits in one insurance year, some private health insurance companies will pay back between three and four monthly contributions to the insured. The statutory health insurers do not offer such premiums on this scale.

Individual tariffs with the PKV
A new entry tariff can be set individually by the private health insurance companies. If an employee is healthy and young, the contributions are significantly lower than with the statutory health insurance companies. But if your own family planning changes, so do the contributions. At this point, many are wondering whether it would still make sense to switch to private health insurance. Because, for example, children are not automatically insured with the PKV. On the contrary, a PKV must be taken out for each child. This also applies if, for example, the child's mother is insured in a statutory health insurance company. The rule here is that whoever earns more must also insure the children. It is then necessary for a new tariff to be concluded with a health check.

Entry-level PKV tariffs are cheap at first, but will become many times more expensive over time
Caution is also required with the so-called entry tariffs. Most of these tariffs are very inexpensive at the beginning. However, such tariffs will be closed over time. This means that no more insured persons will be included in the special tariff. The members in the tariff are getting older and the diseases are increasing. This automatically increases the private health insurance contributions. A tariff change within the health insurance is possible, but is usually not welcomed by the PKV. It is good that the tariff change may not be provided with a change fee due to a new judgment. However, you then have to accept significant performance losses in order to be able to take advantage of a cheap private health insurance tariff. Insured persons report in part that the tariffs rose by 100 to 200 percent in the course of the insurance years.

Pregnancy and private health insurance
As a woman, the difference in benefits compared to the statutory health insurance can be even more serious. Because if an employee becomes pregnant, in contrast to the statutory health insurance, she still has to continue paying the full contributions to the private health insurance during maternity leave. In contrast, pregnant women receive up to EUR 385 in maternity benefit per month from the SHI. The PKV pays nothing. Pregnant privately insured persons can apply for a maximum of one-time payment of EUR 210 from the Federal Insurance Office.

There are also clear differences in the care of sick children. The statutory pay for the loss of wages for the mother or father during the care of the child. The SHI pays up to 90 percent of the parent's average net income that the child is caring for. The continued payment is intended per child and partner for a maximum of 10 days per year. The PKV, however, does not know such social benefits.

So it depends on the individual situation of the individual whether a change is actually an advantage. However, it must also be noted that the contributions from the statutory health insurance companies will continue to increase in the future. Numerous health insurance companies assume that new additional contributions will be charged from 2011/2012 at the latest. However, a change is always possible as long as the access requirements are met. (sb, 28.09.2010)

Also read:
SPD wants to reverse the health care reform
Save on private health insurance
Federal government: Billions package for the PKV

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