Change health insurance – is it worth it?

 

Change health insurance - is it worth it?

 

A change of the legal health insurance can be absolutely worthwhile itself. And it is now also quite simple. When choosing a new health insurance company, however, you should take your time. So that one also chooses the one that best suits one's own wishes and needs. One may be rejected by none, because:

Compulsorily insured persons are free to choose!

Unlike private health insurers, statutory health insurers have to accept every person who is subject to social security contributions, regardless of age and health status. Neither of these have any effect on the amount of the premium. The new health insurance company only has to be open in the federal state where you live or work.

Right to change

There is therefore an unrestricted right to change insurers. And this applies equally to Max Mustermann, who is an employee subject to social insurance contributions, to Frauke, a web designer and blogger who is compulsorily insured through the artists' social insurance fund, and to Dirk, who has been confined to a wheelchair since childhood.

 

Change health insurance - is it worth it?

 

Which health insurance is best for me?

The choice of health insurance is therefore an individual decision. Which factors should play a role, each must and may weigh up for itself.

Individual needs and wishes

Frank, for example, is annoyed that his current health insurance pays a maximum of 50 euros per year for osteopathic treatment. He had very good experiences with this (additional) treatment method after his last slipped disc.

Frauke travels a lot in the world, also professionally. Your health insurance only pays for the standard vaccinations, but not for special travel vaccinations like the one against hepatitis B. She also wonders about the coverage of midwifery services.

Dirk feels that he is not being well advised by his health insurance company and that he is often put off for too long when he makes inquiries about applying for new aids or care equipment. An acquaintance told him that she had had much better experiences with her health insurance company, which even has a local branch office.

Benefits

According to the Federal Ministry of Health, people with statutory health insurance "have a right to adequate medical treatment that meets their needs and corresponds to the generally recognized state of medical science," but there is no benefits catalog in the true sense of the term. Rather, the Joint Federal Committee (G-BA), made up of representatives|of the medical profession, hospitals and health insurance companies, concretizes the currently valid, binding guidelines. The benefits are therefore uniformly regulated by the Social Security Code. (→ Info from the German Federal Ministry of Health)

But health insurers can also offer additional benefits, either by statute or by board resolution. Which additional services a health insurance company offers under which conditions can be found out on request, via its website and (only to a limited extent) via comparison portals.

Health insurance comparison

Comparison portals on the web can at best help to make a preliminary selection. Max can find out which insurance company covers osteopathic treatments at all, but he does not find out which criteria are used as a basis for an assessment such as "Osteopathy: good". Frauke has a similar opinion when she wants to know which insurers include travel vaccinations and under what conditions.

In principle, comparisons of offers are only useful if the personal requirements are very precisely defined. It should also be borne in mind that most comparison portals only use some of the health insurers for their comparisons. A neutral → comparison by Finanztest is the most likely to help here, but there is a charge for it.

It is advisable to write down your own questions and requirements for a good health insurance and to clarify these personally with the favored insurance companies. This is especially true for Dirk. Because the service and customer friendliness of a health insurance company can best be assessed through the testimonials of others and personal contact.

 

Change health insurance - is it worth it?

 

What do I have to do for the change?

The legislator has greatly simplified the process of changing health insurance companies. If you have been a member of a health insurance fund for at least twelve months, you can easily switch to any other statutory health insurance fund.

The new health insurance scheme takes care of

There is only a notice period of two months to be observed and you do not even have to give notice yourself. It is sufficient to submit an application to the chosen health insurance company. The latter electronically notifies the old one of the requested change and that's it. You do not even have to worry about meeting deadlines.

Compulsory benefits that have already been approved continue

In principle, the health insurance company of which you are a member at the time of treatment is responsible for benefits. This applies at least to mandatory services. For example, Max's old health insurance approved the treatment and cost plan for his planned dentures two weeks ago. This is still valid after his change, the cost of dentures is now covered by the new health insurance company.

But: Observe discretionary scope and additional benefits!

However, it can be problematic with benefits where the insurers have discretionary powers, such as cures and rehabilitation measures. They may have to be reapplied for.

In the case of additional benefits not regulated by law, there is no entitlement to cost coverage after switching. Frauke cannot therefore insist that her new health insurance company cover the cost of professional dental cleaning once a year, in addition to travel vaccinations, as she is accustomed to doing with her old one.

Change in case of chronic illness or disability

For people with a chronic illness or disability, a change can make sense, especially if the previous insurance company is not particularly cooperative and, for example, repeatedly rejects aids or measures that fall within its discretionary powers.

Of course, Dirk can also change insurance companies during ongoing treatment. However, he must reapply to the new health insurance company for measures that have already been applied for but not yet approved. The same applies to care services.

Care services

Because with the change of the health insurance company Dirk changes at the same time the care insurance company. Here, too, the principle applies that the nursing care insurance fund has to provide the services, where one is a member at the time of the provision of services. Before making the switch, however, Dirk talks directly to the new health and nursing care insurance company he favors. Because he knows only too well that he must apply for his care services again and again, mostly in the annual rhythm. Therefore, it is important for him to find out how the approval of care measures is generally handled there.

A special case may exist if, for example, the previous health insurance company has lent the insured person a wheelchair. Theoretically, this must then be returned when changing health insurance companies and applied for again with the new insurance company. In the meantime, however, the health insurance companies themselves lend aids such as wheelchairs from the medical supply house and "sublet" them to the insured persons. In this case the wheelchair remains property of the medical center.

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