Which health insurance is the right one?

Which health insurance is the right one?

Whether you have to go to the statutory health insurance (GKV) or the private health insurance (PKV), depends on where you were last insured: Who was previously insured by law, must return to a statutory health insurance. Former private patients must reassure themselves privately.

Those who have never had health insurance are assigned to one of the two systems, depending on their occupation: self-employed, freelancers and civil servants have to become private health insurers, employees and all others are legally insured. For professionals with multiple jobs, the main job that provides most of the income and takes up most of the time is what counts.

If in doubt, people without health insurance should first contact the GKV. The statutory health insurance then refers affected persons to the private health insurance if they can not accept them.

Return to the statutory health insurance

Return to the statutory health insurance

Who was last insured by law, goes to the health insurance, where he last was a member (§ 174 Abs. 5 SGB V). This must resume the former insured, regardless of his state of health. Only those who have never been covered by health insurance, but who belong to the GKV, can basically choose from all open health insurance funds.

Resumption to a private rate

Resumption to a private rate

If someone has to reassure themselves privately, he basically has the choice between all providers. Every private health insurer is required to include people without insurance coverage in the so-called basic rate. Its services correspond approximately to those of the statutory health insurance. Although insurers can ask for the health of the applicant, but can not charge surcharges or reject someone because of illness (OLG Cologne, judgment of 2 November 2012, Az. 20 U 151/12). However, if the insured changes later from the base rate to a regular rate, the company may charge a risk premium.

The contribution for the basic tariff may not exceed the statutory maximum contribution in statutory health insurance plus the average additional contribution. This is around 703 euros per month (as of 2019). Those in need of assistance within the meaning of the German Social Security Code (§ 9 SGB II or § 27 SGB XII), ie receiving Hartz IV or social assistance, only pay half of the premium. Is that too expensive, the insured gets a grant from the job center or the relevant social welfare office.

Alternatively, people who were previously uninsured may try to enter a regular open rate. However, this is usually only for insured persons with relatively good health possible and affordable. A good fee advisor can help you choose the right rate.