Public vs. private health insurance

140 posts in this topic

3 hours ago, LittleWolfie said:

Today I received a letter which states that my rate has now increased to 333 euro total per month. The reason being that even though i have no income because of Corona, this is based on my wifes income (about 4000 gross) and the fact that she is on private insurance.

 
The bit about not qualifying for family cover because she is private I understand, but the (apparently) high updated rate based on her income I am surprised by. I am trying to figure out the rational and\or the calculated rate and to reach clarity about is it the combined income that is used to calculate the insurance rate.

 

Please read §2 (4) in here: https://www.gkv-spitzenverband.de/media/dokumente/krankenversicherung_1/grundprinzipien_1/finanzierung/beitragsbemessung/2020-03-18_Beitragsverfahrensgrundsaetze_Selbstzahler_in_der_Fassung_der_Neunten_Aenderung.pdf

 

Please note that if your wife had earned over the Jahresarbeitsentgeltgrenze (which in 2021 is 64,350€) AOK would also be asking for separate contributions for your children of around 200€ per month, per child, since the better-earning spouse (your wife) has private health insurance, see §10 (3) SGB V: https://www.sozialgesetzbuch-sgb.de/sgbv/10.html

So count your blessings.

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3 hours ago, LittleWolfie said:

Health insurance. No income but privately insured wifes income used to calculate my insurance rate

 

Greetings. Before I post my query, I think, having just read the previous posts on this thread that Starshollow provided an answer on 25th September 2019, which I believe applies to my case in the main. It does seem somewhat incredulous (not Starshollows explanation but the way the system operates in such an instance)  Am I making a correct comparison between the two cases?

 

Here is my post:

 

How does my wifes income affect my health insurance rate?
 
A few years ago I was luck enough to get onto public insurance with AOK as a freelance English teacher
 
SInce then my German wife (we married the end of 2019)  has qualified as a state highschool teacher and works full time but has opted for private health insurance.
 
Our two young children are insured through me.
 
Until recently I have been paying a modest 201 euro total for Krank... and Pfleig... combined.
Over the last two years my income being decreasing tellingly. 2020 was only about 6000 pre tax profit and this year is 0 income so far (and will stay like this for the rest of this year most probably). On AOKs latest income assessment form I had stated I am now a hausmann as I am the primary carer during the week. I also applied having spoken to an AOK representative for the minimum rate.
 
Today I received a letter which states that my rate has now increased to 333 euro total per month. The reason being that even though i have no income because of Corona, this is based on my wifes income (about 4000 gross) and the fact that she is on private insurance.
 
The bit about not qualifying for family cover because she is private I understand, but the (apparently) high updated rate based on her income I am surprised by. I am trying to figure out the rational and\or the calculated rate and to reach clarity about is it the combined income that is used to calculate the insurance rate.
 
Thank you for your time

 

Panda below has answered beautifully and, of course , correctly. 

Basically, LittleWolfie, the system is " something else " and needs a shake up. But, normally , when the lawmakers get involved , they just make it even more complicated  ( and expensive.)😂

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23 minutes ago, john g. said:

Basically, LittleWolfie, the system is " something else " and needs a shake up. .

Don't hold your breath
 

Quote

But, normally, when the lawmakers get involved , they just make it even more complicated  ( and expensive)

 

 

Too many people have an interest keeping it that way - like other complex things in Germany such as - err - the taxation system.

 

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Nail. Head, HEM.

( Of course, it keeps bums like me in work!)😂

So I have a vested interest in trying to keep up with the system, its realities, its contradictions and , equally , its plus sides for the clients. At least health cover in Germany is not the worst in the world.

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Can his wife change her mind and go back into public, or is that it now?

 

Why the heck do people with kids go private?

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Wait a minute...Little Wolfie.. your wife's gross is 4,000 a month. She doesn't qualify for private insurance... or is she a Beamtin? Something is otherwise amiss here.

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Yup - school teacher. Presumably Beamtin. 

Surprised - here that seems to be very hard won nowadays.

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If a Beamtin - then no brainer. Hubby is only thus paying for public insurance because his net is over 470 euros a month.

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Thank you for all your replies. It seems to be a topical topic

5 hours ago, PandaMunich said:

 

PandaMunich, thanks a million for the link. I will follow up on it tomorrow when I have some free time
 

2 hours ago, john g. said:

Wait a minute...Little Wolfie.. your wife's gross is 4,000 a month.

 

Amendment. Net income is 3600 (not including KIndergeld) Not 4000 Gross, my mistake.

 

2 hours ago, john g. said:

 or is she a Beamtin?

 

2 hours ago, kiplette said:

Yup - school teacher. Presumably Beamtin. 

Surprised - here that seems to be very hard won nowadays.

 

Yes, she is Beamtin (Hessen State)

 

2 hours ago, john g. said:

If a Beamtin - then no brainer. Hubby is only thus paying for public insurance because his net is over 470 euros a month.

 

Since April\May 2020 I have had zero income and consider myself Hausmann. Not seeking freelance employment nor claiming any benefits, but effectively primary carer\homemaker.(of course influenced in part by corona outbreak)

Just in relation to your above comment John, as my income is below 470 a month, do I understand correctly that perhaps I should be exempt or perhaps at least entitled to a minimal premium as my wife is  Beamtin (maybe it is worth noting, I got into Public as a freelance teacher back in 2016\17 and I think they still consider me as a freelancer without a current income due to Corona rather than a Hausmann and maybe they are overlooking or failing to see her as a Beamtin and simply private. I may be clutching at straws here and having not yet read PandaMunichs post, I am sort of hoping that Beamtin´s spouses and children receive a special exemption or separate set of criteria to "normal" private insurees.

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3 hours ago, john g. said:

If a Beamtin - then no brainer.

 

13 minutes ago, LittleWolfie said:

 I am sort of hoping that Beamtin´s spouses and children receive a special exemption or separate set of criteria to "normal" private insurees.

 

Is that what you mean, John?  

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21 hours ago, kiplette said:

Why the heck do people with kids go private?

 

Sometimes because they are young and healthy and want to save the 80 EUR a month.  Or because they think they will never have kids and then reality happens.  Or because there is still some pride in some people's minds about being privately insured.  Or because they are foreigners thinking they will be here only for two years and that was 20 years ago.

 

But in this case the wife is a Beamtin.   As far as I know they have special rules and in some states they do/did not even have a choice.

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2 hours ago, Krieg said:

But in this case the wife is a Beamtin.   As far as I know they have special rules and in some states they do/did not even have a choice.

I didn't even know that there are states which don't provide "Beihilfe" for their Beamte. Are there really some? In my day and (I was  Beamter) you could choose to join public insurance, but it would have been a waste of money because you already received Beihilfe.

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21 hours ago, LittleWolfie said:

Thank you for all your replies. It seems to be a topical topic

 

PandaMunich, thanks a million for the link. I will follow up on it tomorrow when I have some free time
 

 

Amendment. Net income is 3600 (not including KIndergeld) Not 4000 Gross, my mistake.

 

 

 

Yes, she is Beamtin (Hessen State)

 

 

Since April\May 2020 I have had zero income and consider myself Hausmann. Not seeking freelance employment nor claiming any benefits, but effectively primary carer\homemaker.(of course influenced in part by corona outbreak)

Just in relation to your above comment John, as my income is below 470 a month, do I understand correctly that perhaps I should be exempt or perhaps at least entitled to a minimal premium as my wife is  Beamtin (maybe it is worth noting, I got into Public as a freelance teacher back in 2016\17 and I think they still consider me as a freelancer without a current income due to Corona rather than a Hausmann and maybe they are overlooking or failing to see her as a Beamtin and simply private. I may be clutching at straws here and having not yet read PandaMunichs post, I am sort of hoping that Beamtin´s spouses and children receive a special exemption or separate set of criteria to "normal" private insurees.

If you deregister your self-employment at the Finanzamt and have no income " officially ", you can then get privately insured with your wife and its high family Beamte benefits. Definitely cheaper. 

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But after he is de-registered and COVID is over, then gets another job, then he will have to take ( keep ) private insurance I  guess ? 

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14 hours ago, john g. said:

If you deregister your self-employment at the Finanzamt and have no income " officially ", you can then get privately insured with your wife and its high family Beamte benefits. Definitely cheaper.

Thanks for the insight John g. In relation to that prospect, can you give a rough idea what my wife´s insurer might expect me to pay as premium as long as I have no income (you quoted a threshold of 470 monthly earlier, does that relate here?)

and what it might cost to then insure my two children through her provider?

 

13 hours ago, yesterday said:

But after he is de-registered and COVID is over, then gets another job, then he will have to take ( keep ) private insurance I  guess ? 

What if I have to supplement our income working freelance as an English teacher again (God forbid!) rather than as an "employee"- I was barely able to find public insurance the first time around?

 

Again thank you for all your help

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You need to check with your wife's current provider, LittleWolfie. Only they and you know your ages, state of health, which tariff etc.

If you then restart self-employment at some stage, you will then have to stay privately insured because you cannot switch from private to public insurance as a self-employed person.

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thanks again John g and also to everyone else for your helpful advice.

I will look into it and post here with how I get on.

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Yep, gladly keep us informed! We can all learn from your experience and I am in this to and fro  every day and can learn even more from people's experiences. The system is something else..👍

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Hi,

 

My wife and I are employees in Germany with both having a private health insurance (my wife got an international health insurance, but that's another story). And we have 2 children.

Even if it makes sense now to have a private insurance, I am a little worried about the long-term effect.

 

However my country (France) is offering public health insurance coverage for every french people living abroad. It is called CFE:

https://fr.april-international.com/en/your-cover-abroad/la-caisse-des-francais-de-l-etranger-cfe

You can join whenever you want (even if sometimes you have to pay some retroactive fees).

It is not fully comprehensive though, for instance covering some cost only up to 70%, so you usually have to take an extra insurance to cover the remaining 30%.

 

I read that it could be considered as a valid private health insurance in Germany.

That could be my backup plan in case I decide to stay in Germany even in retirement (I am afraid that the cost of the private health insurance will explode).

The big issue (same as with international health insurance) is the compulsory long-term care insurance (Pflegeflichtversicherung).

 

Does anybody have any experience with such foreign public health insurance and if it could be used in Germany ?

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