There are a few exceptions in which a switch back to the statutory health insurance is possible
There are a few options to switch back from the PKV to the GKV. The legislator has allowed these gaps to help people in special emergencies. In principle, however, the way back is closed. We show when it is possible to switch from private to statutory funds.
It is tempting: Especially at the beginning of self-employment, costs have to be saved. The private health insurance companies offer super offers of sometimes less than 300 euros a month. Those who are still young, without children and healthy pay much less in private health insurance. But with increasing age and changes in living conditions, the contributions also increase, sometimes by a multiple. Many would then like to go back to the statutory health insurance (GKV). So that the principle of solidarity is not overridden, a later change in the principle is impossible. Otherwise, many would pay little for the PKV at a young age and later return to the "safe haven" of the GKV at an advanced age. There are a few exceptions to switching back, as Timo Voss from the Confederation of Insureds emphasized.
Employees: Falling income clears the way to switch back
Not only self-employed people can switch to private health insurance. The same applies to salaried employees who earn more than EUR 50,850 gross per year. They no longer have to pay statutory insurance because they can choose between private health insurance and statutory health insurance. If the salary stays or increases, the way back to the SHI is blocked forever. But: For those who earn less than the insurance exemption limit due to a change of job or work, they can switch back to the SHI. The gross income limit for employees who were already privately insured in 2002 was EUR 45,900 per year. That means you have to earn less than 45,900 euros to switch.
Former self-employed persons can change when they are employed again
In principle, the self-employed can determine which form of insurance they choose. It doesn't matter how much you earn. A change back is not possible for the self-employed, unless they give up their self-employment and switch back to an employment relationship. However, there is only the possibility to switch back if the annual gross salary does not exceed the mandatory insurance limit of 50,850 euros (or 45,900 euros before 2002). This means that the salary must be below the mandatory limit, otherwise employees must remain in the private fund after they have become self-employed.
Switch back in case of unemployment
Employees with private insurance who lose their job and then receive unemployment benefit I can also switch from private health insurance to a health insurance company. It is different with Hartz IV recipients. No change is allowed here. However, unemployment benefit II recipients are entitled to full coverage of a basic tariff.
If insured persons of the PKV have reached the age of 55, a return to the statutory health insurance fund is fundamentally excluded. This also applies if unemployment would occur. The only way out is to downgrade to a cheaper tariff. Insurance experts advise those in financial need to choose a basic tariff. This corresponds to the health services of the statutory health insurance companies. Legislators have ensured that private health insurance providers cannot refuse an application for a basic tariff. "However, it happens again and again that insurance companies get in the way, then only the way to the consumer center helps," advises Thomas Liebermann, insurance expert from Hanover. What is special about the basic tariff: This is not based on the health status of the policyholder but on the age and gender. However, income plays no role in the calculation of the contributions.
Spouse rules for switching
There are very few exceptions for spouses. If, for example, one of the two is legally insured and the other is privately insured, the latter may switch to the SHI under certain circumstances. Access to statutory family co-insurance is possible if the partner who is to be insured does not have an income, an income below EUR 375 or a mini-job. With all others, a change is out of the question. "Accordingly, there are hardly any opportunities to switch back to statutory health insurance," emphasizes Liebermann. Therefore, young professionals should think carefully about a decision, says Voss. (sb)
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