Health insurance for the self-employed: Private health insurance & sick pay

If, as a self-employed person, you do not fulfill the pre-insurance period, you do not have any Choice: You must take out private health insurance. What do you need to know about this?

Private health insurance for self-employed

As a self-employed person, you can switch from the statutory to a private one at any time Health insurance change – only the return is more difficult, since you have to be younger than 55 and an employee subject to social security contributions with a certain annual income (currently the upper limit is 49.500 euros).

Maybe the private health insurance but also simply more to the statutory, says the benefits can be far more extensive and the tariffs cheaper.

The basic tariff

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Since 2009, private health insurers have had to offer a so-called "basic tariff" that is open to everyone who is not compulsorily insured in statutory health insurance and who has not been voluntarily in statutory health insurance for more than six months insured are.

If you meet these conditions, you must be included in the basic tariff - even in the case of serious illnesses, which could otherwise be used to reject you or raise expensive risk premiums.

Insurance for the unemployed

This also applies if you become unemployed as a private or uninsured self-employed person. However, the Arbeitsagentur (unlike in the statutory health insurance fund) bears only a portion of the contributions, in the case of unemployment benefits no more than 131,34 Euro; the rest is deducted from the unemployment benefit.

If by yours Income After paying the basic tariff contribution, there is only so little left that you would be entitled to unemployment benefit II, the insurance company must reduce the contribution by half.

Amount of premiums

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However, the amount of contributions, here called insurance premiums, is also based on the basic rate by age and gender, but not by income. The basic rate may not be higher than the statutory health insurance (553,16 Euro per month).

Up to this amount, however, insurances are free to demand a high premium from low-income earners. There is also no family insurance, but the partner can get a discount of 50 percent. In the highest case, 829,74 euros are already available for a couple.

Attention expensive additional services

So that those with statutory health insurance can afford individual treatments at the dentist, private health insurance companies tempt with additional insurance - and make good ones with it Shops. The number of contracts recently increased by 15 percent. Around 50 providers, according to the “Apotheken Umschau”, advertise for the favor of the customers and lure him into a veritable jungle of tariffs, which requires careful consideration by the policyholder. Most important question: does he want it? Costs cushion the “standard care” or get a denture that is as high-quality and visually appealing as possible? Many consumer advocates recommend only the really expensive ones Risks Secure “dentures” and pay for extras such as chewing surface sealing yourself.

The first thing to look at is the percentage of the costs that the supplementary insurance pays. But be careful: Usually, the fixed subsidy from the statutory insurance is included in the calculation. Other providers advertise “100 percent”, but only double the fixed subsidy. If the treatment costs more, this is at the expense of the patient. Also accurate studieren: Upper limits, which sometimes apply per year, sometimes over the entire term. Under no circumstances should customers accept contracts in which the insurer reserves the right to terminate the contract for the first three years if the Customer becomes “too expensive”.

Differences depending on the insurance

The benefits you get for these bonuses are usually very different from insurance to insurance. There is only one thing that can help to compare prices and services.

The best way to do this is to get comparative offers from different insurance companies - and not with the help of any comparison tables in the Internet, but personal and binding.

What services do you need?

First consider which services you need: for example, is basic medical care sufficient for you at the basic rate or do you want treatment by the head physician in the hospital? What additional services would you like for dentures? The more services, the more expensive it becomes.

In the case of certain ailments and previous illnesses, private insurance companies also charge risk surcharges, which can destroy the beautiful sample calculations from the tables. Or they refuse admission altogether in a risky case. And: Women pay up to 60 percent more than men, and even among older ones People the contributions are higher.

Health insurance in statutory health insurance

In statutory health insurance, self-employed self-employed persons have the option of obtaining a sickness benefit from the first day of sickness with a special tariff.

The proposed health reform bill obliges all statutory health insurers to make such offers. So far, one can only speculate whether these tariffs will be affordable by anyone. In the standard tariff, which now includes sick pay from the seventh week of illness, the claim to sick pay should no longer apply. So far this is only a draft law!

Contribution classes for sickness benefit in the GKV

As a rule, three draft classes, ie a low (without a health claim), the standard contribution (with sick pay from the 7 illness week) and the increased contribution (with sick pay mostly from the fourth week), are now being determined :

“Are not entitled to sick pay… full-time self-employed workers.”

Your cash contribution should be 0,6 percentage points below the normal contribution. For this purpose, the health insurance funds have to offer “optional tariffs” for immediate sickness benefits, the amount of which the bill does not disclose, of course.

New regulation and media panic

The new regulation should not apply to insurance through the artist social fund - here the draft leaves the law unchanged.

Then a panic message in the media: According to § 44 SGB 5 have full-time self-employed workers from 1. January 2009 in the statutory health insurance no longer entitled to sickness benefit. And now? Change to private health insurance, completion of a private sickness allowance insurance?

Sick pay entitlement remains

Nonsense, says the information service Mediafon. Because at the same time also § 53 SGB 5 is changed. Its paragraph 6 now reads:

“In their statutes, the health insurance company has to offer tariffs for (these members) that entitle you to sickness benefit (from the first day) or at a later date, for… insured persons under the Artists' Social Insurance Act, however, at the latest by the third week of incapacity to work . ”

So if everything remains the same, it means only different! And one must know that - whoever wants to be entitled to a sick pay - has to convert his previous insurance into the standard tariff into an insurance in the elective tariff with a claim for sickness benefit.

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