Int'l Health Insurance in Germany, some are legal!

145 posts in this topic

Posted

Thank you for the comprehensive explanation!

However, I still have one question. Do EU citizens fall under your definition of Expats? I would think that the EU Freedom of Movement laws would dictate that EU citizens are subject to the same rules as German citizens...

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Posted

Engelchen: this was also at the core of my initial questions to the BAFIN. The BAFIN says that they - or rather the law - does not differentiate between non-EU-Expats, EU-citizen and Germans. The rules apply for all the same, i.e. Germans can also use this (now there is a surprise!) . The § 193 VVG Subsection 3 just states this:

Each person with a place of residence in Germany shall be obligated to conclude and maintain with an insurance company licensed to operate in Germany for himself and for the persons legally represented by him, insofar as they are not themselves able to conclude contracts, a cost-of-illness insurance which comprises at least a cost refund for outpatient and inpatient treatment and in which the absolute and percentage excesses for outpatient and inpatient treatment which have been agreed for services covered by the respective tariff for each person to be insured are limited to an amount of Euro 5,000 per calendar year

The only persons who cannot hope to use these insurances under normal circumstances are employees. For them the problem still exists in § 257 SGB V where the law rules that employer may only pay a share of the health insurance costs tax free for the employee if the health insurance is computed like a life insurance...which none of the International Health insurances are. Yet, in the past there had been cases where the employer accepted the choice of the employee for such an international health insurance and instead of paying tax-free a share of the health insurance agreed to pay a bit more taxable income instead, because both sides still made a profit from this. But this usually only works with small and flexible employer entities in my experience.

Cheerio

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Posted

Wow, thanks for all your work.

I have a question, though:

Does this mean I no longer need a policy with Pflegeversicherung attached?

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Posted

Interesting question that. It is called a "PflegePFLICHTVersicherung" which means it is obligatory. And since it is a special, separate tariff in German private health insurances, anyone who switches to an international insurance should only cancel the health insurance and not the PVN (long-.term-nursing-care insurance) as being without might violate German laws. Strangely enough therer are no legal provisons - in contrast to the penalty back-charges for lack of health insurance - in the laws to this regards.

So, gut feeling is: you still have to have it - but nobody can tell you what happens if you go without it.

Cheerio

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Posted

Thanks.

So what I think you're saying is that a person would only be 100% in compliance with the law if he supplemented one of the above-mentioned health insurance products with Pflegepflichtversicherung.

And you say not to cancel your Pflegepflichtversicherung if you already have it...

But what does this mean for people who don't already have it - people moving to Germany, for instance? As far as I'm aware, only one of the above-mentioned companies offer it - with no 'German' ones, I think, offering it separately.

Does this mean, then, that anyone wishing to avail of these products must, in fact, choose the only one with Pflegepflichtversicherung, and that the other products - at least for people who don't already have Pflegepflichtversicherung - are still illegal?

I hope I explained that OK. Any reply would be greatly appreciated.

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Posted

Interesting question that. It is called a "PflegePFLICHTVersicherung" which means it is obligatory. And since it is a special, separate tariff in German private health insurances, anyone who switches to an international insurance should only cancel the health insurance and not the PVN (long-.term-nursing-care insurance) as being without might violate German laws. Strangely enough therer are no legal provisons - in contrast to the penalty back-charges for lack of health insurance - in the laws to this regards.

So, gut feeling is: you still have to have it - but nobody can tell you what happens if you go without it.

Cheerio

I don´t know of any legal problems/ sanctions, either , with regard to the Pflegepflichtversicherung but if you have it - keep it. There is a waiting time of two years before you could even gain from it if the worst came to the worst but if you cancel and start another one - even two days - later - the waiting time starts again!

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Posted

OMG WAIT... I'm technically German so I've always thought I had to have a German health insurance. Does this mean that I can change too?

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Posted

I thought lack of Pflegepflichtversicherung was the entire reason the international expat health insurances weren't good enough in the first place? But if it's still mandatory... nothing's changed?

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Posted

Most of them won´t work ( I doubt ) for non-EU citizens applying for a residence/work visa because the Ausländeramts want to know about the Pflege and because they will be unable to offer the back up, signed and stamped Bescheinigung for the visa appointment.

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Posted

And if you already have an unbefrisstete one?

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Posted

Then no worries, Herr Dinksbumps , because you don´t have to go the Ausländeramt for a visa and show them health insurance.

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Posted

OMG WAIT... I'm technically German so I've always thought I had to have a German health insurance. Does this mean that I can change too?

Yes, you can - that was and is the biggest surprise from the BAFIN statement: every resident in Germany can use them.

I thought lack of Pflegepflichtversicherung was the entire reason the international expat health insurances weren't good enough in the first place? But if it's still mandatory... nothing's changed?

Well, the main reasons were more in the line of what § 193 Abs 4-6 required, i.e. to offer a BASIS-tariff, not to cancel in case of missing payments etc. These rules, for reasons unbeknownst to me and where Ihave serious doubts about their legality under EU competition rules now, seem only to apply to German health insurances.

Pflegepflichtversicherung was one additional issue, but one that for instance ALC solved in the past because you could get also an ALLIANZ long-term-nursing-care insurance, too.

And if you already have an unbefrisstete one?

You can obviously also use the international health insurances, as long as they are formally listed with BAFIN (see my links above).

Cheerio

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Posted

Maybe other freelancers are now wondering about the tax deductible status of such international health insurances. Is there any change there?

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Posted

I do believe this is not entirely resolved yet. Since 2010 you can write off more of your costs for health insurances in your tax declaration...but only if your health insurance report both the premiums received and the no-claims-bonus awarded to the tax authorities. That in itself should not be such a problem even for international insurances, but in reporting to the German tax authorities they are also required to differentiate in their premiums collected how much of a share of the total premium is for coverage adequate to German public insurances and how much is in excess/luxury or whatever you may call it. Because the latter part cannot be written off. With most German private health insurances you can write off about 90% or so when it is a normal, basic tariff. But even they had a hard time initially to work out the differentiation... but for international insurances this is virtually impossible as their tariffs are structured totally different than the German ones.

However, as far as I have been told by tax advisors, you can still write off a flat/capped amount for health insurance (like in the pre-2010 times) and then you could write off your international health insurance costs up to this cap, the exact amount of which escapes me - perhaps PandaMunich or Freising or YL6 can answer this. Or anyone who has filed his 2010 taxes with an international health insurance as part of the costs?

Cheerio

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Posted

However, as far as I have been told by tax advisors, you can still write off a flat/capped amount for health insurance (like in the pre-2010 times) and then you could write off your international health insurance costs up to this cap, the exact amount of which escapes me - perhaps PandaMunich or Freising or YL6 can answer this. Or anyone who has filed his 2010 taxes with an international health insurance as part of the costs?

The cap is:

  • 1,900€ per year for employees, pensioners, Beamte, pensioned Beamter, and non-employed spouses covered under spouse's public health insurance
  • 2,800€ per year for the self-employed, non-employed spouses that have private health insurance, and spouses of Beamter (= Partner von Beamten ohne eigenen Beihilfeanspruch)

The above was taken from the second half of this post in Tax deductions for pension and health insurance.

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Posted

It is called a "PflegePFLICHTVersicherung" which means it is obligatory.

You mean like a Haftpflichtversicherung? No, wait ... :blink:

Is one a Pflege-pflichtversichering and the other a Haftpflicht-versicherung?

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Posted

Ah, kthy , not sure if you´re being tongue in cheek..but anyway: they both have the Pflicht (compulsion) word - the nursing care (Pflege ) because it´s compulsory and the Haftpflicht (( personal liability insurance ) because it´s compulsory to compensate victims of your negligence!

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Posted

Starshollow, thanks for confirming what I've been doing for years and knowing was legal

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Posted

Thanks for the great information provided. It's a big help.

Just one point though. You say that the international insurances are legal. But you also say that the German insurance providers could appeal this situation. Therefore, if someone is staying long-term in Germany then it might be worthwhile to switch to a German insurance now since the back charges issue has disappeared. And after all, the long term Pflegeversicherung is something that could be useful when you get old, and of course the international insurances do not provide this.

l have BUPA and although it's slightly cheaper the moment than the German equivalent l just wonder if the charges with BUPA will increase more. Do you have an example of how much BUPA costs for a 60 year old compared to the costs for similar treatment from a German insurance?

Thanks again

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Posted

The European clause which has been getting me out of trouble for years is and I am paraphrasing but the whole thing is in black and white if you look:

'Providers of health insurance must provide services equal or greater to those offered by providers in the country in which you reside'

AOK write to my wife every year demanding to know why I am not insured either by the German Public or private health sector providers.

From year dot, I sent them a copy of my health policy (was Bupa for years, now Axa UK) with an accompaning letter and all was, and is, forever resolved

What I still can't get my head around here in Germany is, if you make a quick visit to outpatients for lets say a broken finger and tell them you're private, they accept it and they send you the bill (the reason I state the above is that that's what happened to me).

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Posted

Well, billybob...the backcharges issue hasn´t gone yet in many cases. For a start: anyone joining public or private insurance without ANY previous insurance here will be subjected to backpayments. And the majority of private insurers will take a long while to accept the international ones as legitimate.

The long term nursing care issue is still unresolved and I agree with you that long term stayers in Germany ( not those coming for 1-3 years, for example ) should try to get into the German system. There is at least a price reduction concept for old age in the German private system through the 10% gesetzlicher Zuschlag, which the internationals can´t offer.

Having said that, based on the price rises in both the public and private systems in recent years and the uncertainty of future law changes amongst other problems, who can be sure?

However, it´s a case by case approach for us professional advisors and we can only " cook with water " as they say here!!

Edit: once again, it´s my considered opinion that if you´re a non-EU citizen trying to get a freelance work visa, most of the internationals won´t get you past the visa process, at least for a year or so. The Ausländeramt will continue to insist on a Bescheinigung (stamped and signed proof of insurance from the insurance company ) before issuing the visa and the likes of BUPA etc are still unlikely to do that unless they get their act together and realise they´re missing out on business.

Only today, I was helping a client to fill in her forms for the Deutsche Rentenversicherung - page one was " Bescheinigung des privaten Krankenversicherungsunternehmens zur Krankenversicherung " ( ie please get your insurance company to stamp here that you´re insured with them and how and how much ).

It´ll be a while before most internationals will be able to help with that. Thankfully, I could.

l

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Posted

billybob: could not compute the BUPA tarif quickly but did so with ALC for your convenience. With a reasonable deductible of 600 EUR per year the PRIMA PREMIER plan including dental etc costs for a 60 year old around 366 EUR per month. And it will obviously still continue to go up as the international health insurance have an automatic increase of costs up to a certain age (which I think is 75).

BHH: well, lets say you were lucky and not necessarily right in my opinion. I am still scratching my head as to what the BAFIN decided to this regards and it may well be that they interprete certain EU rules differently than the German legislation/Bundestag and the legal heads of both the German public and private health insurances. Probably eventually this will have to go all the way up to the EU supreme court because with this new or finally public decision from the BAFIN all the German private (and in a way also the public ) health insurances are severly hampered and at a serious disadvantage when compared to the international/EU competition.

The problem for this comes all out of the fact that in Germany as the only EU memberstate the private insurances are a substitute for the public health insurance and not a supplement. All other countries have a basic coverage thru their national systems, like NHS for instance. Therefore, in contrast to the UK, the German private health insurances are PART of the system and as such have - at least in the understanding of the GErman legislative AND the German supreme court - obey to certain rules and regulations the German legislative has set. Such as that they must not terminate a contract if people fail to pay their premiums and at the same time maintain an emergency coverage - which neither your BUPA or AXA PPP would dream about doing. Or offering a BASIS tariff with the same coverage like the German public health insurance for people with chronic conditions...again something no international health insurance would offer in their worst nightmare. And so on and so forth.

There are two outcomes possible and I can only toss a coin here if I should predict the correct one:

1. either the GErman law is fully right, then the international health insurances have to play by the same rules if they want to offer a substitutive health insurance, i.e. instead and not on top of the public coverage like the German insurances do. In which case a German or EU court would find that if German health insurances dispute the BAFIN ruling, that the international insurances/EU insurances cannot expect to be accepted as substitutive health insurances if they do not offer the same rules like the German insurances do. In which case by then people who so far only have had international insurances will be obligated to switch to German insurance - but due to the situation without any back-charges, I am sure at least about that

2. or the German law is violating EU laws and thus obsolete. In which case the German insurances will have a field day and start kicking out members who don't pay (reportedly around 90.000) the next day and also terminate somehow those 11.000 people who ended in the Basis-tariff

In the end, I think, we are getting closer now to a point where the German system will collapes and be replaced by a basic public insurance for everyone - you, too, then BHH - and everyone who can and wants will have to add a private supplementary insurance. At least that's what my little chrystal ball tells me....

Cheerio

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Posted

I have a question related to this topic. I’m planning on moving to Germany in April. While I hope to land a job in my profession (marketing/communications) before I move, that may not happen and I’ll have 90 days to find a job before I have to leave on my tourist visa. I am considering buying health insurance for at least the 90 days I’ll be there and a few minutes ago I was reviewing the policies offered by IntegraGlobal (http://www.integraglobal.com/front/personal_plans/personal) (I think they’re actually based out of Austria). Do I need to be concerned that this insurance policy may not be accepted at hospitals or medical clinics in Germany? Thanks.

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