Pflegeversicherung back payments

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Hi, I have a question about Pflegerechtversicherung.

I was self employed acting as a contractor for NATO, living in Germany and working in the Netherlands. I was paying Health insurance through TK which was fine.

I then got a employed directly by NATO and had to move to their Health Insurance system "Alliance Worldwide"

My wife who is German was not working at the time so she and my daughter were covered first by TK then by "Alliance Worldwide"

My daughter now has an apprenticeship with the Finanzamt and requires her own health insurance. However, no company will accept the proof of previous Health Insurance from Alliance Worldwide (Even Alliance Germany) because it did not include Pflegerechtversicherung.

The workaround we got from the insurance companies we spoke to is to BackPay the Pflegerechtversicherung which for my daughter for 2 years we were quoted around 500 euros.

When I check online for Pflegerechtversicherung policies, my daughter would pay around 9 euros per month so no more than 250 Euros for the 2 years we missed.

Are there any regulations for backpayment of Pflegerechtversicherung because 500 euros seems very high.

 

Thanks

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23 hours ago, bobbyger said:

Hi, I have a question about Pflegerechtversicherung.

I was self employed acting as a contractor for NATO, living in Germany and working in the Netherlands. I was paying Health insurance through TK which was fine.

I then got a employed directly by NATO and had to move to their Health Insurance system "Alliance Worldwide"

My wife who is German was not working at the time so she and my daughter were covered first by TK then by "Alliance Worldwide"

My daughter now has an apprenticeship with the Finanzamt and requires her own health insurance. However, no company will accept the proof of previous Health Insurance from Alliance Worldwide (Even Alliance Germany) because it did not include Pflegerechtversicherung.

The workaround we got from the insurance companies we spoke to is to BackPay the Pflegerechtversicherung which for my daughter for 2 years we were quoted around 500 euros.

When I check online for Pflegerechtversicherung policies, my daughter would pay around 9 euros per month so no more than 250 Euros for the 2 years we missed.

Are there any regulations for backpayment of Pflegerechtversicherung because 500 euros seems very high.

 

Thanks

What you mean here is the PflegePFLICHTversicherung, has nothing to do with "recht", I am afraid :-)   Just for clarification so that no-one who reads this gets further confused.

 

May I ask where exactly you applied for new health insurance for your daughter to this regards, i.e. which German insurance provider gave you this information? Because it is mostly in error.

 

While the insurance companies are correct that everyone in Germany has to have a health insurance and if that is a private insurance in lieu of public health insurance, such an insurance has to comply to certain rules and regulations as pointed out in § 193 VVG. And Allianz Worldwide Care does definitely NOT comply with these rules and regulations...
BUT: there is a specific exemption for this regulation for people who work at EU, UN or NATO and such. And this is the highlighted part of the relevant section of the law below. Correctly quoted it is § 193 Abs. 3 Nr. 2 

This part of the law says that because you have been working for NATO, that you were not obligated to join the German private health insurance system. You were basically outside the German system.

And as such neither you nor your co-insured family members were required to have private Pflegepflichtversicherung because the latter can only be obtained in direct connection with a German private health insurance. And since you were not obligated to sign up for it, you and your family member (read here: your daughter) shall not be asked for back-charges on this in any way or form.

 

You can now do several things:

a) convey this information to the health insurance of your choice in writing and demand a written confirmation or rejection, including in your own writing that you will put this issue to the attention of the Ombudsman (or the BaFin)  if they do not cease to demand those incorrect back charges

b ) chose or get help choosing a private health insurance instead that won't create such havoc with the law out of misunderstanding or simply not knowing these legal rules

c ) hire someone (ideally a Versicherungsberater with legal powers like an attorney) to write to the insurance company on your behalf. However, that will cost you and even though you might claim it back from the insurance company, it is certainly requiring you to fork out some money from your side first.

 

Cheerio

 

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.
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6 hours ago, Starshollow said:

What you mean here is the PflegePFLICHTversicherung, has nothing to do with "recht", I am afraid :-)   Just for clarification so that no-one who reads this gets further confused.

 

May I ask where exactly you applied for new health insurance for your daughter to this regards, i.e. which German insurance provider gave you this information? Because it is mostly in error.

 

While the insurance companies are correct that everyone in Germany has to have a health insurance and if that is a private insurance in lieu of public health insurance, such an insurance has to comply to certain rules and regulations as pointed out in § 193 VVG. And Allianz Worldwide Care does definitely NOT comply with these rules and regulations...
BUT: there is a specific exemption for this regulation for people who work at EU, UN or NATO and such. And this is the highlighted part of the relevant section of the law below. Correctly quoted it is § 193 Abs. 3 Nr. 2 

This part of the law says that because you have been working for NATO, that you were not obligated to join the German private health insurance system. You were basically outside the German system.

And as such neither you nor your co-insured family members were required to have private Pflegepflichtversicherung because the latter can only be obtained in direct connection with a German private health insurance. And since you were not obligated to sign up for it, you and your family member (read here: your daughter) shall not be asked for back-charges on this in any way or form.

 

You can now do several things:

a) convey this information to the health insurance of your choice in writing and demand a written confirmation or rejection, including in your own writing that you will put this issue to the attention of the Ombudsman (or the BaFin)  if they do not cease to demand those incorrect back charges

b ) chose or get help choosing a private health insurance instead that won't create such havoc with the law out of misunderstanding or simply not knowing these legal rules

c ) hire someone (ideally a Versicherungsberater with legal powers like an attorney) to write to the insurance company on your behalf. However, that will cost you and even though you might claim it back from the insurance company, it is certainly requiring you to fork out some money from your side first.

 

Cheerio

 

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

Many Thanks for the info .

We have tried LVM who said they would not accept and asked for payment of insurance for the period she was under my cover at Allianz WWC.

We have now gone to Allianz to see if they will give her the insurance.

 

In regards to the law you mentioned, is it the following as I see no mention of NATO/EU/UN etc:

 

bb) Heilfürsorge-, Beihilfeberechtigte u.Ä. (§ 193 Abs. 3 S. 2 Nr. 2 VVG)

 

Rz. 15

Die Versicherungspflicht gilt auch nicht für Personen, die Anspruch auf freie Heilfürsorge haben, beihilfeberechtigt sind oder vergleichbare Ansprüche haben, im Umfang der jeweiligen Berechtigung. Freie Heilfürsorge steht insb. Polizeibeamten (z.B.: § 1 BbgPolHV) und Berufsfeuerwehrleuten (z.B.: § 1 BremHfV) zu, über vergleichbare Ansprüche (Begriff: § 194 Abs. 1 BGB) verfügen Soldaten und Wehrpflichtige (§ 69 Abs. 2 S. 1 BBesG, § 6 S. 1 WehrsoldG). Beihilfeberechtigt sind (sonstige) Beamte. Dagegen verfügen die Mitglieder im Spar- und Unterstützungsverein für Polizeibeamte nicht über vergleichbare Ansprüche, weil es an der rechtlichen Durchsetzbarkeit fehlt (OLG Oldenburg, VersR 2012, 87). Abgesehen davon wäre Vergleichbarkeit nur zu bejahen, wenn sich die Ansprüche entweder gegen den Staat selbst oder gegen eine Einrichtung richten, die der Versicherungsaufsicht unterliegt (OLG Oldenburg, VersR 2012, 87; vertiefend: Both, VersR 2011, 302, 304).

 

 

Again, thanks for the information.

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18 hours ago, bobbyger said:

Many Thanks for the info .

We have tried LVM who said they would not accept and asked for payment of insurance for the period she was under my cover at Allianz WWC.

We have now gone to Allianz to see if they will give her the insurance.

 

In regards to the law you mentioned, is it the following as I see no mention of NATO/EU/UN etc:

 

bb) Heilfürsorge-, Beihilfeberechtigte u.Ä. (§ 193 Abs. 3 S. 2 Nr. 2 VVG)

 

Rz. 15

Die Versicherungspflicht gilt auch nicht für Personen, die Anspruch auf freie Heilfürsorge haben, beihilfeberechtigt sind oder vergleichbare Ansprüche haben, im Umfang der jeweiligen Berechtigung. Freie Heilfürsorge steht insb. Polizeibeamten (z.B.: § 1 BbgPolHV) und Berufsfeuerwehrleuten (z.B.: § 1 BremHfV) zu, über vergleichbare Ansprüche (Begriff: § 194 Abs. 1 BGB) verfügen Soldaten und Wehrpflichtige (§ 69 Abs. 2 S. 1 BBesG, § 6 S. 1 WehrsoldG). Beihilfeberechtigt sind (sonstige) Beamte. Dagegen verfügen die Mitglieder im Spar- und Unterstützungsverein für Polizeibeamte nicht über vergleichbare Ansprüche, weil es an der rechtlichen Durchsetzbarkeit fehlt (OLG Oldenburg, VersR 2012, 87). Abgesehen davon wäre Vergleichbarkeit nur zu bejahen, wenn sich die Ansprüche entweder gegen den Staat selbst oder gegen eine Einrichtung richten, die der Versicherungsaufsicht unterliegt (OLG Oldenburg, VersR 2012, 87; vertiefend: Both, VersR 2011, 302, 304).

 

 

Again, thanks for the information.

the law does not mention specifically EU/UN or NATO. But it is commonly understood and, AFAIK, confirmed not only in legal commentaries but also thru court decisions, that the obligatory health insurance that comes from working for such international institutions (that are being paid for by taxpayers anyway) is considered as a " vergleichbare Ansprüche "  to the Beihilfe or Heilfürsorge (the latter being for public servants in Germany and military).

If you are applying now at Allianz, get the Allianz Worldwide Care involved because they do have some internal channels to the good ol' private German Allianz health insurance company (which is a different company by law to the other Allianz divisions) and get this processed smoother for sure. Though I would not necessarily recommend to choose a certain health insurance company just because it is easier to get in...you definitely want to have a really good coverage for your little girl. Which would have ruled out the LVM to me right from the beginning anyway as a health insurance expert... :-) Not sure who recommended THAT to you?

 

Cheerio

 

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.
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On 27/11/2019, 10:29:12, Starshollow said:

the law does not mention specifically EU/UN or NATO. But it is commonly understood and, AFAIK, confirmed not only in legal commentaries but also thru court decisions, that the obligatory health insurance that comes from working for such international institutions (that are being paid for by taxpayers anyway) is considered as a " vergleichbare Ansprüche "  to the Beihilfe or Heilfürsorge (the latter being for public servants in Germany and military).

If you are applying now at Allianz, get the Allianz Worldwide Care involved because they do have some internal channels to the good ol' private German Allianz health insurance company (which is a different company by law to the other Allianz divisions) and get this processed smoother for sure. Though I would not necessarily recommend to choose a certain health insurance company just because it is easier to get in...you definitely want to have a really good coverage for your little girl. Which would have ruled out the LVM to me right from the beginning anyway as a health insurance expert... :-) Not sure who recommended THAT to you?

 

Cheerio

 

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.
On 27/11/2019, 10:29:12, Starshollow said:

the law does not mention specifically EU/UN or NATO. But it is commonly understood and, AFAIK, confirmed not only in legal commentaries but also thru court decisions, that the obligatory health insurance that comes from working for such international institutions (that are being paid for by taxpayers anyway) is considered as a " vergleichbare Ansprüche "  to the Beihilfe or Heilfürsorge (the latter being for public servants in Germany and military).

If you are applying now at Allianz, get the Allianz Worldwide Care involved because they do have some internal channels to the good ol' private German Allianz health insurance company (which is a different company by law to the other Allianz divisions) and get this processed smoother for sure. Though I would not necessarily recommend to choose a certain health insurance company just because it is easier to get in...you definitely want to have a really good coverage for your little girl. Which would have ruled out the LVM to me right from the beginning anyway as a health insurance expert... :-) Not sure who recommended THAT to you?

 

Cheerio

 

I am a professional independent insurance broker, financial adviser, and authorised advertiser. Contact me.
On 27/11/2019, 10:29:12, Starshollow said:

the law does not mention specifically EU/UN or NATO. But it is commonly understood and, AFAIK, confirmed not only in legal commentaries but also thru court decisions, that the obligatory health insurance that comes from working for such international institutions (that are being paid for by taxpayers anyway) is considered as a " vergleichbare Ansprüche "  to the Beihilfe or Heilfürsorge (the latter being for public servants in Germany and military).

If you are applying now at Allianz, get the Allianz Worldwide Care involved because they do have some internal channels to the good ol' private German Allianz health insurance company (which is a different company by law to the other Allianz divisions) and get this processed smoother for sure. Though I would not necessarily recommend to choose a certain health insurance company just because it is easier to get in...you definitely want to have a really good coverage for your little girl. Which would have ruled out the LVM to me right from the beginning anyway 

Starshollow, 

 

We are now having issues with my wife trying to get health insurance. 

She is over 55 and is currently covered by my NATO insurance. She wants to go back into employment part time with a net wage of around 1300 euros per month. 

We were with the TK from July 2014 to July 2017 when I was a contractor working at NATO. From July 2017 to now I have been with NATO and will be for the foreseeable future. 

The problem we have now is TK will not take my wife back as she is over 55. Plus, she does not meet the income limit for Private insurance. So at the moment she is unable to get German health insurance. 

Currently we are trying to use our legal insurance for advice, but as you were very helpful before, I thought you may have some advice for us. 

 

Apologies for the multiple quotes, my phone threw a wobbly. 

 

Thanks 

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56 minutes ago, bobbyger said:

The problem we have now is TK will not take my wife back as she is over 55. Plus, she does not meet the income limit for Private insurance. So at the moment she is unable to get German health insurance. 

Currently we are trying to use our legal insurance for advice,

 

Why legal insurance?

 

Your wife is eligilble for private health insurance due to her age. Since she had over 24 months of public health insurance in the past 5 years, she might be eligible for public health insurance (it depends on her residence status while she was privately insured and whether or not she was really here).

 

You need professional health insurance advice from someone who understands the special circumstances of expats. For example, someone like @Starshollow.

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My wife will only earn 1300 per month so as far as we are aware, it does not meet the limit for private health insurance (62550) and if she could get it, it would be too expensive due to her age (56) compared to her wage.

My wife is German but has not worked in Germany for years due to my time in the British forces where she followed me around Europe. 

The timeline for all of this is:

July 2014 - left the British armed forces / moved to Germany and registered with the Geminde / joined TK (whole Family cover) as I started working as a contractor

July 2017 - Was hired directly by NATO (Still residing in Germany but working in Netherlands) / Had to leave TK as NATO forces you to use their insurance (Allianz WWC)

Now - My wife has an offer of job but TK will not take her back due to being 56.

 

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38 minutes ago, bobbyger said:

My wife will only earn 1300 per month so as far as we are aware, it does not meet the limit for private health insurance (62550)

 

That is not correct and you have not understood what I previously wrote. See SGB V §6 Abs 3a for more info.

 

Quote

 if she could get it, it would be too expensive due to her age (56) compared to her wage.

 

She needs health insurance regardless of whether or not she is employed. Does the NATO insurance meet the requirements for a regular German resident?

 

Quote

Now - My wife has an offer of job but TK will not take her back due to being 56.

 

Again read SGB V.

 

38 minutes ago, bobbyger said:

July 2014 - left the British armed forces / moved to Germany and registered with the Geminde / joined TK (whole Family cover) as I started working as a contractor

July 2017 - Was hired directly by NATO (Still residing in Germany but working in Netherlands) / Had to leave TK as NATO forces you to use their insurance (Allianz WWC)

 

I'm not sure whether the fact that your wife had public insurance between January 2015 to June 2017 will enable her to get back into public.

 

I would highly recommend that you NOT try the DYI method of buying health insurance in Germany. You need professional help from a qualified independent insurance broker.

 

Quote

Sozialgesetzbuch (SGB) Fünftes Buch (V) - Gesetzliche Krankenversicherung - (Artikel 1 des Gesetzes v. 20. Dezember 1988, BGBl. I S. 2477)
§ 6 Versicherungsfreiheit

(1) Versicherungsfrei sind
1.
Arbeiter und Angestellte, deren regelmäßiges Jahresarbeitsentgelt die Jahresarbeitsentgeltgrenze nach den Absätzen 6 oder 7 übersteigt; Zuschläge, die mit Rücksicht auf den Familienstand gezahlt werden, bleiben unberücksichtigt,
1a.
nicht-deutsche Besatzungsmitglieder deutscher Seeschiffe, die ihren Wohnsitz oder gewöhnlichen Aufenthalt nicht in einem Mitgliedstaat der Europäischen Union, einem Vertragsstaat des Abkommens über den Europäischen Wirtschaftsraum oder der Schweiz haben,
2.
Beamte, Richter, Soldaten auf Zeit sowie Berufssoldaten der Bundeswehr und sonstige Beschäftigte des Bundes, eines Landes, eines Gemeindeverbandes, einer Gemeinde, von öffentlich-rechtlichen Körperschaften, Anstalten, Stiftungen oder Verbänden öffentlich-rechtlicher Körperschaften oder deren Spitzenverbänden, wenn sie nach beamtenrechtlichen Vorschriften oder Grundsätzen bei Krankheit Anspruch auf Fortzahlung der Bezüge und auf Beihilfe oder Heilfürsorge haben,
3.
Personen, die während der Dauer ihres Studiums als ordentliche Studierende einer Hochschule oder einer der fachlichen Ausbildung dienenden Schule gegen Arbeitsentgelt beschäftigt sind,
4.
Geistliche der als öffentlich-rechtliche Körperschaften anerkannten Religionsgesellschaften, wenn sie nach beamtenrechtlichen Vorschriften oder Grundsätzen bei Krankheit Anspruch auf Fortzahlung der Bezüge und auf Beihilfe haben,
5.
Lehrer, die an privaten genehmigten Ersatzschulen hauptamtlich beschäftigt sind, wenn sie nach beamtenrechtlichen Vorschriften oder Grundsätzen bei Krankheit Anspruch auf Fortzahlung der Bezüge und auf Beihilfe haben,
6.
die in den Nummern 2, 4 und 5 genannten Personen, wenn ihnen ein Anspruch auf Ruhegehalt oder ähnliche Bezüge zuerkannt ist und sie Anspruch auf Beihilfe im Krankheitsfalle nach beamtenrechtlichen Vorschriften oder Grundsätzen haben,
7.
satzungsmäßige Mitglieder geistlicher Genossenschaften, Diakonissen und ähnliche Personen, wenn sie sich aus überwiegend religiösen oder sittlichen Beweggründen mit Krankenpflege, Unterricht oder anderen gemeinnützigen Tätigkeiten beschäftigen und nicht mehr als freien Unterhalt oder ein geringes Entgelt beziehen, das nur zur Beschaffung der unmittelbaren Lebensbedürfnisse an Wohnung, Verpflegung, Kleidung und dergleichen ausreicht,
8.
Personen, die nach dem Krankheitsfürsorgesystem der Europäischen Gemeinschaften bei Krankheit geschützt sind.
(2) Nach § 5 Abs. 1 Nr. 11 versicherungspflichtige Hinterbliebene der in Absatz 1 Nr. 2 und 4 bis 6 genannten Personen sind versicherungsfrei, wenn sie ihren Rentenanspruch nur aus der Versicherung dieser Personen ableiten und nach beamtenrechtlichen Vorschriften oder Grundsätzen bei Krankheit Anspruch auf Beihilfe haben.
(3) Die nach Absatz 1 oder anderen gesetzlichen Vorschriften mit Ausnahme von Absatz 2 und § 7 versicherungsfreien oder von der Versicherungspflicht befreiten Personen bleiben auch dann versicherungsfrei, wenn sie eine der in § 5 Abs. 1 Nr. 1 oder Nr. 5 bis 13 genannten Voraussetzungen erfüllen. Dies gilt nicht für die in Absatz 1 Nr. 3 genannten Personen, solange sie während ihrer Beschäftigung versicherungsfrei sind.
(3a) Personen, die nach Vollendung des 55. Lebensjahres versicherungspflichtig werden, sind versicherungsfrei, wenn sie in den letzten fünf Jahren vor Eintritt der Versicherungspflicht nicht gesetzlich versichert waren. Weitere Voraussetzung ist, dass diese Personen mindestens die Hälfte dieser Zeit versicherungsfrei, von der Versicherungspflicht befreit oder nach § 5 Abs. 5 nicht versicherungspflichtig waren. Der Voraussetzung nach Satz 2 stehen die Ehe oder die Lebenspartnerschaft mit einer in Satz 2 genannten Person gleich. Satz 1 gilt nicht für Personen, die nach § 5 Abs. 1 Nr. 13 versicherungspflichtig sind.
(4) Wird die Jahresarbeitsentgeltgrenze überschritten, endet die Versicherungspflicht mit Ablauf des Kalenderjahres, in dem sie überschritten wird. Dies gilt nicht, wenn das Entgelt die vom Beginn des nächsten Kalenderjahres an geltende Jahresarbeitsentgeltgrenze nicht übersteigt. Rückwirkende Erhöhungen des Entgelts werden dem Kalenderjahr zugerechnet, in dem der Anspruch auf das erhöhte Entgelt entstanden ist.
(5) (weggefallen)
(6) Die Jahresarbeitsentgeltgrenze nach Absatz 1 Nr. 1 beträgt im Jahr 2003 45 900 Euro. Sie ändert sich zum 1. Januar eines jeden Jahres in dem Verhältnis, in dem die Bruttolöhne und -gehälter je Arbeitnehmer (§ 68 Abs. 2 Satz 1 des Sechsten Buches) im vergangenen Kalenderjahr zu den entsprechenden Bruttolöhnen und -gehältern im vorvergangenen Kalenderjahr stehen. Die veränderten Beträge werden nur für das Kalenderjahr, für das die Jahresarbeitsentgeltgrenze bestimmt wird, auf das nächsthöhere Vielfache von 450 aufgerundet. Die Bundesregierung setzt die Jahresarbeitsentgeltgrenze in der Rechtsverordnung nach § 160 des Sechsten Buches Sozialgesetzbuch fest.
(7) Abweichend von Absatz 6 Satz 1 beträgt die Jahresarbeitsentgeltgrenze für Arbeiter und Angestellte, die am 31. Dezember 2002 wegen Überschreitens der an diesem Tag geltenden Jahresarbeitsentgeltgrenze versicherungsfrei und bei einem privaten Krankenversicherungsunternehmen in einer substitutiven Krankenversicherung versichert waren, im Jahr 2003 41 400 Euro. Absatz 6 Satz 2 bis 4 gilt entsprechend.

 

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Okay, please excuse my ignorance, my German is not that great, especially when it comes to legal text.

 

Do I take it that the only way we can go is for my wife to get private insurance as she needs her own insurance when working and cannot be covered by my Allianz WWC which she is covered by at the moment as a spouse?

If so, then it will not be worth her working as the insurance premiums would be so high that it would take most of her wages. most of the ones I have seen would be around 600 to 700 euros.

 

I find it really bad that someone who was covered by family GKV and because their husband was forced to change from the GKV he had to an international Private insurance, cannot go to work and pay taxes etc. because they want to start work again later in life when the PKV premiums would be too high to make it worth while.

 

 

 

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Surely the wife can get "normal" public insurance in her own right if she's working more than a mini job? In fact she is compelled to join the GKV on a salary of 1300 a month if she has a normal private sector type job.

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15 hours ago, bobbyger said:

Okay, please excuse my ignorance, my German is not that great, especially when it comes to legal text.

 

Then you really need professional assistance. 

 

Quote

Do I take it that the only way we can go is for my wife to get private insurance as she needs her own insurance when working and cannot be covered by my Allianz WWC which she is covered by at the moment as a spouse?

 

Why can't she continue be covered by your insurance? Does your insurance meet German requirements or are you exempt from German requirements due to your NATO status?

 

Quote

I find it really bad that someone who was covered by family GKV and because their husband was forced to change from the GKV he had to an international Private insurance, cannot go to work and pay taxes etc. because they want to start work again later in life when the PKV premiums would be too high to make it worth while.

 

I couldn't  disagree with you more. 

 

There is already too much freeloading in the public system. Although you might have been forced to change, your wife could have remained a voluntary member of the public system. She CHOSE to leave the public system in favour of better coverage covered by your employer. 

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18 minutes ago, murphaph said:

Surely the wife can get "normal" public insurance in her own right if she's working more than a mini job? In fact she is compelled to join the GKV on a salary of 1300 a month if she has a normal private sector type job.

 

No, not at her age.

 

There is clause preventing people from enjoying cheaper private health insurance for most of their lives and then changing into the public system once it starts to become more expensive (see my post from yesterday). 

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Ah I see. Yeah if she's enjoyed the cheaper private cover for years then it's fair enough that she can't enter the GKV. Thx engelchen :-)

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That is not the case, though, murphaph. The lady was publicly insured for three years before having to leave it due to her husband´s job.

I am a professional independent insurance broker and authorised advertiser. Contact me.
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50 minutes ago, john g. said:

That is not the case, though, murphaph. The lady was publicly insured for three years before having to leave it due to her husband´s job.

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

@john g. that is correct and as @Starshollow mentioned in a previous post on this thread Allianz WWC does not meet the regulations to be considered as a Private Insurance in Germany.

 

On ‎26‎/‎11‎/‎2019‎ ‎10‎:‎00‎:‎35, Starshollow said:

While the insurance companies are correct that everyone in Germany has to have a health insurance and if that is a private insurance in lieu of public health insurance, such an insurance has to comply to certain rules and regulations as pointed out in § 193 VVG. And Allianz Worldwide Care does definitely NOT comply with these rules and regulations...
BUT: there is a specific exemption for this regulation for people who work at EU, UN or NATO and such. And this is the highlighted part of the relevant section of the law below. Correctly quoted it is § 193 Abs. 3 Nr. 2 

This part of the law says that because you have been working for NATO, that you were not obligated to join the German private health insurance system. You were basically outside the German system.

 

This seems to be an issue that relates again to someone joining NATO and being outside the "Norm".

My wife has contacted a lawyer and he is going to the Social Court in Dusseldorf next week and will enquire.

 

The way I see it is we were GKV insured then according to the information from Starshollow we were basically outside the German system. So I don't know how that affects going back into GKV after 55 Years of age and especially when you need to in order to start work in a job where you don't meet the Versicherungspflichtgrenze for compliant German PKV.

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1 hour ago, engelchen said:

Why can't she continue be covered by your insurance? Does your insurance meet German requirements or are you exempt from German requirements due to your NATO status?

According to the post from Starshollow yes, being with NATO puts me outside the normal German system.

 

1 hour ago, engelchen said:

There is already too much freeloading in the public system. Although you might have been forced to change, your wife could have remained a voluntary member of the public system. She CHOSE to leave the public system in favour of better coverage covered by your employ

Yes there probably is a lot of freeloading. however my job does not meet the Versicherungspflichtgrenze for PKV. I was forced by NATO to move to the Non-German Compliant insurance.

There was no communication from TK when we cancelled that my wife would have trouble if we wanted to move back. There is a lot of information available and not all is correct. plus the laws are a minefield to navigate.

I have already spoken to my HR and informed them of these issues and the fact they need to look into it and advise accordingly on any potential pitfalls but for 29 member states it is very difficult to keep track of them all. What would be better is clearer guidance/regulations at the individual country level for how to handle NATO/International organisations when it comes to returning to the national Health insurance system. (Possibly making the regulations quoted by Starshollow easier and cleared for the insurance companies to understand)

 

I understand the need to cut back on freeloading. However, not every situation is a round peg for a round hole and people should not be penalised for joining international organisations.

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That's true. There should be no penalty for a German resident going to work for NATO or whatever that Germany is a member of. I hope your wife gets sorted. 

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Looks like we have it sorted. The woman from TK wasn't aware of the rules, when you leave and go to insurance provided by an international organisation, the company you were with before has to take you back regardless of age.

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That is wonderful news, bobbyger!!!!!

I am a professional independent insurance broker and authorised advertiser. Contact me.
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@Bobbyger: Thanks for posting your problem here, hopefully it will help others in a similar situation.

 

So glad that things have worked out well for you and your family. 

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