If you change private health insurance, you may get financial benefits and save. Because the contributions of the PKV increase threefold in old age.
(09/23/2010) Many, especially older, private health insurers complain about the increasing contributions of their health insurance. Although the contributions from the statutory health insurance funds are increasing, the increases in the contributions for private providers are sometimes very drastic. If you get into private health insurance (PKV) today as a mid-thirties, you pay far less than in the statutory. But at the latest at retirement age, the savings are over. In some cases, the insured person expects insurance premiums to be three times higher than the start of the tariff. Many private health insurers report that they sometimes have to pay 600 to 800 euros a month for their health insurance.
On the one hand, it is due to the demographic change in our society. People are getting older and are getting longer and more intensive medical care in old age. Medicines and treatment costs are becoming increasingly complex and therefore also more expensive. On the one hand, technical progress in medicine is an advantage for people, on the other hand, healthcare costs are increasing.
Another major reason for the premium increases are the so-called lock offers of the PKV tariffs. In order to attract customers, private insurers are continuously setting new tariffs. These tariffs are initially unbeatably cheap compared to voluntary statutory health insurance. The new tariffs mainly include young contributors who cause little cost. Tariffs that have been on the market for some time will be closed at some point because more and more sick people are insured in the tariff. The tariff will then be closed at the latest at this time. This means that no new members will be accepted especially for this PKV offer. All those who are insured under this tariff now remain “among themselves”. The older the customers remaining there, the higher the contributions will be. Suddenly, the insured are faced with the situation of having to pay much higher premiums. In some cases, the private health insurance contributions increase three or four times. Many private health insurance providers also suffer from old tariffs from the 1970s and 1980s. At that time, many factors and risks were not taken into account. If the rising costs are not taken into account, these old tariffs also have higher and higher contributions.
The insured can hardly defend themselves against this situation. Because if you are “caught” in such a tariff, you cannot switch to another PKV provider. The accumulated provisions for old age remain partly with the old insurer. The provisions for old age are used to compensate for the expected higher costs in old age. If you still want to switch to a different provider, you will notice that the contributions are almost the same. Because the provisions for old age are not included in the new tariff. One way out could be to change tariffs with the same health insurer. This change is made possible by the Insurance Contract Act. Only if new private health insurance tariffs offer more health services can the private health insurance company request a renewed health check.
But a change within the same company is not welcome. Because the old tariffs are weakened financially by a change and with the new tariffs there is a risk that the costs and thus the contributions will be increased. For this reason, insurers do not like to provide information about which alternative tariffs can be offered. Especially not if the insured person is older.
If the insurers do not provide any information, it is possible to compare the corresponding offers from their own insurer on the Internet. With appropriate offers, you can now go to your insurer and request a change of tariff. You shouldn't let yourself be thrown away immediately. Some time ago, the PKV insurance tried to prevent a tariff change by a high premium. But that should be over after the judgment of the Federal Administrative Court. According to the judgment, surcharges with file number AZ: 8C 42.09 are no longer permitted. In addition, the providers may not require a new health check if the desired tariff does not offer more or better services than the previous one. The decisive factor is the state of health when the customer is admitted, which was determined with the old tariff.
If private health insurance wants to prevent a change by any means, those affected should either contact the consumer advice center or consult an ombudsman for private health insurance. An ombudsman has the task of avoiding a legal dispute by agreement between the two parties. However, neither the provider nor the insured person is bound by the recommendations of the arbitration board. Only "recommendations" are made. An ombudsman can be reached nationwide on telephone number. 01802/550444. If no agreement or compromise could be reached and the private insurance remains stubborn, you can also lodge a complaint with the financial regulator "BaFin". Last year, 1,757 insured people complained about their private health insurance.
But how can you save money when changing tariffs? There are significant savings potential that should be checked first. You should carefully examine which health services are important and which can rather be neglected. For example, there is considerable savings potential with additional services such as single rooms in hospitals or treatment by a doctor. For example, if you save yourself a single bed, you can save between 10 and 50 euros a month in contributions. Another option is to reduce reimbursement contributions. If you accept a reduction in glasses, dental treatment and other aids, you can also save large amounts.
It is important that the PKV contract for medical fees extends to the maximum rate of the fee schedule (3.5 times). The reimbursement of psychotherapy should already be included in the contract with 20 treatments. Otherwise, the costs of a long illness can quickly exceed your own budget. So you have to think very carefully about which health services are really necessary and which can rather be neglected. That depends on the insured person's own, individual situation.
If, due to various circumstances, you are faced with the choice of either remaining in the statutory health insurance or switching to private health insurance, this step should also be carefully considered. Various services are not offered at all in the PKV. For example, if you want to start a family, you should be aware that there is no non-contributory family insurance in the private health insurance. This means that children and non-working wives or spouses cannot be insured for free. Here it should be checked again exactly whether a change to the private health insurance is worthwhile. Here, too, the consumer advice centers offer their help and calculate the contributions in advance in the long term.
The PKV's image is still good. According to a survey, the PKV performs relatively well compared to the GKV. 73 percent of the respondents consider the benefits of the PKV to be more extensive. 51 percent found the price-performance ratio positive. 73 percent assume that the private health insurance will continue to offer good medical care in the future. At the SHI, only 45 percent believed this. But these are survey results that say nothing about the quality and actual performance. (sb, fp)
PKV: Services and quality a reason for changing?
Aid does not accept alternative therapies
Federal Government: Billions package for the PKV
Photo credit: knipseline / Pixelio.de