Health insurance and pre-existing conditions

19 posts in this topic

Posted

Hi - I'm new to this site... i am a 51 yr old canadian, recently had mastectomy for DCIS (non-invasive). I was planning to come to Germany to live with german BF until our divorces are final. Then I was diagnosed etc. Our residence is settled- near Munich, BF has amazing job with government, I have extensive savings etc-I am planning on the "attending language school route to start - then try and get entrance to University - if not I hope that we can be married in 1.5yrs,,,

All recovered now and looking into the health insurance issue.

I assume that the health insurance (if I can get it),will say that they don't cover any Pre-existing conditions.

1. any good suggestions on which would be a good company to apply to? can I get a residence permit - I would assume that my health status would be "all healthy" which apparently I am.

2. what would happen if I had an emergency regarding my pre-existing condition - would I be turned away for treatment?

3. If I needed follow up surgery - would I have to pay cash to get treated?

just wondering if anyone else has any experience with pre-existing conditions.

thanks so much for any advice you can forward...

muskokaGirl

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Posted

When I was looking at insurance, all the companies I looked into didn't want to exclude any pre existing conditions. Instead, they wanted to either charge a higher premium and have them covered, or just not cover me at all. I had an operation on my thumb cause I snapped a tendon and one place turned me away because of that. I got one in the end that didn't care about it, but that would probably be different in your case.

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Posted

Make sure you get offers from more that one insurance company. Sometimes Agents only work for one company and the prices between companies may be really different. I recently swapped saving myself 100 EUR a month.

I also had pre-existing condition (slipped disk). I have that covered in my insurance contract and I have to pay higher premium due to higher risk. My health treatments regardig slipped disk are covered though.

Some companies may refuse to insure you (as happened to me).

I'm curently insured with AXA.

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Posted

Try IMG Europe.They include pre-existing conditions after 2 years´cover. Non-German insurers are (still)allowed here for foreign non-employees. Very little chance of a German company accepting you as their health questions go back 5-10 years and you would have to go for a medical check-up anyway.All the best!

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Posted

Hi everyone,

I'm a dual citizen of the U.S. and Germany living in Germany for the first time. I currently do not have a job, am here (like so many) to work on an art project and improve my German. I've read through the health insurance info and posts, and understand a lot more now. I'm going to try for the Künstlersozialkasse (public insurance for artists), but as I haven't made a living off my work in the past, and have scant documentation of my sales, the chances of getting in are slim.

So I am wondering if anyone has had SUCCESS getting affordable private insurance that includes a pre-existing condition, and what firms would do this? My concern is having this covered here, but also continuity of insurance for when I go back to the States, as I know many companies there have pre-existing condition clauses if you're not insured for a certain number of days or months...

Thanks!

Chris

Topics merged by admin

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Posted

I had to end up taking AXA from the UK, was about 90 Quid a month I think (was years ago) as no German insurance company would insure me for less than 400 a month because I have Celiac (gluten intolerance). I looked at nearly all the German ones out there and several from the UK and AXA was the cheapest I could find.

Mind you though, I would not recommend them. Was very unsatisfied with them.

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Posted

chris: as an US citizen with no prior public health insurance in any EU memberstate you are certainly not eligible for voluntary membership in public health insurances in Germany. That leaves you indeed with only private health insurances as an option. Starting from January 2009 the private health insurances have to accept you into a so-called "Basis Tarif" without even considering your existing conditions, i.e. those will be covered. BUT: this basic tarif will be quite expensive, probably close to 500.- EUR/month (there might be some special rules for low income, but not sure yet about that). The "normal" private German health insurance will either deny an application if your pre-existing condition is too grave a risk in their consideration, or exclude it from coverage or ask for a hefty additional risk premium. So, it all will depend on what pre-existing condition you are suffering from.

The international insurances Eurobabs mentiones, like AXA PPP from the Uk and others become more and more problematic for Expats who need to get a Visa and residence permit and all, since German immigration offices (Ausländeramt) have in recent times more and more only accepted such insurances which can also offer the long-term nursing-care insurance (German: Pflegepflichtversicherung). Most of the international insurances I know can't offer that and are then quite often summarily rejected as being not in line with the regulations stipulated for Visa and residence permits etc. Besides: these insurances, too, will usually only accept you by excluding pre-existing conditions - but at least they can accept you.

With regards to your other wish, to find an insurance which would continue to cover you if you move back to the US: most insurances will or can not cover an US Citizen when being a resident in the US again. A German private health insurance will autmatically cease to be effective if and when you give up your German residence. Therefore I can not see how this can be solved - except hoping that while you are living in Germany, President Obama can create a new health insurance system for the US...

Cheerio

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Posted

Hi, this is Chris again, and I learned a lot about insurance in the last months.

I now have health insurance. I have never worked or been insured in Germany beforehand. I do have a German passport (easier for me than most). I was told by many folks, including agents, that the public health insurance in Germany would NOT cover me, but with some pushing I was able to get coverage through AOK, which will cover all my pre-existing conditions. AOK also told me no initially, but I asked that if it is a law to be insured in Germany, what was I supposed to do? They seemed to have some wiggle room and caved into my request.

In addition, I did a lot of research about insurance once I return back to the states. As long as my insurance is continuous (not interrupted for more than 60 days or so), American insurance companies WILL cover me for pre-existing conditions--at least the companies in MA & NY. They don't care if you had public or private insurance beforehand.

Just want to say, IT PAYS TO DO THE RESEARCH. People have told me many different things that aren't necessarily true. So keep looking for your best option, ask a ton of questions, and push if you need to. Insurance is so important!

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Posted

Chris: good for you, congrats! Not sure I understand the "wiggle-room" so, would you care to shed more light on how they were able to accept you as a voluntary member if you have not had public health insurance in any EU memberstate for at least 24 month out of the last 5 years? Because this is according to all I know and get told everytime the yardstick to be applied without exception... It might help many people if you have found a way around that...

Cheerio

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Posted

Chris: good for you, congrats! Not sure I understand the "wiggle-room" so, would you care to shed more light on how they were able to accept you as a voluntary member if you have not had public health insurance in any EU memberstate for at least 24 month out of the last 5 years? Because this is according to all I know and get told everytime the yardstick to be applied without exception... It might help many people if you have found a way around that...

Cheerio

Woah, I am returning to the forum after a long time and only now see your question! So, if you are still around... :)

Actually, I don't know why they made an exception if the above is true - because the stars were aligned in my favor that day, the rep I met was a nice one, or if this does happen from time to time.

What I do know is when I asked some native Germans about health insurance, this one sentence was uttered by two different people. "AOK - they have to take everyone". So I believed what they said, and went to the AOK office, where I spoke to a woman in person, saying (in bad German): "I am a German citizen living here for the first time who has too many pre-existing conditions to be accepted by private health insurance, but per German law I HAVE to have insurance. What am I supposed to do?" Then we stared at each other a while, she sighed, and somehow decided, okay. She helped me fill out a form, "Anzeige zur Pflichtversicherung nach SS 5 Absatz 1 Nummer 13 SGB V". I had lived in Germany 3 months at that point and had to pay for the insurance retroactively from the time of my Anmeldung. Seeing how lucky I was to be accepted at all, I paid it without question.

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Posted

HI Chris,

yes I am still around :P - if you come back to the finance forum every now and then, you can hardly miss me contributions...

Re-reading our conversation I see that I must have missed that you had dual citizen-ship. As a German citizen you do indeed have a right to get under the umbrella of public insurance thru the "Nummer 13" rule this lady applied to you.

Cheerio

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Posted

So many ins and outs here. Starshollow or John G., if you're around maybe you can fill in some information for me. Though I know you make your bread by brokering private insurance!

Like Chris, I've got issues with a preexisting condition, and it is getting worse! it is high time to improve my coverage. Suffice it to say I am American and unmarried at the moment, though I would consider marrying my European partner.

:

Specific questions

I had 2+ years on the NHS, within the past 5 years. Would this help qualify me to get public insurance? If so, I'll be running right down . . .

My next question involves the marriage option. I realize I could of course go right on my husband's insurance (as long as I don't earn over 400 euros per month). Question is, would being married to a European enable me to go right out and get my own public policy? (Which would be desired so that I wouldn't have to shrink my earnings.)

Any info from the in-the-know would be greatly appreciated!

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Posted

I am American and unmarried at the moment, though I would consider marrying my European partner.

:

Specific questions

I had 2+ years on the NHS, within the past 5 years. Would this help qualify me to get public insurance? If so, I'll be running right down . . .

Yes, according to § 9 Abs 1 SGB V you fullfil the requirement to become a voluntary member (Freiwillig versichert) at a public health insurance with the pre-insurance in the NHS being longer than 24 months during the past 5 years. But make sure you'll have some documentation from the NHS /HMRC to prove this.

My next question involves the marriage option. I realize I could of course go right on my husband's insurance (as long as I don't earn over 400 euros per month). Question is, would being married to a European enable me to go right out and get my own public policy? (Which would be desired so that I wouldn't have to shrink my earnings.)

No, marriage is indeed only required/helpful to enter the spouse's public insurance, it does not matter for your own insurance. For the latter, the requirements of § 9 SGB V need to be met which you fulfill in my opinion. Worst case scenario (and not sure that describing marrying as "worst case" is ok, I myself being happily married :D ) : you'll marry, stay with your husband and your lower income for one year, because after 12 consecutive months with your husband, you would again be entitled to your own public health insurance membership.

Cheerio

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Posted

Starshollow, the way I understood her post Teabiscuit already has private insurance here, regrets her decision, and wants to switch...

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Posted

Hmm, it´s all very true what Starshollow has written about being entitled to public insurance because of the 2 in the past 5 year rule but I have a doubt here. Teabiscuit, you´ve been here since 2009? You are self-employed, I believe , and currently privately insured, is that correct? So I personally doubt you could now switch to public, based on that.

Edit: just remembered you from yesterday, Teabiscuit , on another thread. You are applying for the Artists´s insurance/Künstlersozialkasse - in that case, if they accept your application, you can indeed get publicly insured as you´ll - legally speaking - be their employee! But only if that happens or, alternatively, you become an employee earning at least 401 euros a month.

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Posted

I have been in Berlin since 2010. But I take the point, John G. I am really very much in need of better coverage, so I will be trying all channels, no matter how unlikely. I think I am a good candidate for KSK, but at this point going through the long approval process would be literally bad for my health! It's funny how it appears that European countries have better health care coverage, but actually the virtues of the system are greatly exaggerated, unless you live in the UK, it seems. (Other set of problems there, as well!)

Onward . . . ! I'm in the States for a few weeks but when I'm back in Berlin I will report if I make any progress! Thanks all.

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Posted

May I ask where you are currently insured, Teabiscuit? That could have an effect on your future coverage ( eg if public insurance through KSK channnels would accept the legality of your current insurance ).

By the way, you say Starshollow and I etc live off private insurance - well, we couldn´t live off public insurance BUT we both actively offer public health insurance when it either makes sense or is obligatory! Speaking of Gunn & Partner - and I know it´s also true of Starshollow and his team - we make sure our clients are well-informed of their choices ( if any ) and inform people of the laws, obligations, grey areas, no-brainers et al.

I´m confident our record on this forum over the years will show we are all serious in helping our clients get the right insurance for their needs and within the laws.

Starshollow and others here plus we have a licence to risk and a duty to offer Best Advice...even if people sometimes want to shoot the messenger! :) ( what people want is not always the same as what they can get, legally or financially or for health reasons! )

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Posted

I just noticed that I missed something in your prior contri, Teabiscuit - the fact that you have been living in Germany already as a resident for some time...that may have waived your eligiblity to enter public insurance as a voluntary member despite the 2+ years in NHS... as you would have had to enter public insurance within the first three months of residence in Germany. Sometimes people get lucky and are still allowed to slip under the roof of public insurance, but that is then just that: luck, not a legal right.

Obviously, if you make it into KSK, it is a different ballgame as you would be compulsorily insured in public health insurance then - but you might also face back-charges for both health insurance and public pension contributions because from the point of view of the KSK, once they have ascertained that you ought to be a member of KSK, they will check how long you have been living in Germany with the same occupational background and then say that you should have been with them all the time as it is, as said above, a compulsory insurance for artists.

So, there are always two sides to things but I sure hope you are going to get into KSK as this appears to be the only viable option for you.

Cheerio

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