Private health insurance (PKV) at an economy price – for up to less than 100 euros per month

How to save thousands of dollars every year with good nerves and advice? –


The “last chance for privately insured people” is advertised en masse on the Internet, through ads that lead to the tariff change broker.
For a few thousand euros the premium is lowered, by a tariff change. Two horse feet are built in at least. On the one hand, the
Premium after tariff change later above average – “after a few years you pay more than before”. Moreover, the model is illegal because
it is prohibited legal advice (LG Saarbrücken, judgment of 17.05.2016, ref. 14 O 152/15; BGH, judgment of 14.01.2016, ref. I ZR 107/14).


Dilemma of the privately insured

Those insured with private health insurance are entitled to free advice on changing tariffs from their own private health insurance company, §§ 6, 204 of the German Insurance Contract Act (VVG).
But the sales force, e.g. agents, are more interested in keeping the premium pretty high – they live on it. It’s not reprehensible, it’s a loophole.
Some insurers (VR) therefore provide better centralised advice on this.


The PKV would have to compare all tariffs (still) existing with it, if an advice is requested by the VN – means for instance the broker Peter Zinke, which a manual
developed on how to drive VR into counseling liability. In fact, the policyholder gets little of what he is actually entitled to, this broker is convinced.


If he then wants to change to the statutory health insurance (GKV), it looks little better. With usual consultation hardly a VN becomes smarter, as it in
the GKV comes back – and can then later lead an official liability suit “because he was served by a proverbial blonde”. Thereby it goes for PKV-insured,
if they live long enough, to save up to mid-six figures in premiums, enough to not have to sell the family home.


Mass offers with the question whether they are dubious?

Let’s start with the broker from Norderstedt (*name changed), who offers a bogus residence abroad – let’s say a mailbox for 400 euros a month,
for an indefinite period, for the way back into the GKV. A letterbox company on Belize costs less, and moreover only annually – the domicile however extra.

Or let’s take another provider: For up to more than € 11,000 a trip to England is organized – Brexit included, because the implementation will last
or not come at all.

Residence and passports also sell various EU countries and EU applicants, for up to more than 360,000 euros – whether that is suitable for the return to the GKV,
is in question on a case-by-case basis.


The typical case of a consultation seems to be cheaper because a change of residence (work at home or abroad), status (self-employed or employee),
possibly at home and/or abroad. Family members play a role, as well as friends, in any case openness to change – including the
anticipated succession. This is complex because, in addition to health insurance, it also affects tax law, for example. Flexibility is required.


The emergency tariff – bargain for PKV-insured with good nerves

Usually, the insurance broker said that in old age you can switch to the standard tariff at the level of SHI – an incomplete statement, because it is questionable,
which doctor also treats at the fee rates provided for there. The PKV gets then as a monthly contribution from about 180 € or even far more.


Who refuses his PKV some money, because he cannot pay or simply with it better plans, becomes after few months of delay of payment “forcibly” in the
emergency tariff for around 100 EUR monthly premium, with low benefits in case of acute need for treatment, even if he does not pay anything there. This also fulfils the insurance obligation in the PKV. Those who then always only partially pay their contributions up to a residual amount in order to avoid recovery measures remain in the
Contingency Plan. If, for example, you later need all the benefits of your original “luxury” health insurance again for an expensive but not acutely necessary treatment,
only has to pay the outstanding premiums in arrears – and returns to the original full tariff the next month, as long as he likes.


Health support fund as an alternative?

Some domestic providers, and have done so for decades, offer the “third way” of coverage in the event of illness as a health benefit fund.


Some health support funds (UK) also offer legal advice through lawyers in the event of a dispute with the PKV and the UK steps in if benefits are refused.
with assignment and enforcement on the part of the UK.

A popular advice to be allowed to cover in a UK: First into the basic tariff without risk surcharges, then after one month by non-payment into the emergency tariff.
This means that the insurance obligation is fulfilled, a GKV can be terminated with it, and the UK can cover the remaining needs.


The emergency tariff is not at all for really needy people, because who becomes socially needy, the contributions are paid if necessary in the basic tariff after reduction -.
so it’s not a case for the emergency tariff at all.


Emergency tariff can secure prosperity and build wealth

Those who have a high-quality tariff save thousands of euros every year by not paying the emergency tariff. If he were only to switch to a cheaper rate, he would be
it is not certain that he will ever be able to re-insure the high-value benefits, as there is no easy way back, possibly with risk surcharges and waiting periods,
if not everything is ruled out. The emergency tariff is different – if necessary, he pays his premium for one month in the emergency tariff, which he has always owed.
and returns to his old rate next month with immediate full benefits. From the contributions saved, some of the usual treatment can then be
be paid by the patient in the emergency tariff. In this way, expensive private health insurance is only paid for when it is actually needed.


Are there pitfalls?
Yes indeed, that is why good advice is necessary – even this massive saving is seldom given for free, if the effort is not in vain.
was supposed to have been.


by Dr. Johannes Fiala and Dipl.-Math. Peter A. Schramm

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About the author

Dr. Johannes Fiala Dr. Johannes Fiala

Dr. Johannes Fiala has been working for more than 25 years as a lawyer and attorney with his own law firm in Munich. He is intensively involved in real estate, financial law, tax and insurance law. The numerous stages of his professional career enable him to provide his clients with comprehensive advice and to act as a lawyer in the event of disputes.
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