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Techniker Krankenkasse sets tariff "TK-Privat".
(13.08.2010) The Techniker Krankenkasse (TK) is ending the "TK-Privat" tariff again at the end of the year. The box office justified the step with the fact that the election tariff would not be economical enough. With this tariff, health insurers of the TK health insurance fund were able to take advantage of health services such as “privately insured”.
At the end of the year the health luxury tariff "TK-Privat" will be discontinued. This step affects around 7,000 health insurers. It was only in 2007 that Techniker Krankenkasse offered this tariff and advertised that the additional benefits were on par with those of private health insurance. The advertising slogan was then: "Insured with TK as treated as a private patient". Among other things, patients with this optional tariff got an appointment with a specialist or family doctor faster and had to plan less waiting time. This was possible because the TK paid 3.5 times the simple fee rate for the fee schedule for doctors when insured members chose such an additional optional tariff. In addition to the regular health insured contribution, an additional contribution for the "TK-Privat" tariff had to be paid.
The telecommunications fund justified the step with the fact that the tariff would not pay off economically. The system of election tariffs is responsible for this. "In private health insurance, risk is not calculated fairly. That is why the health insurance tariffs are structurally under-financed," the association of private health insurers told Rheinische Post. For this reason, the election tariffs are "under-financed" despite additional contributions from the insured, as the head of the association explained.
If only a few are insured via such a tariff, the social balance between healthy and sick insured persons no longer works. If, for example, there are many chronically ill people in such a system who often have to see a doctor, the entire tariff system starts to falter. In contrast to private health insurance, there is no health check for insured persons who choose this optional tariff. There, the insured are classified based on their general state of health.
Health insurance companies that offer such a "luxury health tariff" can stop the offer at any time. This was also explained by a spokesman for the Federal Ministry of Health: "Election tariffs are based on the respective statutes and do not belong to the statutory catalog of rules with their services". Insured persons who have such a tariff cannot therefore object to the cancellation of the offer.
If you want to continue to have a “private patient status”, you can also choose a reimbursement model. However, such tariffs are much more expensive, so that a comparison to the actual benefit factor makes sense. As a participant in the "reimbursement" electoral tariff, health services must first be paid for yourself. The insured give the health insurance card to their health insurance company. After submitting the costs, the health insurance company reimburses part of the costs, the rest of the amount must be paid by the insured person. For this reason, it is recommended to take out additional private insurance to keep the risk of excessive costs low. For many health insurance companies, the choice of the reimbursement tariff is a prerequisite for the "excess" or "premium / premium refund" tariffs. (sb)
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