Now faster way (back) into public health insurance

[Starshollow 6,069]

Now this is a surprise... (10 minutes with Elton and you are gay as a maypole!)

 

Ok, so far the legal situation in Germany was this: if you wanted to get into the German public health insurance as voluntary member (i.e. for instance as a self-employed person), either from the outside of the EU with no prior public/state health insurance coverage within an EU memberstate's public health insurance system or as a person who choose private health insurance in Germany initially and somehow regretted it, you had to become a compulsory member (or dependent family insured member) for 12+ month before you could then continue your public health insurance as a voluntary member in your own right.

 

In the wake of the new legislation since August 1st, this, too, has changed...and nobody fu...ing noticed, not even me (and I read the fu..ing law) !!!

Wow!

I just did some online research in some other experts forums for health insurance and stumbled about this info, which then was confirmed by checking out a website of one of the larger public health insurance groups in Germany, BKK: http://www.bkk.de/arbeitgeber/neu-lexikon-sv-und-steuerrecht/?tx_bkklexikon_pi1[bkkl-item]=159909,0

You have to scroll down pretty much to the end to get to the gold nugget of this new legal information:

 

<h2 class="stw_gld1_head" id="gld3."></h2>

 

 

<h2 id="gld3." class="stw_gld1_head">3. Obliqatorische Anschlussversicherung ab 01.08.2013</h2>Mit dem "Gesetz zur Beseitigung sozialer Überforderung bei Beitragsschulden in der Krankenversicherung" wird beginnend ab 01.08.2013 eine obligatorische Anschlussversicherung eingeführt. Ziel ist es, einen lückenlosen Versicherungsschutz zu gewährleisten. Künftig schließt sich grundsätzlich an jede Beendigung einer Versicherungspflicht oder einer Familienversicherung nahtlos eine freiwillige Mitgliedschaft an, ohne dass es einer Erklärung oder Anzeige des Mitglieds bedarf; eine Vorversicherungszeit ist nicht zu erfüllen. Das Mitglied kann innerhalb von 2 Wochen nach Hinweis der Krankenkasse seinen Austritt erklären. Voraussetzung ist allerdings, dass das Bestehen eines anderweitigen Anspruchs auf Absicherung im Krankheitsfall nachgewiesen wird. Wird ein solcher Nachweis nicht erbracht, ist der Austritt unwirksam.

 

So, what says here is this: do to the new regulation which is supposed to prevent people who were family insured to drop out (because as young folks the exceeded the age limit, for instance), the rule is now that if you have been compulsory insured or family insured and this status ends, you'll become a voluntary member no matter what. And especially (bold in the above quote): you don't have to fulfill any prior insurance time/period.

 

What does this mean?

 

Case 1: you are employed with a gross salary over the legal threshold and decided to take on private health insurance because you were young, single and could save a lot of money. Now you meet this girl/guy whom you gonna marry and he/she bring three children into the happy marriage and he/she has no job/income. So far you were in the bad situation that even if he/she already was in public insurance, he/she would have to pay up to 50% of the max premium in public health insurance because half of your income would have counted for computing his/her premium while for each child you guys would have to pay the min contribution of 150+ EUR per month.

 

Now you only have to convince your boss to reduce your gross salary for 1 month (!!!) under the legal threshold JAEG, by which you become compulsory public insured again (in the past you had to do this for 12 months, which is a bit more complicated and also means more loss of income). After the one month, you can go back to your prior salary but still remain in the public health insurance as voluntary member. And add your wife and kids for free as dependent family members...

 

Case 2: you have been self-employed in Germany and with private health insurance. Now you only need to find someone for 1+ month for an employment with compulsory public health insurance (midi-job or more) and after that you can go back to being self-employed while keeping this public health insurance as a voluntary member for all it is worth.

 

Case 3: you come as a self-employed person from outside the EU with no prior public health insurance in an EU memberstate. Therefore you can't enter the public health insurance in Germany as a compulsory member. All you need now is to find someone to hire you (Visa permitting, of course) as an employee for 1+ month and you have every right to stay in the public health insurance system later as a voluntary member.

 

Case 4: you have been privately insured and are over 55 years old. Not even employment gets you back into public health insurance anymore. But if you become a family/dependent insured member thru your spouse while having no income at all higher than 385 EUR p.m. for just one month, you can afterwards continue to stay in the public health isnurance even as a voluntary member in your own right when you work and earn money again.

 

this will help solve a lot of problems for people who have a good reason to want to go back into public health insurance. It will. unfortunately, also invite more abuse of the system, because now it is much easier to contemplate going with private health insurance (and save money for yourself while opting out of the social welfare system) because the way back if your situation changes is much easier. But it is the law...make the best out of it. And find a good professional and independent advisor to help you with that, because it will take a long time till the last employee in a public health isnurance has learned and understood this.

 

Cheerio

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

[topcat 1 373]

 

Now you only have to convince your boss to reduce your gross salary for 1 month (!!!) under the legal threshold JAEG, by which you become compulsory public insured again (in the past you had to do this for 12 months, which is a bit more complicated and also means more loss of income). After the one month, you can go back to your prior salary but still remain in the public health insurance as voluntary member. And add your wife and kids for free as dependent family members...

 

I am actually quite astounded to read this from Starshollow! Are you actually advocating this or just pointing it out as a way to work the system to your benefit?

 

To my mind, there is nothing to differentiate this from getting your employer to reduce your wage for a period of time in order to pay less child support or claim benefits that you are not entitled to in the first place.

 

I realise there are lots of people in precarious financial situations who feel that they have a right to abuse the bureaucratic system because it is flawed and unfair, while there are still many others who are not in financial hardship but take advantage of the system to their own financial ends. I am not going to get into that whole bunch of worms; I am just going to say that abusing the system to gain benefit financially that you are not entitled to is just fraud, nothing more nothing less, and taking money out of the pockets of the rest of us who toe the line.

[gabi1 397]

this is going to be a huge wealth transfer from the public to the private insurance then:

 

Simple case of increasing premiums with age, enticing all the old (and health costly) population to go back to public insurance.

The private insurances make money no expenses, the public have huge expenses without the income from high earners low cost young population.

 

what a great way to kill universal health care...

[Starshollow 6,069]

 

I am actually quite astounded to read this from Starshollow! Are you actually advocating this or just pointing it out as a way to work the system to your benefit?

 

To my mind, there is nothing to differentiate this from getting your employer to reduce your wage for a period of time in order to pay less child support or claim benefits that you are not entitled to in the first place.

 

I realise there are lots of people in precarious financial situations who feel that they have a right to abuse the bureaucratic system because it is flawed and unfair, while there are still many others who are not in financial hardship but take advantage of the system to their own financial ends. I am not going to get into that whole bunch of worms; I am just going to say that abusing the system to gain benefit financially that you are not entitled to is just fraud, nothing more nothing less, and taking money out of the pockets of the rest of us who toe the line.

 

The dire truth is, Topcat, that way too many people - Expats and Germans alike - have been tricked into signing up with private health insurance without clear and fair information about the consequences. the main consequence being, that it is a one-way road when you opt out from public health insurance. the number of cases we here at CR&Cie. get on our desks where people only find out about that when they marry or, even worse - because then the advisor/salesperson should have warned against this in the first place-, when they fetch their family to Germany, too. And only a few years ago (mainly 2009-2011) all major German private health insurance companies introduced badly calculated "cheap" tariffs to draw self-employed people with low incomes out of the public health insurance. These tariffs have then exploded in costs above and beyond any reasonably increase (in comparsion to other tariffs on the market) and are thus bringing thousands of people to the brink of bankruptcy for something which is not their own fault in the first place.

It is for those that have been caught unware or naive in such private health insurance that I think this gives a fair chance to escape a trap created by the chaotic German health insurance system in the first place and by poor consumer protection (due to lack of serious regulation of insurance advice for too long). To this regards I DO actually advocate this way - it is not a fraud in the legal way to agree to reduce your gross salary for a short while at all.

 

There may be also a number of people who see this as an invitation for free-riding the system. I agree that this is a bad thing. But you have this everywhere, be that ALG II, taxes or other areas of social welfare. That is not vindicating it but rather just stating a fact of life. In the end what has to happen in Germany is - in my personal opinion - that we, too, introduce a general and universal public health care where private health insurance can be used as a supplement to beef up the coverage for those who want (and can afford it).

this is already in motion and I only give the current system another 5-10 years, then everyone who wants will be able to get back from private to public health insurance where such a "Bürgerversicherung" will be established. And eventually the substitutive private health insurance will dry or die out in Germany, too.

 

 

this is going to be a huge wealth transfer from the public to the private insurance then:

 

Simple case of increasing premiums with age, enticing all the old (and health costly) population to go back to public insurance.

The private insurances make money no expenses, the public have huge expenses without the income from high earners low cost young population.

 

what a great way to kill universal health care...

 

Gabi: I understand your reasoning fully. But in my daily business, as described above, I see way too many cases where both Expats and Germans have been badly advised and missold on private health insurances and are now facing consequences they were not aware of when making the decision. And the consquences should have been made aware to them by the advisor, but too often those were mere salesmen and not interested in what harm they may cause.

 

What I don't see is that this is going to become a trend where people now cleverly develop a strategy that they enter private health insurance now with the knowledge how easy (as compared to the long past) it is now to get back into public insurance. That would require a foresight that is beyond the average person's scope. Besides, there is an excellent way for people in private health insurance to reduce their costs even more in old age and still be secured for worst cases: the new "Notlagen-Tarif".

http://www.der-kvprofi.de/veroeffentlichungen/notlagentarif-oder-die-hinrichtung-der-pkv.html

This article from a friend and colleague of mine who is a recognized expert in health insurance in Germany analyses that the new Notlagen-tarif allows everyone in private health insurance to reduce the monthly costs for insurance to something like 100-150 EUR tops. Said Notlagen-Tarif will then cover all kind of emergencies and acute required treatments, i.e. those things in health care that cost the most money. Only normal treatment (like check-ups, flue treatment etc or dental cleaning) would not be covered, something everyone can well afford by himself. This is another stupid rule in the latest laws where it was not entirely thought thru by the legislation and will bring all kind of grievances to the German private insurance companies eventually.

 

But since I do believe that the days of the German private health insurance in the prevailiing form are numbered anyway, it is just another nail to the coffin.

And when hundreds of thousands of people who are currently privately insured stream back to the public insurances when the Bürgerversicherung comes, they will bring with them billions of EUR in capital stock built up to reduce costs in old age which will end in the big pot of public insurance somehow. Those are currently 165 billion (with a "B") EUR...

 

So, to wrap both of your comments up: yes, you are right that it is unfair if people knowingly decided to pay less for health care when young and healthy and want to return back when old and ill (though the becoming ill in old age does not change their premiums in private health insurance, which seems to be a common misunderstanding of some). But the majority of people who want or need to go back should never have been offered a private health insurance in the first place and they were often tricked and betrayed and therefore it is good that now for them there is an easy way out.

 

Cheerio

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

[topcat 1 373]

 

it is not a fraud in the legal way to agree to reduce your gross salary for a short while at all.

 

I am sorry, I disagree. As much as I sympathise with individuals who have been mis-sold private insurance or any other service in the first place, they have a duty of care themselves to check out the consequences of what they sign up to; buyer beware and all that. Having your employer "reduce" your salary for one month to avoid the consequences of your own ineptitude is wrong. There is no excuse to lie about your circumstances in order to reap financial, health or any other benefit.

 

Two wrongs do not make a right!

[justin_caise 126]

When calculating your monthly income, do you include pension and Rente? I am in the situation of paying a fortune for legacy private insurance, although I am retired. I heard that I can no longer get into public, but your tip about low income and family connection might do it? My wife managed to get a mini job for a year and opted out of Arroganz private, maybe I can too?

[El Jeffo 42,120]

Correct me if I'm wrong, but it seems to me that the public health insurance funds can only benefit from having more members who pay the maximum contribution.

 

Given that the rule prohibiting people above the age of 55 from changing back to the public system doesn't seem to have been waived, I don't see the danger of thousands of elderly retirees taking on a job for a month (if they could even get it) to cheat their way back into the public system, if that's what you're concerned about.

[Starshollow 6,069]

 

When calculating your monthly income, do you include pension and Rente? I am in the situation of paying a fortune for legacy private insurance, although I am retired. I heard that I can no longer get into public, but your tip about low income and family connection might do it? My wife managed to get a mini job for a year and opted out of Arroganz private, maybe I can too?

 

Justin: not sure if I understand your question(s) correctly. What does the first question/forst phrase relate to? the "no-income-higher-than-385-EUR-per-month" rule in order to become a dependent family member? For the computation of income in the public insurance, all kind of sources count, including capital gains, rental income etc. AFAIK a pension income does also count, I am afraid. But if it is a pension from abroad, there might be different rules for that - not sure. It might be worth inquiring that with the DVKA, the central office of the public insurances for all issues concerning foreigners in Germany: http://www.dvka.de/oeffentlicheSeiten/Fremdsprachen/Englisch.htm

 

So, in the end you will only be able to join the public system via your wife's public insurance if your accountable income drops below the above mentioned threshold. Or, if you move for a short while into another EU memberstate with state health insurance systems and then return to Germany (perhaps now even 1 month is enough for that, too as these rules have to be applied without discrimination to all EU citizen or people coming from EU countries with the national health insurance from there, too).

 

Cheerio

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

[LukeSkywalker 7,605]

 

Case 1: ...Now you only have to convince your boss to reduce your gross salary for 1 month (!!!) under the legal threshold JAEG, by which you become compulsory public insured again (in the past you had to do this for 12 months, which is a bit more complicated and also means more loss of income). After the one month, you can go back to your prior salary but still remain in the public health insurance as voluntary member.

As if employers like Siemens, BMW or any other multinational will go for that or even allow that.

 

 

Case 2: you have been self-employed in Germany and with private health insurance. Now you only need to find someone for 1+ month for an employment with compulsory public health insurance (midi-job or more) and after that you can go back to being self-employed while keeping this public health insurance as a voluntary member for all it is worth.

Which potential employer will do all this paperwork for just 1 month?

 

 

Case 4: you have been privately insured and are over 55 years old. Not even employment gets you back into public health insurance anymore. But if you become a family/dependent insured member thru your spouse while having no income at all higher than 385 EUR p.m. for just one month, you can afterwards continue to stay in the public health isnurance even as a voluntary member in your own right when you work and earn money again

Self-employed people have no steady income like an employee and that's why the tax authorities look at their annual income and not just at one particular month where they happen to have no income or very low income.

[Starshollow 6,069]

 

As if employers like Siemens, BMW or any other multinational will go for that or even allow that.

correct - slim chance in these cases. But the majority of employees in German works for SMEs. They are notably more flexible in such areas.

 

 

Which potential employer will do all this paperwork for just 1 month?

more often than not it will be a family member or friend who'll help out with this, me thinks.

 

 

Self-employed people have no steady income like an employee and that's why the tax authorities look at their annual income and not just at one particular month where they happen to have no income or very low income.

granted - if the 55+ old is self-employed, he would have to give up his self-employment, i.e. de-register at the Gewerbeamt etc. to make this work.

 

Cheerio

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

[Hazza 5,458]

What if you went part-time for a month?

 

Lots of companies allow you to go part-time (although not always just for a month) - but the HR depts certainly have the facilities to allow it.

[sonwon 2]

 

<snip>

For the computation of income in the public insurance, all kind of sources count, including capital gains, rental income etc. AFAIK a pension income does also count, I am afraid.

<snip>

 

Are savings in an account counted as income in Germany, around 8,000 euros?

[Starshollow 6,069]

 

Are savings in an account counted as income in Germany, around 8,000 euros?

 

only the interest from said savings is income...

 

 

Not sure if the way I managed it is still possible....

 

I stopped paying the private premiums and after 3 months was "Thrown out" for non-payment (I was self-employed at the time). I then rang TKK and they took me. Been there ever since.

 

Not possible anymore, I am afraid. Changed a lot after 2009...

 

Cheerio

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

[sonwon 2]

Just wondering if anyone has tested and if it worked? There can be a difference between law and application.

[onemark 787]

I've said this before and I'll say it again:

 

this entire debate is simply proof positive that a social insurance system - such as that existing in Germany - should be abolished and replaced with a social welfare system (medical, retirement unemployment and long-term nursing care) funded entirely - or almost entirely - through taxation.

 

Such a system would offer the basics, with people being able to obtain private add-on insurance.

 

Taxes might have to rise but that would simply be the money that we're paying currently for social insurances.

 

Not only do such systems work, johng even agrees with me on this subject. So there.

 

Here endeth the lesson.

[HEM 11,079]

Don't hold your breath.

 

Germany likes to do taxation & health insurance like the French (esp citroen) build cars:

 

Why do it simple when complicated also works?

[Starshollow 6,069]

 

I've said this before and I'll say it again:

 

this entire debate is simply proof positive that a social insurance system - such as that existing in Germany - should be abolished and replaced with a social welfare system (medical, retirement unemployment and long-term nursing care) funded entirely - or almost entirely - through taxation.

 

Such a system would offer the basics, with people being able to obtain private add-on insurance.

 

Taxes might have to rise but that would simply be the money that we're paying currently for social insurances.

 

Not only do such systems work, johng even agrees with me on this subject. So there.

 

Here endeth the lesson.

 

Onemark: you might be surprised, but I agree with you, too, on all counts. The German system is only matched by one other nation in the world, Chile. Everyone else who has had similar systems in the past (Austria, Netherlands) have moved to a basic public insurance for everyone plus private supplementary coverage where needed and wanted (and paid for)

The lobbies in Germany are well entrenched and it may take a while, but my professional and personal estimate is: 5-10 years and we shall have the "Bürgerversicherung" or however it is gonna be called in Germany.

 

Cheerio

 

PS: have not forgotten your Canada Life/Helvetia inquiry in another thread, just need more time, sorry

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.

[john g. 37,691]

Well, Starshollow, I must say I agree with HEM here! I bet any reform here ie simplify everything..will end up just as complicated! Because of the consensus approach in politics, nobody can agree on anything!!! Plus entrenched interests - bet you Beamte won´t agree to losing their privileges re insurance! There are A LOT OF Beamte here! PLUS the opinions of doctors, dentists and hospitals...their budgets in the future will have to be more favourable than at present ( I just have to talk to my doc and dentist to hear them moaning..) Reminiscent of the UK at the time of the setting up of the NHS....

I am a professional independent insurance broker and authorised advertiser. Contact me.

[HEM 11,079]

 

I bet any reform here ie simplify everything..will end up just as complicated!

 

Example: Schornsteinfeger...

[onemark 787]

starshollow: Thanks.