PressSplit
The contributions for private health insurance can eat up your pension. But switching is difficult. What’s behind it?
Berlin – 1,050 euros per month for private health insurance, compared to 1,200 euros Interest – this was the financial situation of the pensioner Dieter Wassmann (name changed), about whom the Time recently reported. Around 150 euros remained for food, leisure activities and other things. Despite having paid off the condominium and living as a self-employed person, the savings were almost used up, according to the report: A solution had to be found.
Despite being self-employed, joining the GKV – through a trick
He identified his private health insurance (PKV) as the major problem. The pensioner had been using the services for many years, but with PKV, the premiums increase the older the insured person gets. Switching to statutory health insurance (GKV) is not that easy. According to Wassmann, Time He came up with a trick: He simply moved to Denmark, which meant he had to cancel his German insurance, and was then able to slip into the GKV when he moved back.
A stethoscope lies on euro banknotes (symbolic photo). The contributions for private health insurance can eat up your pension. However, changing is difficult. What is behind it? © IMAGO / Wolfilser
“Private insurance makes sense for high earners at a young age when low contributions have to be paid,” quoted the Time Sven Tintemann, lawyer for insurance law. Anyone who expects to receive a low pension and continues to pay high contributions to private health insurance should think about leaving. But that is not so easy.
Changing insurance only possible in one direction – high hurdles with the GKV
The basic rule is that every voluntary member of a statutory health insurance scheme can alternatively take out private health insurance. According to the Federal Ministry of Health, it is the other way round, i.e. a Switching from private health insurance to statutory health insuranceaccording to current legal regulations, this is excluded. However, there are exceptions, namely when living conditions change to such an extent that compulsory insurance in the statutory health insurance system arises “for the first time or again”. In this case, those affected can switch to any statutory health insurance provider.
However, this does not apply to persons who:
- Have reached the age of 55
- Have not been legally insured in the last five years
- For at least half of this time, you were uninsured, exempt from compulsory insurance or self-employed.
According to Zeit’s reporting, Wassmann fulfilled all three criteria, which raises the question of how something like this works. When asked about this, the responsible Federal Ministry of Health had not yet commented.
When the statutory health insurance excludes the self-employed – and when not
Self-employed people can slip into the statutory health insurance scheme before the age of 55 if they become subject to compulsory insurance. According to the Consumer Center This happens, for example, when they sign an employment contract as an employee and either give up their self-employment completely or limit it to a part-time job. However, the age limit still applies in these cases. In addition, the following regulations apply:
- You may not employ employees who earn more than 538 euros (mini-job limit) per month.
- You must earn at least as much from your employment as you would from your self-employed job. If the profit from self-employment is too high, the health insurance companies will assume that self-employment is more important.
- In an employment relationship, those affected must work more than 20 hours per week.
There are two hurdles for employees who were previously privately insured: First of all, the age limit of 55 years applies here too – anyone older than that cannot switch to private health insurance. The second hurdle is the SalaryInsured persons may not exceed the so-called annual salary limit if they want to switch to the statutory health insurance scheme. In 2024, this will be 69,300 euros gross.
The reason for these high hurdles is as follows: The legislator wants to prevent people from benefiting from the services of private health insurance for a long time when they are young and then, when private health insurance contributions become more expensive than those of statutory health insurance, from switching to the cheaper statutory health insurance.
Health insurance is becoming more expensive – both statutory and private
Private health insurers say that the massive increase in contributions up to retirement age is by no means only affecting private health insurance. According to the 2023 annual report, private health insurance premium income rose from 39.80 percent (2018) to 47.07 percent (2022). At 47.1 billion euros, premium income in 2022 was around 3.7 percent higher than in the previous year.
The health insurance companies, responsible for the statutory health insurance, are increasing their contribution rates. The homepage shows what this looks like in detail Krankenkassen.deFor example, at AOK Nordost, it shows a Plus 1.80 percent since 2015At KKH Kaufmännische Krankenkasse, it was 2.38 percent more. One cost driver in both types of insurance is medical progress. According to the PKV Association, the costs of progress affect both insurance systems equally. Anyone who wants to switch – regardless of which direction – should seek thorough advice beforehand. When they retire, privately insured people could face similar costs to Wassmann.
