Getting the best treatment in the hospital is what many privately insured people want.
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Cologne The pandemic has made the weaknesses of the German healthcare system clear to the general public. Reports of the number of corona cases by fax, no analysis of cases of illness and no digital consultation hours at the beginning of the pandemic. Corona would have been a good reason to rapidly expand digital structures. However, digitization in healthcare is progressing slowly.
With the corona crisis, the satisfaction of German citizens with their health system is also dwindling. In 2020, 73 percent of Germans still counted their healthcare system among the top three worldwide. In 2022 it was only 57 percent, according to the healthcare barometer of the auditing and consulting firm PwC. For this purpose, 1000 citizens were surveyed.
“The declining approval ratings for the German healthcare system should shake us up. We urgently need a reform that will make our healthcare system fit for the future – not just a small reform or piecemeal as before,” says Michael Burkhart, Head of Healthcare at PwC Germany.
Anyone who lives and works in Germany is generally covered by statutory health insurance. People can choose between different cash registers. But the list of services provided by statutory health insurance is limited. With a private additional policy, you can take advantage of additional services.
Employees who earn more than 66,600 euros per year can switch to private comprehensive health insurance. The change should be carefully considered. Returning to the statutory insurance system is difficult and only possible up to the age of 55.
The change should be preceded by a thorough selection of offers. The offer is confusingly diverse and complex for laypeople. After all, the tariffs of private insurers differ greatly in terms of service and conditions. Unlike statutory health insurance companies, the range of services is not fixed.
>> Read here: For whom private health insurance is worthwhile
The rating agency Franke and Bornberg helps to see through the jungle of offers. The insurance experts have examined the tariffs of private comprehensive health insurance for the Handelsblatt. Quality is the priority here. It therefore makes up 70 percent of the assessment. 30 percent of the price is included in the evaluation. The sample case presented here is a person aged 35. Results for other sample cases can be found in the tables.
“Anyone who decides to switch to full private health insurance can tailor the catalog of benefits to their own needs,” says Michael Franke, Managing Director of the rating agency Franke und Bornberg. The premiums do not depend on income, as is the case with statutory health insurance, but on the benefits, age and state of health at the time of entry into the insurance.
In order to be able to compare the tariffs, the rating agency has divided the offers of the insurers into three categories. The basic protection is based on the scope of services of the statutory health insurance companies specified by the legislature. The standard protection includes more services for privately insured persons, such as accommodation in a double room in the hospital or 60 percent of the costs for dentures.
Top protection tariffs allow medical services to be billed at maximum rates, which include treatment in the hospital by the chief physician and accommodation in a single room. Insured persons can enjoy first-class services with the top protection tariffs. They offer state-of-the-art medicine. The tariffs enable quick access to specialized doctors, who often only charge for services on a private basis.
Out of 24 insurers, 14 were given the highest rating of “very good”. In the example of a person aged 30, newcomers have to pay a monthly premium of between EUR 567.21 and EUR 768.06 for a top protection tariff rated “very good”.
Hallesche Krankenversicherung was awarded the highest grade of “very good” for the tariffs “NK.Select XL Bonus, URZ, PVN”. She scored 98 out of a possible 100 points in the test. In the sample case, insured persons have to pay a premium of EUR 660.73 per month.
“The NK.Select XL tariff is family-friendly and offers services that have not been offered at all or only occasionally by individual competitors,” says Wiltrud Pekarek, member of the board of Hallesche Krankenversicherung. As an example, she cites the non-contributory co-insurance of a child up to the age of one or the medical video consultation without being counted towards the reimbursement of contributions.
Another special feature is the so-called bonus option: “Every month, the insured person receives a bonus of 100 euros, which is offset against a claim,” explains Pekarek. That is why insured persons would only have to submit invoices from a contribution of 1,200 euros.
Telemedicine offers
Gothaer Krankenversicherung received top marks for its “MediCompact Premium” and “PVN” tariffs. The monthly premium is 627.06 euros. The insurer is expanding its digital offering. “This includes services such as checking and assessing symptoms of illness using our symptom checker, finding a doctor and hospital, and telemedicine offers,” says Sylvia Eichelberg, CEO of Gothaer Krankenversicherung.
The award-winning providers include Continentale Krankenversicherung with its “Premium, SP1, PVN” offer. The monthly premium is 567.21 euros. The insurer also emphasizes a family-friendly design: “When receiving parental allowance, a contribution waiver of up to six months is included for each insured parent,” says Helmut Hofmeier, CEO of Continentale Versicherung.
The tariff is characterized by an innovative concept for deductibles: There is a deductible of 20 euros per service, which is limited to 500 euros per year. For children, this maximum is 250 euros. “If customers do not submit any invoices, a refund of up to six monthly payments is possible – two of which are guaranteed by the collective agreement,” explains Hofmeier.
The methodology of the ranking
In the case of civil servants, the state covers part of the treatment costs in the event of illness via the allowance. For the part that is not covered, civil servants need additional private health insurance, known in technical jargon as aid tariffs. “The aid tariff should be tailored to the aid regulations,” recommends Michael Frank from the rating agency of the same name. Because the assumption of costs differs significantly depending on the federal state. When evaluating, Franke and Bornberg assumed the federal government’s aid conditions. Of the 19 offers examined, nine were awarded the highest mark. The premiums for the top subsidy tariffs are between 275.52 and 327.04 euros per month.
When asked about the trends for the healthcare system in the coming years, experts unanimously name digitization: “An important milestone in the digitization of the healthcare system and health insurance will be when electronic patient files and electronic prescriptions are implemented,” says Helmut Hofmeier from Continentale Insurance.
As in many other sectors, the self-image of companies is changing, Wiltrud Pekarek from Hallesche Krankenversicherung is convinced: “Health insurers no longer act purely as reimbursers, but as health partners.” This development is noticeable in additional services.
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