Health insurance for the self-employed: private health insurance and sickness benefit



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If you are not self-employed, you have no choice: you must insure yourself in the private health insurance company. What do you need to know?

Health insurance for the self-employed: Private health insurance and sickness benefit Health insurance for the self-employed: Private health insurance and sickness benefit

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Private health insurance for self-employed

Overview

As a self-employed person, you can always switch from legal to private health insurance - only the return is more difficult because you have to be younger than 55 years and employees with a certain annual salary (currently the upper limit for 49.500 Euro).

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Maybe the private health insurance but also simply more to the statutory, says the benefits can be far more extensive and the tariffs cheaper.

The basic tariff

Overview

Since the year 2009, private health insurers have to offer a so-called "basic tariff", which is open to all those who are not compulsorily insured under statutory health insurance and which are not insured voluntarily in statutory health insurance for more than six months.

If you meet these conditions, you must be included in the basic tariff - even in the case of serious illnesses, which could otherwise be used to reject you or raise expensive risk premiums.

Insurance for the unemployed

Overview

This also applies if you become unemployed as a private or uninsured self-employed person. However, the Arbeitsagentur (unlike in the statutory health insurance fund) bears only a portion of the contributions, in the case of unemployment benefits no more than 131,34 Euro; the rest is deducted from the unemployment benefit.

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If your income after the payment of the basic tariff contribution leaves you with just enough money to be entitled to unemployment benefit II, the insurance company must reduce the contribution by half.

Amount of premiums

Overview

However, the amount of contributions, here called insurance premiums, is also based on the basic rate by age and gender, but not by income. The basic rate may not be higher than the statutory health insurance (553,16 Euro per month).

Up to this amount, however, insurances are free to demand a high premium from low-income earners. There is also no family insurance, but the partner can get a discount of 50 percent. In the highest case, 829,74 euros are already available for a couple.

Attention expensive additional services

Overview

So that people with statutory health insurance can afford individual treatments at the dentist, private insurance companies lure them with additional insurance - and do good business with it. Most recently, contracts signed rose. Around 15 providers, the “Apotheken Umschau” reports, campaign for the favor of customers and lure them into a true jungle of tariffs, which require the policyholder to weigh them up carefully. The most important question: Does he want to cushion the costs of "standard care" or get the best possible, visually appealing dentures? Many consumer advocates recommend that you only cover the really expensive risk of "dentures" and pay for extras such as sealing the occlusal surface yourself.

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The first look must be the percentage of the cost that the supplementary insurance pays. But be careful: Usually, the fixed subsidy from the statutory insurance is included. Other providers advertise with "100 percent", but only double the fixed subsidy. If the treatment costs more, this is at the patient's expense. Also study carefully: upper limits that sometimes apply per year, sometimes over the entire term. Under no circumstances should customers accept contracts in which the insurer reserves the right to terminate the contract for the first three years if the customer becomes “too expensive”.

Differences depending on the insurance

Overview

The benefits you get for these bonuses are usually very different from insurance to insurance. There is only one thing that can help to compare prices and services.

The best way to do this is to get comparative offers from different insurance companies - not by means of some comparison tables on the Internet, but personally and bindingly.

What services do you need?

Overview

First of all, consider which services you need: for example, do you have basic health care at the basic rate, or do you want to have a head physician treatment in the hospital? Which additional services would you like for dentures? The more services, the more expensive it gets.

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For certain ailments and pre-existing illnesses, private insurance companies also require risk supplements, which can be counterbalanced by the beautiful sample calculations from the tables. Or they refuse to take a shot at the risk. And: Women pay up to 60 per cent more than men, and even in the elderly the contributions are higher.

Health insurance in statutory health insurance

Overview

In statutory health insurance, self-employed self-employed persons have the option of obtaining a sickness benefit from the first day of sickness with a special tariff.

To make such offers, the bill on health reform now submitted obliges all statutory health insurances. Whether these tariffs, however, will be affordable by anyone, so far can only speculate. In the standard rate, which includes a sickness benefit from the seventh week of illness today, the sick pay claim for it should be omitted. So far, that's just a bill!

Contribution classes for sickness benefit in the GKV

Overview

As a rule, three draft classes, ie a low (without a health claim), the standard contribution (with sick pay from the 7 illness week) and the increased contribution (with sick pay mostly from the fourth week), are now being determined :

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"Have no claim to sick pay ... full-time self-employed."

Your cash contribution should be for 0,6 percentage points below the normal contribution. The funds must offer "eligibility" for an immediate sick pay, about the amount of the bill, of course, excludes.

New regulation and media panic

Overview

The new regulation should not apply to insurance through the artist social fund - here the draft leaves the law unchanged.

Then a panic message in the media: According to § 44 SGB 5 have full-time self-employed workers from 1. January 2009 in the statutory health insurance no longer entitled to sickness benefit. And now? Change to private health insurance, completion of a private sickness allowance insurance?

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Sick pay entitlement remains

Overview

Nonsense, says the information service Mediafon. Because at the same time also § 53 SGB 5 is changed. Its paragraph 6 now reads:

"The health insurance has to offer in its statute for (these members) tariffs, which give rise to a claim for sick pay (from the first day) or at a later date, for the ... Insured under the artists' social security law, but no later than the beginning of the third week of disability . "

So if everything remains the same, it means only different! And one must know that - whoever wants to be entitled to a sick pay - has to convert his previous insurance into the standard tariff into an insurance in the elective tariff with a claim for sickness benefit.

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