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Found 21 results

  1. Hi,   I am urgently looking ways to switch my health insurance from Private to Public as every year the premium is increased by Insurance provider. That too when our Medical expenses are almost null.  I have heard that one way is if the income goes below 54k pa then one will automatically be switched to Public health insurance.  So my question is does it also apply if the working hours are reduced to decreased the income?    Thanks, Ashfra
  2. Hi all,   Sorry, I know there are many posts on this but I really could not sum up an answer after reading all those posts :(. Please advice.   1. I am here in Germany for almost 3 years as a student. From the beginning until the 2nd year I was having AOK insurance. At the second year, since I was turning 30yrs, I moved to private insurance Mawista. Now I want to go back to AOK or TK public insurance. Is there anyway to go back ??  The reason for going back is I might be starting my full time job in July/August.   2. If at all I cannot go back to public health insurance, could you please advice me a good private insurance. Note that I might get married in the next year, and may be have 2 kids in the coming years.    3. Will my employer also contribute if I am in a private health insurance? I see that there are options such as private health insurance and private voluntary insurance.
  3. Hey peeps,   I'm a strong believer in bullet points as a storytelling device in online forums, so here is a breakdown of my current situation:   1. I'm a Brazilian-German citizen who came to Germany one year ago. In Brazil, I was a freelance translator for a European company, and in Germany I kept doing the same as they provided me with steady work and a decent living wage. 2. Since I had never worked in Germany before, I was not eligible for public health insurance. So, with the help of the wonderful John G. from this forum (hi, John!), I signed up for the cheapest available private health insurance option at the time: HanseMerkur. 3. Cheapest available private health insurance option = 350 Euros/month. It was PAINFUL, but I made it work. Until now. 5. Said European company moved the translation operations to Brazil and gradually stopped sending me jobs. Right now, I am virtually unemployed, with no other meaningful source of income, while still having to pay for private insurance. In fact, they just took this month's premium as a direct debit from my account. Ouch. 6. Of course, I'm looking for a job, and relying on savings meanwhile. But they are running out FAST, and I'm not sure I will be able to afford my expenses next month. 7. I am... kind of desperate. I'm working a Minijob to keep things afloat, but of course it's not enough for rent + health insurance. I don't know what to do if I don't find a job within a month or so.   So... what are my options if I don't find a job soon? I can't sign up for public insurance, and it's not legal to just ditch the Krankenkasse. I'm looking into the possibility of changing my Minijob into a part-time contract because this would at least mean partial coverage of my insurance... but not even that is guaranteed. So what does a freelancer do when the tide changes and they suddenly find themselves moneyless? What if I simply cannot afford health insurance anymore? What are my options in the short-term?   This has been keeping me up at night... and the irony of it is I can't even afford to go to the doctor now for stress-related issues because of the goddamned annual deductible of 500 Euros.   Don't trust the freelance fallacy, kids. Find an unbefristeter Arbeitsvertrag.
  4. Hello everyone,   I've asked on here before regarding S1 health insurance forms and eventually I was able to get mine sorted. However now that everything is up and running I expect the walls to come tumbling down again.   Firstly does anyone know if I am required to resubmit the S1 form annually? When I received the S1 certificate it did indeed have an expiry date for a year later, however I don't know if this is just an expiry to use the S1 form to sort out your insurance or if the subsequent insurance that you acquire will also expire on that date. For example I had an S1 certificate from the UK that expired at the beginning of April 2019. However I took that certificate to AOK and was issued with my AOK insurance card last year. The insurance card itself has no expiry date on it and instead has xxxxxx in the place where the expiry date would be (which to me implies no expiry). I was hoping someone here would know so I wouldn't have to go into AOK and ask or worse still find out I am not insured next time I am at the dentist.   The second part of my question relates to being a UK citizen living here in Germany and if anyone else is in a similar situation and knows the potential outcomes. I am married to a German citizen and have a freshly born German citizen son here. I've been here for just over four years and married for about one and a half. My work is still UK based (I am a sailor in the North Sea) and all my taxes are paid in the UK as I actually spend more time there per year than I do here. I have made absolutely no preparations, enquiries or precautions regarding Brexit whatsoever so was wondering if anyone had any knowledge on the following;   - What will happen to people like me with S1 health insurance after Brexit? - Is it possible that even with a wife and child here I could be deported? - Would I be eligible for German citizenship and what would that entail, could I get dual citizenship? - Is there anything I should be doing etc. in preparation for Brexit? - I fly in and out of the country on a monthly basis to the UK for work. Will I likely suddenly have visa issues?   Any help, advice or thoughts will be much appreciated! 
  5. Background: I started to work January-1 and signed up myself and mywife for TK Non-contributory Dependants Co-insurance / Family.    Unfortunately, I had to quit my job end of march - terrible office culture. Funny enough my wife found a job in Munich and started her work on 15-April.    TK Insurance reapplicaiton over wife I explained the situation to TK and they said we are covered about a month so we put insurance start date 1st May. However, the period without employer contribution (April-1 to April-15) and insurance start date made me worried that we might perhaps be invoiced some cost...   My question to good people of TT,  a) are we going to end up with an invoice for period: - April-01 to April-15 (no employer) and/or - April-15 (work start) to May-1 (insurance start date)     b.) shall we change insurance start date to April-15 instead of May-01    
  6. Hello, sorry if this has been already asked. I have been in Germany for 1.5 years and the health insurance is still very confusing :/   When I first began my studies here (I am non eu) I was paying around 90/month for TK public health insurance. After I started working a mini-job (15 hour per week & less then 450) these payments stopped & my employer was covering them. Then, I got a new job at my university (8 hours per week) & 1 month later I quit the other mini-job to start a new job at 20 hours a week. I thought that because I was working as a student assistant, this job didn't count but appartently it did according to TK. Anyway, my insurance was paid by employer during the time I had the student assistant job & regular 20/hr week job. (total of 28 hours, wk) Now I am being charged 90/per month again while only working the main job 20/hr per week (over 450 euro/month) I am confused because I thought if you made over 450 your employer paid the contributions, and under 450 you covered the payments? Does it not go by salary? I have tried to get this resolved by calling both my insurance & employer, and they have been no help in explaining this.
  7. Hi all, I'm hoping there's someone out there with the expert knowledge I'm looking for. I've searched everywhere, but can't quite find anything which fits my circumstances. I am a British citizen who lived and worked in Germany for a total of 28 years, paying compulsory health insurance (Krankenkasse) and contributing to the state pension scheme. Because I worked in the public sector, payments were also made into the public sector occupational pension (VBL) for most of those years AND I also made extra voluntary payments without any tax relief for 20 years (VBLextra) I have also worked in the UK and have 18 qualifying years for the UK state pension.  My situation now is that I left Germany and moved back to the UK in 2016 and will reach retirement age for both countries in three years time. I have not turned my back on Germany, and may indeed decide to move back there at some time. What I would like to know is if there are any pitfalls I should be aware of, eg when it comes to how much tax I would have to pay to each country, taking into account tax free allowances, or even more importantly, if the timing of a move back to Germany would have an influence on whether I would have to pay into the German health insurance, which of course I would love to avoid if possible, being that the health care system here in the UK would cost me nothing. From what I understand, I will pay German tax on my German pensions and UK tax on my UK pension, independent of where I am resident, so again, it's a question of tax free allowances.  Even if I do decide to stay in the UK, I think the fact that I was in the German system longer than the UK system may mean that when I start to receive my pension I will be obliged to pay Krankenkasse contributions out of my pension and, horror of horrors, not just taking the German pensions into account, but also the UK pension or even any further income I might receive worldwide. So basically, I would like to find out which residency (German/UK) would be financially advantageous after all deductions and whether the time of taking up residency important is. Many thanks for listening and even more thanks for any answers.
  8. I have been trying to find an answer to my situation in the forums but I have not found one that best suits my situation so far. My question is related to health insurance. I am a Marie Curie Early Stage Researcher employed by a German company. The EU H2020 project grant gives the company EUR4100 to pay me. My income tax, SV, KV, RV, PV all come out as employee contributions. But my employer contributions also come out of my gross. This leaves me with a netto of just over EUR2000. I am currently with AOK, I just turned 30 on 1FEB2019 and my contribution to AOK is currently €262, but double amount comes out of my gross so essentially I am paying €524 per month to be insured. In my job contract it stated the employer contributions may also come out from my gross, subject to national laws. It is very expensive for me to be paying so much for health insurance and I don't think I will be staying here after 3 years. I have a 3 year job contract for my PhD. I already secured a residence permit based on this insurance, I was thinking of applying for a Blue Card as well. Although I am 70% sure I will not want to stay in Germany after 3 years. I live alone, my husband will not be joining me in Germany so I do not need family cover. No kids either. I am currently with AOK and thinking maybe Mawista Science is a better option in my case? It would only cost me EUR60 or so for the first year and a bit higher for subsequent years. I will be leaving Germany for 11 months for a secondment in UK, is it possible to talk to my health insurance provider to not charge me for those months? I already have NHS health cover for my stay in Germany. It would be most kind of you all to help me out with any advice, thank you in advance!
  9. Hi Everyone,   First of all, apologies if the topic is somehow redundant, but I failed to find this topic in the forum yet.  We are doing the 2018 tax return for my girlfriend, who moved to Germany in October 2017. She found a job and started to work in May 2018, and until then, she paid TK contributions (circa 180€/moth). The contribution were charged to my account for convenience, but she was reimbursing me the cost also monthly.   - Can she include those insurance expenses in the tax return to get some deductions? (from January 2018 to May 2018) - Is the fact that the charges were made to my account going to cause any issues?   My research points that these contribution can be included in Angaben zu Vorsorgeaufwendungen, line 17. This lines states as an example: "bei freiwillig gesetzlich versicherten Selbstzahlern" that I understand it is the case.   Since she was not working on 2017, I believe that no deductions are possible because no taxes were paid at all.    Both my German language and German Tax law knowledge are quite limited, so hopefully someone in the forum has dealt with this topic already and can provide some clarification.   Many thanks
  10. Hey guys, how are you? Sorry for bothering with so many questions, but I looked around and could not found anything. I will try to go step-by-step so I can express myself better.   You guys could help me with personal experience or poiting to rules that I may have oversaw!   First of all: I'm a Brazilian guy, 31, who has a 2 year "Preparation for Studies" visa, from august 18-20.   Now I can work, 120 days fulltime / 240 part time.   1) first of all, from the official sites, I could not fully understand if this is a if/and, and so: If I work 60 days full time, can I still work 240 days part-time or then I get 60 days discounted of that? or 120 days?   2) I just got a job that I'm supposed to work 4 hours a day, but I ended up working 4:30 days. From what I understood reading this forum, then that will be considered a fulltime job, right? Or since is pratically a minimum salary no one will really check it out?   2a) Apparently they could take those extra hours and give me some days off. My supervisor who run this was on holiday and I will check with her. But how should I inform my hours to them? Does the German government could potentially find out and care about that or they don't really care?    3) And if I find another 4hours a day job, could I have TWO JOBS each one running for 4 hours and that would be considered a "Full-time" job?   4) I have a Careconcept health insurance that I pay 35 Euros a month but is totally ok and I already got treatment under that. BUT the job is applying me to AOK, I Guess. I was wondering if I leave the job, if I could reapply to Careconcept or simply keep them both and if I'm out, I continue my Careconcept? Or there is no way out since I enter the Public HEalth insurance business??     5) What would be the best official channel to discuss these things? Specially the point 3 I guess. I looked up at the ausländerbehörde website and could not find a proper communication place for that and I'm not sure if I could book an appointment - could I perhaps just show up there? Or is better not even to attract attention?   Thank you so much and sorry for the many questions and a great week for you all!!  
  11. First some background - My wife (citizen of US and Germany but with residence, work history and assets in the US) and I (US citizen), currently still 5-8 years away from retirement, have some thoughts of possibly retiring in Germany. Obviously the decision of where to locate ourselves is a lot more than a financial decision, and perhaps my limited German language ability (rectifiable) and inability to blend in from a skin color stand point (not rectifiable) will play a bigger role in the ultimate decision. However, the tax impact is not an insignificant factor we project to have financial assets between 5 to 10M USD in a mixture of pre- (401K, 303-B) and post- tax portfolio of stocks, bonds, US mutual funds and private partnership assets. The main purpose of this thread to confirm my macro-level understanding at this stage. We will engage professional expertise such as that on this board before making a final decision.   Taxes: From my understanding of the tax situation thus far  - We might be best advised to convert our US pre-tax assets to post-tax before establishing a German tax residency. That'd cause us to pay the top US tax rate at the time of such conversion, but that is below 42/45% German tax rate pre-tax assets would be subject after the German tax residency. Such a conversion would make the portfolio post-tax and we'd incur the German tax rate on only the returns generated by it.  - I understand that the tax rate for income generated from assets is 30.5% (= 25% + 5.5%)   Health Insurance: We will obviously forfeit the US medicare coverage in such a move. What I am less clear is the range of annual health insurance costs we should be budgeting for. Also, what might be a good assumption in the increases in the insurance costs with age. Again, interested in a macro-level understanding. Neither of us has worked in Germany. [I have as an ex-pat but only for a year - though taxes were filed on my behalf for two years.]   Impact of Real Estate investment prior to establishing German tax residency: As I indicated, a move to retire to Germany is yet unconfirmed and likely 5-10 years away. Yet, once in a while - the thought of buy an apartment - likely in Berlin/Hamburg (the two cities that interest us) prior to the move does cross our mind. If we don't retire here, we can sell it or keep it as a second residence. We have resisted it so far as we wonder if that might have a potential to complicate our tax picture outlined above.   We would appreciate any information or advice on the above points.   
  12. So, in order to simplify our post-Brexit lifestyle, my partner and I got married at very short notice. I work for a European state  organisation which means she is automatically added to my private insurance. However, her current public health insurer (Mobil) insists that she has to pay them for another two months(but of course now based on my income and not hers) which means (a) a lot of money to be paid for no benefit and (b) she effectively has two health insurances during this period. Does anybody know if this is really the way things work here or is her insurance provider wrongly trying to make her pay for two additional, unnecessary months of coverage? Thanks!  
  13. I am currently with TK (public) Insurance and planning to switch to Private Health Insurance (Let's keep aside all the pros and cons of switching from public to private - that's a different discussion altogether ). I have heard from a lot of folks that although the initial premium might be less for private insurance but the yearly premium hikes might become costly in the long run! Is there are any generic locking period that I need to stay with the subscribed private insurance provider for a certain number of years or is it case/plan specific? Also, are there any additional rules/restrictions for switching to another private insurance provider (e.g., HanseMerkur to DKV or others) after a few years with the first one in case of yearly premium hikes and whether there will be any cost benefits with such switches?    Any advice will be much appreciated!
  14. Hi guys,   I've been officially registered in Berlin as my Hauptwohnsitz (main residence) since October 2015. I have no health insurance and have not been employed or earning any income.   N.B. Any quick responses are appreciated as I may need to tell my new employer today to hold off on getting me my first German social security number if indeed this will open Pandora's box. See below.   Questions:   -Is there a particular Krankenkasse I can sign up to not back-charge me for two years of no health insurance? - Or can I now sign up with a cheap foreign health insurance company (i.e. UK based) to either just count as my ongoing insurance or to present to my upcoming Krankenkasse so that they don't think I have been uninsured and maybe then don't back-charge me? - If I do end up having to pay back-charges, how much will that be based on no income? (I'm still actually registered in the UK as a freelancer but have submitted £0 tax returns for a couple of years) - Today I am signing up with Deliveroo as a freelance bike courier. I have to get a Gewerbeschien for that. If I cancel the Foodora job and just take the Deliveroo freelancer job, can I stay off the health insurance radar? - Whether I work for Foodora and Deliveroo or just Deliveroo, does the fact that I will probably be only earning under €1500 mean my health insurance premiums will be only circa €150 per month from now on? (Presuming I don't just take some kind of cheap foreign health insurance?   Useful background info:   I am from the UK where the NHS just happens automatically, so obligatory health insurance is unfamiliar to me. I have not been employed or earning any money while I have been in Germany. I have just been using savings to renovate a mixed use Gewerbeeinheit property where I have been living, with the aim of setting up a business in the property, maybe.   Money is nearly out, so, yesterday, I signed an employment contract with Foodora for circa €850 per month as a bike courier to keep me afloat financially while I renovate. Today I will also sign up with Deliveroo on a freelance basis to earn roughly €15 per hour for a number of hours of my choosing on top of Foodora.   I wasn't sure if I would be in Germany for long at all at first and don't plan to be here for more than the next 3-4 years, so health insurance into old age is not an issue for me. I have just attended to any health queries on my visits to the UK for the moment, but that seems untenable for the next few years, so heath insurance would be a plus, but not if it is just asking for trouble.   Toytown research:   N.B. I have read a few similar posts and feel a new post is worthwhile as the useful posts I found were old and things change. I'm particularly hoping that @PandaMunich and @Starshollow or @john g.may have some good input. There was talk in earlier posts by @john g. of Central stopping but then reverting to back-charging, which seemed particularly relevant: https://www.toytowngermany.com/forum/topic/203249-health-insurance-backpayment-finished/?page=1 From @lightcycle: "A friend of mine recently got health insurance with AOK after two years of no insurance, she asked them if they were going to back-charge her for that time and they said "no, we don't do that anymore". Anyone heard anything similar? Have they really stopped the back-charging nonsense?"   From @john g. "lightcycle: that´s interesting! I´m surprised but glad! I work in the insurance business and I know there´s one private health insurer which is no longer enforcing backpayments. Where will it lead? Don´t know...we´ve been through this before. A big private insurer, Central, did this in 2009 and got a lot of business. I know I got people insured there for that very reason. Then other private insurers got annoyed - as did the Govt. Central had to backtrack. The whole issue is absurd - how can you backcharge people for services they haven´t had? Bloody ridiculous."   Thanks for your help! It is appreciated!   Related posts I have viewed:   Good overall wiki article by Patrick Ott (@StarsHollow): https://www.toytowngermany.com/wiki/Health_insurance   A very relevant yet old and long post widely discussed by key Toytown players (as quoted above): https://www.toytowngermany.com/forum/topic/203249-health-insurance-backpayment-finished/?page=1   Some relevant info from the UK gov: https://www.gov.uk/guidance/living-in-germany#health   Short but sweet on a similar topic: https://www.toytowngermany.com/forum/topic/134167-implications-of-having-no-health-insurance/   A guy sadly getting slagged off for asking a question: https://www.toytowngermany.com/forum/topic/355342-billed-for-not-having-health-insurance/?page=4  
  15. Does anyone know if it is possible to keep the german health insurance after leaving the country? I am due to receive braces and oral surgery soon but I may be leaving the country in during the treatment, as I will not be going far, I could travel back to have the adjustments done on the braces. If I pay directly for the insurance, can I keep it after I leave? From talking to people about this I have got all sorts of answers, some have argued that I can be considered a resident of a country for up to 6 months after I leave?   I can't ask my health insurance company as they are currently assessing my request for this treatment and I do not want them to have a reason to delay the approval.
  16. Hello,   I cancelled my health insurance this past September and signed up with a new health insurance plan starting January 1st.  Today (Jan 2nd) I got charged by both my old and new insurance companies. I went back and looked on my cancellation confirmation letter and I missed that they asked for proof of my new insurance within 2 months, which I did not send. Both policies are yearly.  I really don't want to have to pay for 2 private insurances for the year. Is there any way I can get out of one of them?    Any help is greatly appreciated. 
  17. My girlfriend and I recently moved from Tallinn, Estonia to Hamburg, Germany on the 11th of October this year after I got a job in Germany. I am an Egyptian national so I cam here with a Blue Card Visa and waiting for my appointment on the 10th of Jan to apply for the residence permit. I am insured in TK (public insurance).My girlfriend is an Estonian national who have been unemployed since August this year as she left her job and we traveled  two months for vacation before going to Germany. She is not insured in Germany yet.We came to realize that she is pregnant so we wanted to insure her in the health system in Germany. First we tried with the public insurance TK and they requested an E104 document from her Estonian public health insurance provider. We provided that to them but as she wasn't insured from August till October, they said that they cannot insure her. As far as I understand any EU national who was insured previously in a public insurance system in the EU is eligible for the voluntary health insurance in Germany. Right?So we tried with Private insurance but nobody wanted to take her as she is pregnant.My girlfriend is 3 months pregnant now and the doctor bills have been so expensive. We are planning to get married but that would require me to obtain the residence permit and that would take months!Kindly advice.
  18. Help on moving back to GKV from PKV

    Hello everyone,  This is not the first time I am posting regarding this topic.  What is my problem ?  I am really frustrated with my PKV. Feels like they just don’t care. 1.Even requesting for a bescheinigung, they respond with a post which reaches me after 3 weeks. That too just to ask me why i need it for. Then it took another 2 weeks to get the bescheinigung. 2.Every E-mail communication is answered by a post the week after. 3.They’re never reachable on call. The times I called, I was waiting for more that 30mins. Tried in the morning, aft noon and in the evenings as well.    How did I get here?  2016 :  I am in this situation cuz of my lack of German skills. My previous Company’s CEO introduced me to the Versicherungsmakler(was a client of the company , Speaks only German) and told me that all the employees of the company are insured through him, so I can take one through him as well.  So for the stupid thought of good will for the company as hes a client I signed up with him asking the following questions. -Will I get a card which I can swipe like to GKV ? – He said JA -Will I have to pay more than the GKV ? he said Nein I told him ok, then I’ll take the one with the same premium as my AOK. Then signed the document he gave.   My question ? Is there a legal way to deal with this ?  Can I prove them that I am in this situation because of my ignorance and not because I wanted to save money or out of bad faith ? 1.       Due to lack of language skills ? 2.       I can prove them showing that I have been paying the same amount of 621(now 670) EUR that I was paying to AOK ? – Just to show that I took PKV without the intention of saving money?. 3.       May be I took it for the premium benefits? No, I used them once in 2017 for 130 EUR doctor payment for skin rash, and once in 2018 110 EUR for doctor payment for a cold.    Thank you very much!   P.S : My spouse is working and is insured by AOK. My kid(6 months old) will join me in Germany soon. So I will pay 120 EUR to have him insured in AOK as I do not want him to pay the price for my mistake.  
  19. I have been staying in Germany since 10.06.2018. I have a residence permit (ICT type) tied to my present employer.  I want to change my job now. I already got a new employment offer. I want to change my ICT card to an EU Blue Card. As I will be on notice period in the next 90 days, my present employer will cancel my health insurance as I have to travel back to my home country i.e. India.   I have one question regarding the documents required for application of EU blue Card:   If I apply for Blue card now, as a health insurance proof document, can I subscribe to a travel insurance and provide that as a document ? I am talking about insurances such as this : https://www.mawista.com/en/health-insurance-for-foreign-nationals-in-germany/stays-up-to-5-years/online-application/  
  20. Looking for Versicherungsberater

    I am a UK citizen who will be moving to Munich in mid-March 2019 (i.e. just before Brexit). I do not know yet whether I will be employed in a contract job or self-employed.  In either case, it's my understanding from various Toytown threads that in order to get into public health insurance, because I am over 55, I need to prove I have been living in the UK for 12 months and 1 day.  By next March I will have been living in the UK for 15 months, so the only question is, what proof I need to provide of this.  I would like to hire a versicherungsberater to help me through the process.  I will be visiting Munich next month, on Dec 20th and 21st, and would like to meet this person to discuss my situation, especially to find out what documents I need to bring with me when I arrive in March.  Is there a versicherungsberater in Munich, please, who would be willing to take my case on, and could meet me on December 20 or 21?     Additional information:  I had been living in the USA prior to December 2017, when I moved back to the UK.  By March of 2019 I will have been here in the UK for 15 months, safely over the required time of 12 months and 1 day.  However, the proofs I have do not all go back that far.  I registered with a GP in the UK as soon as I arrived, in December 2017, and have a letter stating that.  I also have bank statements from December 2017.  However, my other proofs of residency (rental contract, utility bills, employment contract, national insurance contributions) did not start until March, because I did not find a flat and a job immediately upon arriving in the UK.  (I stayed with family members during the first couple of months).  It seems to me that it's risky to assume that the date on the GP letter should be the start point for the 12 months and 1 day.  I have a rental contract for a flat and utility bills dated from March 5, 2018, so I'm working on the assumption that, to be safe, I shouldn't try to move to Germany until mid-March.  But I don't know if there are other bureaucratic obstacles that I have no way to predict, which is why I need professional assistance.     Please could you contact me if you are a versicherungsberater in Munich who would be willing to work with me, and could meet me on the 20th or 21st of December.     Thank you very much.  
  21. Hello,  I will be starting my bachelor studies soon at a German University. The thing is that I already have some minor pre-existing health issues with my kidneys. Am I eligible for public health insurance even though despite my health issues and the fact that I hail from a Non-EU country?   This question has been discussed several times but I couldn't find an explicit answer for eligibility of Non-Eu nationals for public health insurance.   Thanks