The health care reform comes into force

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The health care reform comes into force: At the beginning of the year, numerous aspects of the health care system change

At the turn of the year, the health reform of the black and yellow federal government comes into force. The reform in the health system changes numerous points for statutory health insurers, doctors and health insurance companies.

Statutory health insurance premium increase
The most important point for citizens is the increase in statutory health insurance premiums. The contribution rate increased from 14.9 to 15.5 percent. This increase is shared equally between employees and employers. What is special: In future, any further adjustment of the contributions will be borne by the employees alone. This means that the federal government has overridden the parity system. In total, the health insurance companies expect additional revenues of around six billion euros. The increase in the contribution rate will largely replenish the forecast deficit of the health insurers. Example: With a gross salary of EUR 2,000 in total, employees now have to pay EUR 164 instead of EUR 158 per month.

Additional contributions: In future, the health insurance companies will determine the amount themselves
The additional contributions apply as the second additional revenue of the health insurers. From now on, the health insurance companies can determine the amount of the additional contributions themselves. This eliminates the so-called “one percent rule”. The additional contributions are charged in addition to the contributions. Most health insurance companies have announced that they want to forego additional premiums this year. However, numerous health economists are already predicting that almost every health insurance fund will raise an additional contribution in a few years. On the one hand, this is due to demographic change and, on the other hand, due to the rising costs for health services and pharmaceuticals. The additional contributions are levied regardless of the income of the employee or voluntarily insured by law.

Social compensation for low income groups
Low income groups can count on social compensation. However, this compensation is so complicated and narrow that only very few can actually make use of it. Health insurers who have to pay more than two percent of their average gross income per month for an additional contribution receive a so-called social compensation from the federal government. However, the amount of the compensation is based on the amount of the additional contribution collected on average by all health insurers. And only this difference is then paid out to the person concerned. If the individual allowance is higher, the insured person must pay the difference out of his own pocket. If the additional contribution is below the average of all, the person concerned benefits and receives a higher compensation from the taxpayer. Conversely, this means that from next year onwards, all insured persons will have to monitor almost every day how high the individual additional contributions of the health insurers are in order to be able to switch accordingly. Those who are retired, chronically ill or not flexible enough to switch are disadvantaged - with the additional contribution and with social compensation.

Hartz IV recipients are exempt from the additional contributions
Hartz IV recipients will no longer have to pay the additional contribution, while unemployment benefit I recipients and pensioners will still have to pay the additional contributions. Only the aforementioned social compensation comes into play here. 16 health insurance companies are currently charging an additional contribution. As a rule, a flat rate of eight euros per month is required. If a health insurance company charges an additional contribution, members of the health insurance fund can exercise their special right of termination. The health insurance companies are obliged to inform the insured in good time. You can switch within six weeks of the announcement.

Healthcare savings
In order to limit the rising additional expenditure in the health sector, around 3.5 billion euros will be saved this year for medical fees, hospitals and the pharmaceutical industry. Together with the premium increase, the deficit in the health fund is to be paid off.

Switch to private health insurance
The Federal Government has made the access requirements for employees considerably easier in the sense of private health insurance. The “three-year rule” was replaced in favor of a “one-year period”. Employees only have to earn more than 49,500 euros gross in one year to be able to switch to private health insurance. However, numerous associations and consumer advice centers advise caution. Because once you have switched to private health insurance, you are also prevented from returning to statutory health insurance. The PKV, for example, has no family co-insurance, so family members and children must be insured individually in the PKV. Before switching citizens, they should get advice from an independent consumer advice center. Insurance brokers are often keen to sell expensive private health insurance for their own benefit.

The state wants to contribute less The federal government will pay a little less into the health fund this year. The share of the federal grant will decrease from 15.7 to 15.3 billion euros in 2011. The Federal Ministry of Health had actually planned to reduce the tax subsidy to 13 billion euros. The target now higher is supposed to secure social compensation until 2015. (sb)

Also read:
From 2011: higher health costs
Health insurance companies: Additional 100 euros in the future?

Image: Verena N. /

Author and source information

Video: Kari Stevens, Cigna Legal Health Care Reform Consulting u0026 Communications


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