Health insurance for multiple sclerosis sufferers

anyone here with MS? Need advice on insurance.

I hope you don't have it.

so do I. just need some advice. I have been experiencing limb numness for about three months and saw a neurologist who told me to contact him again if it persisted. It has. Up until now I have had public Uk health insurance but on January 1st i switch to private German health insurance. I am sit scared of going back to the dr and getting a diagnosis (which is not a foregone conclusion) an then come january finding out I am uninsurable. to say I am worried sick is an understatement.

There are a myriad of other reasons you could have limb numbness. I would get at least two opinions regarding your diagnosis.

that's not the problem. I am aware what I should do diagnosiswise but unsure how that will affect my ability to get health insurance

Get coverage now. Don't wait and don't limit yourself to private. Go to AOK and tell them that you want signed up now so there is no lapse in your insurance as you go from the UK to the German system. Overlap the two and don't get off AOK until you have private in hand if that is what you really want. That is the insurance advice.

As for the MS, get doubly covered ASAP and go back to the Neurologist as soon as you do. Talk to him and make him talk to you. There are things that will help in early stages and a doctor that is unable to diagnose needs to be replaced with one that can. There are some good docs in this neighborhood for that and there are some new drugs as I am sure you know. Get covered and get definitive answers and most of all, GOOD LUCK. Here is hoping for the best!

Of course, I know that's not what you were asking. But I thought I'd add my two worthless cents anyway since it is an open forum. I have no idea about how the health insurance works in Germany as I have American health insurance. But one thing I do know for sure stress excerbates illness, but you probably know that already. Anyway, I do wish you all the best.

Sorry to hear you are worried about MS, genuinely.

I know we haven't always got on but that's shit, i wish the best for you.

As for insurance, i know that most won't cover pre-existing conditions so get down there now before you are officially diagnosed.

thanks

can they refuse me insurance or bump up premiums if I am diagnosed after taking out insurance?

(if it wasn't for the waiting lists, this is one situation where NHS wins hands down)

If not pre-existing then i believe not. Not sure how the fact you have already had tests for the condition reads though ...

To be honest , I am not sure how it works in Germany but I think they cannot bump up premiums at all. Health insurance rates are a percentage of your salary and can only rise collectively and not individually.

It is not like the illegal system they operate over here in the US where your rates are increased if you claim more than 74% of what you put in in any one year.

I don't have German insurance so I can't say for certain, but I don't think so, otherwise everybody's premiums would go through the roof as soon as the person got sick.

I agree with eurovol, try to switch before the end of the year if you can and make sure that you opt for full coverage (and not just basic insurance), just to be on the safe side. That said, I sincerely hope it's a false alarm. Good luck!

If you go for private insurance you will probably have to answer a questionnaire and depending on how it's worded there may be questions along the lines of 'have you consulted a doctor during the last year in connection with ... ?' There is also usually a three month wait but this may be waived if you are moving directly from NHS cover.

Would you be able to get into the Krankenkasse in Germany or are you a UK employee ?

I agree don't wait until January, get cover now.

I hope you don't end up needing to use it that much.

I just want to add here:
GAK! German health insurance is shite. If you have a pre existing condition and don't qualify for public, you're fucked six ways from sunday. Good luck BTC, hope everything turns out peachy

First off, I'm really sorry to hear that you're not well, but nothing has been officially diagnosed yet so try not to get yourself too worked up yet. (I know it's easier said than done). As LR mentioned above it could be one of many things.

I'd tend to agree with Eurovol, get into the regular Krankenkasse as soon as possible, once your in your in (at least I haven't heard of anyone being kicked out of the regular krankenkasse). You can always go private at a later stage. The wife of a colleague of mine has MS and gets everything she needs from the normal health insurance, if not in the luxury version.

The best of luck to you.


With regards to the NHS, my sister and brother in law would disagree with you big time. They refused to pay a treatment for my niece (a different illness but ...) which was looking promising and would have cost them £6.70 a week. Tess

What Eurovol said. I'd get into the public health system ASAP.
Take care of yourself mate.

Sorry to hear about your worries. I hope you're okay.

My husband had a pre-existing condition (hip problems) when he came to Germany and was unable to get private health insurance for that reason. However, the public system cannot refuse anyone with pre-existing conditions. He has had excellent care, including a hip operation since being here, so we've been very happy with the public insurance. Obviously your situation is different, but I would be quite confident that you will get the appropriate treatment on the public system.

Good luck!

Don't do anything until you've talked to someone like Starshollow.

All we can give you is our best guesses.

EDIT: added link

who is Starshollow?

Starshallow is a TT advertiser. He's one of our insurance agents. See his business page: C R & Cie insurance.

For what it’s worth, my girlfriend is German, she has had AOK health insurance for years. About four years ago she started having problems with numbness and semi-paralysis, it took a long time for her to be correctly diagnosed but eventually she was diagnosed with Devic’s disease which is a rare form of NMO which is a rare form of MS, so not the obvious choice for the doctors to check out I guess. We understand that 1 in ten million people get this disease.

Anyway the point is she has physiotherapy and ergotherapy twice a week, she has been on several different types of medication over the last few years and when she has an attack she gets cortazone infusions or pills to curtail the attack. All of this is paid for by AOK and her premiums have not been increased. Also AOK paid for her treatment and meds while she was in Ireland and had to go to the doctor there.

She recently changed meds to a new product just on the market (I cant think of the name of it at the moment) she required two infusions and then that might be it for at least a year. This was recommended by professors in two separate hospital institutes, however AOK refused to pay for it. We sent them a letter via a lawyer stating that we wanted to bring them to court to pay for the medication and they changed their minds quite quickly and approved the cost of the new medication.

So, as others have said, I would get health insurance as soon as possible before you are potentially diagnosed with something. But check with the insurance company if they have a 3 month or 6 month period after joining that you are not eligible for full cover, I think there is this clause in Ireland but I am not certain. Hopefully you are not diagnosed with anything and are in the clear but if you are don’t consider it the end of the world, it has been hard at times for my girlfriend but with some lifestyle changes and help from friends and family she has learned to live with the disease and lives a full and active life.

Hope this helps

Public insurance like AOK cannot increase in cost no matter what conditions you have. If you go private though, this is probably not the case, and you can't get back onto the public system easily. Especially seeing as you've possibly discovered something, this puts you in a tricky situation with the private insurance. I would drop the private insurance idea and then sign up for public.

Don't panic mate. If you do have MS - which hasn't been diagnosed yet - it definately is not the end of the world. There are a number of other medical problems that can also cause your current condition. Some, dare I say, a lot more serious than MS. But of course it doesn't have to be such a worst case scenario. So you should have yourself thoroughly examined as soon as possible. I'm sure your current medical insurance (NHS) will cover those costs. You mention you will be joining the German health insurance system at the beginning of the year. As far as I am aware there is nothing to be worried about if you join the "gesetzliche Krankenversicherung" (DAK, BEK etc.). They cannot and will not turn you down, no matter if you have MS or any other disorder. To my knowledge "gesetzliche Krankenversicherungen" have a kitty for patients with chronic diseases. A private health insurance will however most likely turn you down, even if you join them before such a disease was confirmed. Especially if you (have to) report such a chronic disorder to them in the first 6 months after signing the contract. I don't have MS but I shared nearly 12 years of my life with a gorgeous girl who does. She receives all the treatment she needs, and (nearly) all costs are covered by her "gesetzliche Krankenversicherung". No problems whatsoever. There is also a lot you can do yourself to reduce the severity and delay any progression. Some cost a little, some don't. Her life insurance, by the way, which we had just taken out, was returned with a very rude letter. Despite all the obstacles she looks as beautiful as ever and lives a perfectly normal life. So as I said above, don't panic. Go to the doctors instead. Best!

very helpful posts you lot! I knew TT would come up trumps.

I should stress that no diagnosis has been made and the doctors never mentioned MS to me before. However, I am a neuroscientist so know that the reason they sent me for the MRI was because they were checking for MS lesions. My relief that none were found was palpable at the time. The doctor did say that I should come back if it persisted, which is has and has been added by other symptoms. The pattern of symptoms now has me very worried. I do have a slim hope that there will be a perfectly innocent explanation but if not, I really do not wish to be caught out as uninsurable.

I will go back to the doctor but before I do so I will secure insurance, probably with the public insurance if I can. Starshallow is considering my predicament and I will not finally act until I have heard back from him.

Thankyou again everyone.

Bell,

I'm hoping with you that whatever you have is not MS and clears up. I've had two run-ins with MS - a woman that lived with us for several months and a colleague, so permit me with a bit of advice with any long term numbness or episodic symptoms (even season rhinitis) - keep a diary - how you feel (physically & mentally) and your routines - excercise, food, stress. Especially food. What you eat can affect you so much that being able to look back at understand this relationship can perhaps help. As a side-note and not intended as a suggestion, but based on her diary, my colleague ended reducing all dairy products and it seems to have helped her crisis a lot.

Bell the Cat has already contacted me, crowd. So he will get some personal info not being displayed here, but since this is an issue probably interesting for a number of people, here is some professional advice and information:

1.) if there is a "pre-existing condition" or the threat of such a condition (even if not totally determined yet), the best option at the moment for anyone -if eligible- for it is to enter the public German health care system because be law they can and may not close the door on someone with a health problem. Since the treatment and coverage in public health insurance is quite o.k. in an international comparison, this is a solid move. It remains to be determined if BTC is eligible for public health insurance or not, which, as most of you know by now from all the different threads and discussions here, is partly depending on his occupational status which I do not yet know enough about. If he is a UK (or basically EU) citizen, I would guess it to be possible.
2.) Appart from that with the beginning of 2009 also the private German health insurances will have to offer a "basic" or "standard" tarif which may - according to the change of law in April this year - not exclude anyone based on pre-existing conditions. Therefore, if BTC should for any reason not be eligible for public health insurance and if the check-up he recently had from a doctor would in combination with a later positive diagnosis of MS be legally considered as a "pre-existing condition" and hence exclude him currently from coverage at all or of this particular risk by any private insurance, he would only remain for 13 month without adequate coverage from an insurance. This is a description of the worst case as you can see. And I am fully aware that "only" 13 month is still a long time, "only" being meant here in comparison to "forever".
3.) Now the question is: how to deal with an application at a German private health insurance right now? A couple of things I tell you here are in the twilight-zone of the law at best, so you never heard them from me, right?
i) When applying for a health insurance, you need to answer truthfully all health questions in the application form. Failure to disclose information can make the whole contract void if the insurance finds out. Therefore as a professional I have to advise everyone applying for a private health insurance to answer truthfully to the last. But...
ii) if you are in a predicament like BTC, the rules may change and in order to save your skin you might need to use some methods of the last resort (provided that my answers at 1) and 2) are not a sufficent solution at this point). In an application there are a number of questions like this
- are you aware of any existing illness, ailments etc. ?
- did you undergo outpatient treatment, examination or consultance through doctors, alternative pracitioners or other therapists oder are there any illnesses, disablements or ailments in existence that have not been treated within the last 5 years
- are there any treatments or examinations recommended or planned at this point of time for the future

BTC would have to answer, if acting completely truthfully, yes on all three account, obviously. If he does, he will have to name the doctor who did the examination and the insurance will probably check back with him, even if BTC simply states "because feeling some numbness in limbs" and not "because of suspicion for MS". Thus, if answered thruthfully the chances are very high that he will either be rejected from German private health insurance if they detect such a (potentially very expensive) condition or that they would exclude this particular risk - in both cases no good solution for BTC.
Therefore quite obviously the only chance is to lie through your teeth. As said above, I can normally only recommend to everyone to be completely honest in answering the health questions from insurances because you are risking a lot if you conceal a known health risk like high blood pressure, since the insurance could also cancel/step back from the contract if you are to be treated with a totally unrelated illness like cancer if they find out. But in a case like this, when it is highly likely that no coverage from them will be available at all if the truth is disclosed, lieing is the last resort available.
But you need to do that dilligently. First you have to establish a new relationship with a doctor you have not consulted in the past. Get a simple check-up for a flue or whatever with this doctor so that you are reigistered in his files as patient and do not tell him about your suspicion or the treatment/examination by another doctor nor demonstrate the health problems you have experienced if they can be still hidden, that is. As an EU citizen coming out of another EU insurance you will most likely not have to go through another check-up ordered by the insurance. If you are not an EU citizen and/or if you have been insured in the last 3 or more year outside of Europe you will be required get a check-up from a doctor of your choice but it will only work then if your illness/ailment can be concealed in blood tests and superficial check-up.
Now you lie about your potential or established illness/ailment and provide the insurance with the address of your new German doctor and a former doctor (in your case) in the uK who also does not know about the health problems. Attention: this will only work if you have not had the prior examination/treatment paid and recorded by another public health insurance like the NHS since this data might be available to the German insurance in the end.
Because what will happen if after only a couple of weeks or month you would be diagnosed with MS or another illness requiring similarily expensive treatment is that the insurance will of course try to shed the risk and costs by checking your health background. If they can establish from files of another insurance or of another doctor (whom they can only detect if he is registered with your former insurance or in the files of your current doctor) that you mislead them about your health status or that you failed to disclose such vital information, the will cancel the contract at once. Therefore you must be sure that you have not left any traces of the prior examination/treatment and those traces would be easiest found in the files of prior insurances who were charged by the other doctor(s).

AS I said above; it is not easy to lie with sufficient chances for succes and if you know that your prior examination has been recorded somewhere with another insurance, be it public like NHS or private in another country, do not even try to trick your way into the insurance because the chances are to high of being detected and thrown out with a good kicking. But if you have paid for former treatments/examinations in cash, you can try to use the above mentioned way, of course being aware of the risk described therin about loosing your insurance coverage if detected.

All in all I sincerely hope that this is just a theoretical mind-game and that BTC will not receive the much feared diagnosis nor will be rejected from public health insurance. Any application for private health insurance, however, would nevertheless require lieing already at this stage...

Therefore my final recommendation would be this:
- try to get into public health insurance. If you'd rather have private health insurance eventually, either wait until it has been established that your fears were unfounded, then cancel the public insurance and change to private (2 month notice). Or apply now in accordance with the precauions elaborated above and in full knowledge of your risk.
- If you are in employment currently and if this feared illness should turn out to be only too true, there is one thing you could do to make sure that you will be entered into public health insurance: have your employer lower your gross salary below EUR 3.970.- per month and you will receive compulsory public insurance. In order not to loose too much income you could negotiate with your employer that the difference in salary compared to your current status would be paid out as overtime payments, bonus or any other form of income not to be counted in the German public health insurance system as gross salary (allowance for car, for housing and so on, are othe examples of not counting as gross salary).

Hope this information will help BTC and others in similar predicaments,

Cheerio

lummy, its more serious than I thought. As far as I know I cannot go onto public insurance and I am not prepared to lie. Nor do I wish to spend 13 months without any access to medical treatment when I may have a serious condition. Guess Iäll just have to go back to Britain.

that was a little melodramatic - I will have to consider very seriously what I do next. Certainly does not inspire any confidence in insurance-based health systems anyway. Surely healthcare should be about treating the sick and not driving the sick away?

Find out for definite!

Monkstown: that would also be my first and best advice: to make sure that German public health insurance is definetly not available at the moment and if there is anything one can do to get around any existing legal problems in order to get into the public health insurance. My gut feeling (without knowing very much about the details of BTCs legal work status yet) is that since he is still insured with the NHS based on the right for personal and professional mobility within the European Union he should be eligble for public health insurance...
Will check back with BTC next week and see what we can find out and achieve to this regards.

BTC: you are right that health care - here meaning "public" health care - should be about treating the sick and not turning them away. It is of course different with private health insurance, which is primarily a business and accepting a potentially ill person without charging extra, extra money would be harming all the other clients of the insurance (and the profits of the insurance, of course, not to forget). With regards to the German public health insurance system we will need to see if you are eligible or not and the eligibility has unfortunately been made much more complicated through the recent health law reforms.

From my personal point of view Germany needs eventually to charge everyone, regardless of income or occupational status, with a standard fee/premium in a compulsory public health insurance (which, however will be lower in coverage and services then today) and everyone who wants to have better coverage and can afford it will have to pay in a private add-on insurance. It is unbelievable that we did have in recent years according to public statistics as many as 300-400 thousand people in Germany without health insurance!

Cheerio

I am currently on secondment in Germany, working for the same company I worked for in Ireland. I have been here about a year and a half but had problems that arose from internal company politics with regards to my national insurance payments. That has just been sorted so I am paying national insurance in Ireland (its called PRSI there) while working on secondment here. By doing this I am eligible to apply for public health insurance here at no extra cost to my national insurance payments, I plan to do this on Friday all going well. I have been told that all I need is a copy of my E101 form, I can let you know if it is that simple, this being Germany I presume I will be asked for something else as well. I do know that a colleague of mine who was paying national insurance in the UK got public health insurance here by doing the same thing.

If you are still in the NHS I am assuming you are still paying national insurance in the UK, if this is the case you should be eligible for public health insurance here at no extra cost to your national insurance payments, again I guess you will have to check the fine print to see if you have to state whether or not you are ill or suspect you may be ill. I can let you know how I get on at the Krankenkasse if you like.

I have been here a little over 2 years. You are allowed to make a declaration and continue to pay National Insurance in the UK for up to 2 years, and that is what I have done. But that period comes to an end on Dec 31st 2007, which is why I have to seek German ppublic or private insurance now. My dilemna is about the utterly shit timing of my current medical complaint and whether getting it seen to medically will jeopardise my chances of getting insurance.

Are you sure thats correct? As I said I have to sort this out myself but I am nearly sure my colleague working here has been paying national insurance in the UK for much longer than 2 years, I think he's here 5. However it might be something to do with the fact that he is also working for the same company here as he was in England.

Yes, I'm sure. I am working for the same company as I was in the UK. You have to make a declaration to the UK and German tax authorities and can only do that for one year with a subsequent extension for another year if you are based permanently in Germany.

Just got the following feedback from one of my contacts at public health insurances when describing the employment and prior insurance situation of BTC.
Here is the good answer for BTC and anyone in an identical situation:

Wenn Ihr Mandant bisher in der gesetzlichen Krankenversicherung in Groß Britannien versichert war, kann dies auf die die Vorversicherungszeiten nach § 9 Abs. 1 Nr. 1 SGB V angerechnet werden.

Wir benötigen von der englichen Krankenversicherung jedoch einen E 104, der zusätzlich zum Antrag mit einzureichen wäre.

Therefore, if BTC or any other person in similar circumstances has so far been insured with the NHS or any other European Memberstate public health insurances system for the last couple of years, an immideate change into the German public health insurance is possible if the above mentioned form E104 can be provided as proof.

Of course, others who have been on a private health insurance scheme outside of Germany are not in the same situation...

Cheerio

Starshollow has been utterly fantastic and we now have a result. I will be signing up for the public insurance as soona s I can get my E104 from the NHS. I have also now made the appointment with the neurologist for a fortnight from now. It will be an enormous relief to actually see a doctor now after all these weeks of worry. And hopefully all my fears will actually be groundless and there will be some simple explanation.

I hope the best for you BTC, and that it will all turn out to be something not as bad as you thought.

well, I did go back to the doctor and her referred me to another neurologist. We have done a lot of tests now and have comprehensively ruled out neurodegenrative diseases or even spinal problems. Not fully come through to a final conclusion but it appears that one possible cause of my nerve problems has been a poorly designed office chair. Needless to say, this is all an absolutely huge relief after all the months of worry. Thank you for all your concern.

You should maybe think about your desk too. My husband has recently got one at work that he can either sit or stand at (it's electric).

It's not completely cured his pain but he feels a lot better than he did!

does anyone know whether getting an ergonomic physiotherapist in to look at workstations in the office can be covered by Pflegeversicherung? Or even Krankenversicherung?

Hi Bell!

I can't say too much about the German health system but what I can say about MS is try to relax a bit!!! They can't leave you to suffer and stress does make it worse!

So to make a short story long...

I was diagnosed in 1999 with MS.
I took a nap on the couch, woke up and my left foot was numb. Ok, it's just asleep...no problem I say. Well by the end of the week I could hardly walk as my legs were numb from the waist down. It stayed that way for a few months.
I went to the doc who sent me to the Neurologist who gave me a MRI,CT and (Agh!) spinal tap.
After he said I had MS he sent me to another brain doctor (the best in the USA) who confirmed it. (all that money for them to tell me I had dain bramage!)

I decided that there was no way I was going to let it stop me and it hasn't!
I keep myself healthy, I do not take ANY meds for it and have not had a need to see my doc in 6 years! (I told him that he has people who need his care worse than I do.)
The only time I have any problems is when I get stressed. (tingly foot, blurry eye)

So take care of yourself, keep a good sense of humor, try not to stress and if you ever need someone to talk to who has it who understands, let me know!

thanks fo that Ashley, but if you look two posts up, I have just found out that I do not have MS

@BTC
I'm very glad to hear your good news.

well so am I