PKV: For nonpayers only emergency care

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Non-paying tariff for private health insurance?

Private health insurers (PKV) have long been considering introducing an extra tariff for insured persons who do not pay their contributions. According to media reports, only the costs of medical emergencies are to be borne by defaulting contributors.

According to the non-payers, the private health insurance companies have already suffered damage of 550 million euros. In order to limit this, according to the plans of the private insurers, a non-pay tariff is now to be introduced, in which only the provision of emergencies is covered.

Only medical emergency care planned? An expert discussion took place in the Bundestag's Health Committee on Wednesday, during which the PKV association also discussed the introduction of a non-pay tariff, according to media reports. According to this, the defaulting contributors are to be accommodated in an extra tariff, which only provides for medical emergencies for a contribution of 100 euros per month. When asked by "FOCUS Online", a spokesman for the PKV association did not want to confirm these conversation details, but said that "ongoing negotiations between the Ministry of Health, the Ministry of Justice and our representatives" are taking place here. The PKV association also makes no secret of the fact that in view of the almost 144,000 defaulting contributors and the associated burdens of 550 million euros, alternatives are being sought in dealing with the non-payers. "We have to find a way to deal with non-payers," the spokesman for the PKV association told FOCUS Online. In the case of the above-mentioned figures from the PKV, non-payers are to be understood as any insured persons who have not paid their contributions for three months or more in 2011.

Extra private health insurance tariff planned for non-payers General health insurance was introduced in 2009 under the then Minister of Health Ulla Schmidt (SPD). Since then, private health insurance companies can no longer simply cancel their members if they do not pay their contributions. Instead, the accommodation is provided in a so-called basic tariff. This is based on the benefits of the statutory health insurance (SHI), but can be connected to contributions up to the maximum contribution of the statutory health insurance. For the insured affected, it is often also a burden that cannot be financed, so that the "PKV companies have to regularly write off this amount and raise it from aging reserves", the spokesman for the PKV association told FOCUS Online. However, "only a few insured persons remain non-payers in the long run", which is why financial relief is also in the interests of defaulting contributors, the association spokesman continued. In this way, the outstanding amounts would remain manageable and those affected would have a real chance of reducing their debts if payments were resumed.

Critics see home-made problem The limitation of insurance benefits to medical emergencies is generally permitted by law, but the definition of the emergency must be looked at carefully. For example, there is good "experience from the Asylum Seekers Benefits Act", according to the PKV Association. Although the concerns of private insurance companies regarding the introduction of a non-pay tariff can be understood from a financial point of view, critics see this as a homemade problem for private health insurance. Because private health insurance companies in particular, which have massively lured their customers with cheap offers, are now experiencing significant loss of premiums. Also, many privately insured simply cannot afford the annual premium increases. The introduction of a non-paying tariff would also lead to the fact that almost 150,000 people are suddenly provided with medical emergencies, the critique of the position of the private health insurance.

Nonpayers also a problem with statutory health insurance The problem of nonpayers is also increasing with statutory health insurers, according to a spokesman from the AOK scientific institute (WIdO) during the expert discussion in the health committee. A damage of around one billion euros had arisen here last year, although the GKV, unlike the PKV, had no difficulties in covering it. The failures would be compensated automatically via the solidarity system. In the case of private health insurance, on the other hand, the loss of premiums may not be passed on to the other insured persons, so that company funds must be used to compensate. Possibly also an explanation for the special engagement of the private insurance companies in the search for alternatives in dealing with the defaulting contributors. (fp)

Also read:
Health insurance companies: Non-payers cause losses
Private patients flee to the health insurance companies
Health insurance companies: additional contributions will come again
Complaints about an increase in private health insurance contributions
Health insurance: what will change in 2012
Private health insurance can cancel

Photo credit: Ronny Richert /

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Video: PKV vs GKV


  1. Delvin

    And is it effective?

  2. Malall

    You, maybe, were mistaken?

  3. Shazuru

    Very curious question

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