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Family part private, part state insured

11 posts in this topic

Posted

I've been privately health insured since I came to Germany many years ago, and my wife has always been state-insured. She gave up her job to have our daughter and is now "freiwillig versichert" and has a part-time job for less than €400.

Recently I got the yearly letter from my health insurance that tells my employer how much my health insurance contributions are ("Bescheinigung für den Arbeitgeber"), so that they can pay half. I noticed at the bottom that it said I should hand in letters for other family members to my employer as well, so I rang them and it turns out my daughter's insurance (by law forcibly private through me) should have been listed there as well.

Anyways, this got me to thinking that shouldn't my wife's contributions be on there as well, or at least we get a similar letter from her insurer. After all, her employer is not required to make contributions, but her premiums are calculated from our combined income. We spoke to her insurance, as probably 95% of their customers have their contributions directly taken out by the employer, they don't seem to have a clue. Of course, if my wife earned a little more (well, now it's up to €450) then she'd get the contributions from her emplyer and her premiums would be lower.

I realise this is pretty specialist, but if anyone has an idea, I'd be grateful.

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Posted

If I read TK correctly, then it should be possible:

  • Zuschuss zur privaten Krankenversicherung
    Den Zuschuss zur privaten Krankenversicherung zahlt der Arbeitgeber, wenn der privat versicherte Arbeitnehmer krankenversicherungsfrei oder von der Krankenversicherungspflicht ausgeschlossen ist. Außerdem müssen folgende Voraussetzungen erfüllt sein:


    • Dem Arbeitgeber muss eine Bescheinigung des Versicherungsunternehmens vorliegen, in der die zuständige Aufsichtsbehörde bestätigt, dass die Versicherung nach dem vom Gesetz geforderten Voraussetzungen betrieben wird. Diese Bestätigung muss alle drei Jahre erneuert werden.

    • Die Leistungen müssen denen der gesetzlichen Krankenversicherung entsprechen. Es ist dabei unerheblich, ob der Mitarbeiter mit seiner Versicherung eine höhere Selbstbeteiligung oder Leistungsausschlüsse für bestimmte Krankheiten vereinbart hat.

    • Auch die Familienangehörigen, für in der gesetzlichen Krankenversicherung familienversichert wären, müssen mit solchen Leistungsansprüchen krankenversichert sein, egal ob in einer privaten oder in einer gesetzlichen Krankenversicherung.

The relevant law is §257 Absatz 2 SGB V.

However, you should know that the employer's total contribution is capped at what he would have had to pay if you had remained in public health insurance and all your dependants would have simply been familienversichert at no additional cost, i.e. the employer's contribution is capped at per month:

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Posted

Contact member johng, he's the insurance expert.

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Posted

Thanks both, I think Panda's post covers it - it should be possible, but the cap on the employer's contribution means they're already paying the max with just me and my daughter.

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Posted

Do you get your fully paid contributions to Public insurance scheme considered as Vorsorgeaufwände on your tax return?

Depending on what your current private insurances use up, you may be able to get some money back this way.

Based on info e.g. here, the sum cost up to 4 800 Euro (couples), minus the tax free part payment from your employer is tax deductable.

This means you aren't quite so out of pocket for the full costs.

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Posted

Based on info e.g. here, the sum cost up to 4 800 Euro (couples), minus the tax free part payment from your employer is tax deductable.

Those 2,800€ per year are only given to people who pay health insurance entirely out of their own pocket, i.e. self-employed.

Guy, being an employee, gets half of his health insurance covered by his employer, and therefore only gets 1,900€ per year as an allowance, which has already been used up by his share in his health insurance contributions.

But since health insurance is a legal necessity, he is allowed to claim for exactly the part of the private health insurance (of course only for the share he paid!) that corresponds to public (= basic) cover, i.e. for more than 1,900€.

Same procedure with his wife, she can claim up to 2,800€ per year for all her insurances since she has no employer, but at least for what she paid for her health insurance, even if it was above 2,800€.

For details see post 17 in Int'l Health Insurance in Germany, some are legal!

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Posted

Those 2,800€ per year are only given to people who pay health insurance entirely out of their own pocket, i.e. self-employed.

<...>

Same procedure with his wife, she can claim up to 2,800€ per year for all her insurances since she has no employer, but at least for what she paid for her health insurance, even if it was above 2,800€.

Thanks for the information and the correction - I just give all my paperwork to my tax advisor and hope for the best, but had some vague idea how it should work, but feel I should have a better idea so I can check up on him :-).

So aware that I'm probably hijacking this thread, but is it possible to clarify further this split between employed and non-employed/self employed allowances:

I'm employed and pay for private health insurance - my employer pays me the full whack possible in part payment (mine and one and a bit of the kids insurance would be enough). I do pay out more than €1900 though.

Also, my wife is not working, but we're paying her private health insurance, so should she be getting a €2800 allowance? Then both the kids are private insured (via my wife's insurance), so we also have to consider their payments too.

Anyone have a clue what the calculation looks like in this case (€1900, €2800 allowances, payment in excess of these allowances & employer part payment)?

----

edit - maybe I answered this one myself via info here:

Die Beiträge zu einer Basiskrankenversicherung, die weitestgehend dem Niveau der gesetzlichen Krankenversicherung entspricht (Grundversorgung ohne Chefarztbehandlung, Einbettzimmer, Krankentagegeld usw.) und zur gesetzlichen und privaten Pflege-Pflichtversicherung sind sogar in voller Höhe als Sonderausgaben absetzbar, auch wenn sie den Höchstbetrag überschreiten (§ 10 Abs. 1 Nr. 3 EStG). In diesem Fall bleiben dann allerdings alle weiteren sonstigen Vorsorgeaufwendungen unberücksichtigt (§ 10 Abs. 1 Nr. 3a EStG).

So my tax allowance increases to cover all of the basic level insurance payments (but this then means I can't claim things like berufsunfäigkeits versicherung etc..). So the various allowances are only used if you health insurance is below this level, and you have other insurances to add to the mix.

Or am I still confused?

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Posted

I believe by Basiskrankenversicherung they are referring to the Basistarif that they forced all private insurances to offer. This has largely the same cover as the state insurance.

If one of these Basistarife is not involved, then it does not apply.

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Posted

Hey Guy, sorry - this use of similar or identical words is clearly confusing, but the tax law has nothing to do with the BASIS-Tarif that private German health insurances have to offer.

What the tax law refers to here is this: ever since the "Bürgerentlastunggesetz" - which was forced on the gov. by a decision of the German supreme court - in 2010 the gov. has to allow that you can write off your full health insurance costs because they are considered as priority coverage for everyone and since the state does not cover it/pay for it, you are allowed to write it off entirely.

With one caveat: the Bürgerentlastungsgesetz made clear that only those costs out of any private health insurance contract can be written off that are more or less for the same coverage as in public health insurance. That is meant with BASIS-Krankenversicherung here. All those parts of someone's private health insurance that are above and beyond the coverage offered by public health insurance are considered private luxury and are not allowed to be written off.

Which is why now for everyone who has a private German health insurance the helath insurance company has to report the premiums paid and which part of those premiums are actually BASIS coverage and not more to the Finanzamt - and then this and only this part can be written off. In some cases it is 90% in some other cases only 70% or less of the actual premium, depending on what kind of good or bad tariff with regards to coverage quality you have.

For international health insurances only the 2.800 EUR write-off threshold applies as they can't differentiate between what is typical public coverage in Germany and what not and are also not equipped to report premiums paid etc directly to the German tax authorities.

Hope this makes it clearer?

Cheerio

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Posted

I'm employed and pay for private health insurance - my employer pays me the full whack possible in part payment (mine and one and a bit of the kids insurance would be enough). I do pay out more than €1900 though.

Also, my wife is not working, but we're paying her private health insurance, so should she be getting a €2800 allowance? Then both the kids are private insured (via my wife's insurance), so we also have to consider their payments too.

Yes, you should claim for all those health insurance contributions.

Just add the kids' contributions either to yours or your wife's (source) in the Anlage Vorsorgeaufwand (exact guide is in yellow section of the TT Elster wiki) and also attach all your "Bescheinigungen über Vorsorgeaufwendungen nach §10 Abs. 1 Nr. 3 EStG".

So my tax allowance increases to cover all of the basic level insurance payments (but this then means I can't claim things like berufsunfäigkeits versicherung etc..). So the various allowances are only used if you health insurance is below this level, and you have other insurances to add to the mix.

Correct.

Yes, in all likelihood, you will have already exceeded the allowances with your health insurances, and therefore will not be able to claim for other insurance such as Kfz-Haftpflicht or Privathaftpflicht or Berufsunfähigkeitsversicherung.

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Posted

Berufsunfähigkeitsversicherung: the last loophole to write your BU-contributions off nowadays is in a combination with a RÜRUP-pension plan (I try to avoid the other name BASIS-pension plan because what with the confusion about BASIS health insurance as seen above it would probably cause some heads to explode if I did).

Normally I am not a fan of combining any form of investment or pension plan/saving with any form of risk coverage - these usually are better selected in separate contracts for many good reasons. But: the tax advantage is simply too good not to think about this option, especially if you have long-term plans for your stay in Germany AND have still something to do on the pension planning side anyway with some solid tax benefits thrown into the bargain.

Cheerio

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