Tip – application for private health insurance

Answer health questions truthfully when applying for private health insurance

Private health insurance - costs

If you want to escape the "two-tier society" in medical care, you apply to a private health insurance company for admission to private health insurance and thus say goodbye to the SHI system. But be careful! – The health issues can have their pitfalls.

When applying, however, caution is advised because the health questions that are part of the application for private health insurance can be very tricky and hold a high potential for error. Many people who could actually switch to private health insurance are rejected due to errors in the application process. Finally, private health insurance companies would prefer to have only young and dynamic people in their health insurance, who are not sick and do not get sick easily.

Calculation of risk surcharges is common practice

At first glance, there is no question of equal treatment, although many people cannot be held responsible for their illnesses because they were inherited. It is a fact, however, that if there are pre-existing conditions or similar risk-increasing factors, such as anomalies, private health insurance companies will impose surcharges or restrictions on benefits.

In the presence of high blood pressure, for example, private health insurance companies charge a risk surcharge. The same applies in the case of thyroid disease, although this depends on the degree of goiter. In addition, overweight and psoriasis lead to risk surcharges. If allergies are present, applicants for private health insurance must undergo an individual review of their application, as allergies can vary greatly in severity and are associated with different treatment methods. In the presence of slight allergies, as a rule, no surcharges or benefit restrictions are to be expected. Applications may be denied if allergies are severe. If an applicant already has diabetes, he or she has little hope of being accepted into a private health insurance plan.

In the case of migraine, it is important for the applicant to indicate the frequency of occurrence of the symptoms and the medications administered. The private health insurance company may grant acceptance without special aggravation or reject the application, depending on its strength. In the case of kidney stones, these should be surgically removed by the time of application if possible.
A recurrence is excluded. In addition, the operation should be at least 12 months ago.

Illnesses of the last ten years are decisive

The illnesses which occurred in the last ten years are decisive for the application. Whoever conceals medical treatments or health complaints automatically violates the pre-contractual duty of disclosure and thus gives the insurer the legal basis to contest the existing contract, to withdraw from it or to cancel it. To refuse benefits. Only a reduction of benefits is not provided for by the law, even if it is a less serious breach of duty on the part of the applicant. It is not so easy to answer the health questions in the insurance application without errors. Therefore, it is advisable to check the questions about illnesses, health disorders, physical and mental infirmities or chronic illnesses and consequences of accidents and to check exactly when the illness occurred.

Even minor illnesses such as colds or minor sports injuries must also be listed, but only if this is expressly required by the private health insurance company in the insurance application. However, the answer to this question is a tightrope walk, because in case of doubt, the applicant can easily give the impression of a sickly person or even a hypochondriac patient who visits the family doctor for every little thing.

Off to the basic tariff

The question of whether or not you will be rejected when applying for private health insurance actually only arises in the special tariffs, not for the basic tariff. For the application for this, questions are also asked about the health status. However, the private health insurance company in the basic tariff may not increase or decrease the premium or reject the applicant on the basis of the information provided in the health examination. Here the so-called Kontrahierungszwang exists. The contribution amount for private health insurance is limited to a maximum rate for each insured person. In 2014, this maximum rate is 627.75 euros.