Healthcare reform and health insurance: tariffs of private funds

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The best solution to insure yourself with a private health insurance is the standard tariff. Healthcare reform and health insurance: tariffs of the private health insurance and health insurance: tariffs of the private health insurance

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Simone Janson Simone JansonSimone Janson is publisher, German Top20 blogger and Consultant for HR communication.


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This entry contains content and information that may be out of date, eg due to legal or statistical changes. Because it can still be helpful to get an overview of the topic, you can still find it here.

What is the standard rate?

The standard tariff is a sector-specific tariff in the private health insurance (PKV) and has fulfilled a social protection function since its introduction 1994. It is primarily aimed at older insured persons who need a cheap rate for financial reasons.

The change in the standard rate is for privately insured - if the legal requirements are met - only within the respective insurance company possible. The scope of services is based on the service catalog of the statutory health insurance (GKV). The amount of the contribution depends on the pre-insurance period and the age of the insured, but may not exceed the average maximum contribution of the SHI for individuals or 150 for married couples or the maximum SHI contribution.

Obligations of private insurers

The GKV-Wettbewerbsstärkungsgesetz (GKV-WSG) has obliged private insurance companies to offer 2007 a new standard tariff from July onwards, the so-called modified standard tariff, especially for those persons who have lost their private health insurance or who were never insured.

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For this modified standard tariff applies: If the legal requirements are met, the Company Do not refuse the insurance in the modified standard rate.


  • Due to previous illnesses, no risk premiums may be charged or exclusions may be agreed. The amount of the contribution depends on the age and sex of the insured, but not on his state of health.
  • There are no age restrictions for access to the modified standard tariff.
  • Both the conventional and the modified standard tariff will ensure medical treatment.
  • The monthly contribution for individuals must not exceed the average maximum amount in the SHI. That's about 2007 Euro in year 500. Depending on the age of entry, however, the contribution can also be significantly lower. In addition, special provisions apply to insured persons with a low income in the modified standard tariff: If there is a need for financial assistance (in accordance with the regulations of the Social Security Code) or is this due to the payment of the health insurance contribution, the contribution is halved. And those who can not pay this reduced fee will receive a grant from the Jobcenter or Sozialamt.

Changeover to the basic tariff

To the 1. January 2009, the contracts which the returnees have completed in the modified standard tariff will be converted to the new one. Then, in the area of ​​private health insurance, there are also full opportunities for exchange in favor of the insured and a general duty to insure.

Insured persons can more easily switch between insurance companies in the future. For this purpose, the aging provisions of the insured are transferred in the case of a change of insurance to the extent of the basic tariff.

Change between insurances

So far, the competition of private insurance companies was mainly limited to the recruitment of young (healthy) insured persons, while for older insured a change of insurance was often associated with significant premium increases and thus in fact took place only very rarely.

The reason: In the event of a change, the so-called "aging provision" - that is the amount that insureds save for smoothing out their (otherwise higher) old-age contribution from their premiums - could not be taken to the new insurance company. Choppers therefore had to completely rebuild their aging provision, which made their contributions to the new insurance significantly more expensive. In fact, the change was impossible for many years PKV insured.

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In the future, a PKV insured person can take his aging provisions to the extent of the basic tariff when moving to another private company. He is then placed in the new company as if he had entered there at the age at which he had concluded the original insurance contract in the old company. For tariffs which go beyond the basic tariff in the scope of services, which include services that are, for example, included in supplementary insurance schemes for statutory health insurance, portability is introduced at the level of the basic tariff.

As of 2009, the following provisions apply to retirement provisions in the basic tariff:

  • Uniform performance specifications for which a contribution to the aging reserves is to be possible
  • Contracting obligation of insurance companies
  • Risk compensation between companies

For PKV insured persons who conclude a new health insurance contract under the 31.12.2008, the portability to the extent described applies without restriction. For insured who have a health insurance contract before the 1. January 2009 have completed, a temporary change possibility is provided: You can only in a period of six months from 1. January 2009 to move to another company taking the aging provisions into the scope of the basic tariff. Under certain conditions, these "old insured persons" can also switch to the basic rate without interruption within their company, taking the aging provision into account.

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