What is a great private health insurance company

Is private health insurance too expensive in old age?

Is private health insurance too expensive in old age?

In private health insurance in old age, “too expensive” is a very relative term. In the case of illness, the better performance is definitely “worth it”. It's not primarily about costs, but above all about your health!

If you take out private health insurance, you will receive better benefits in a high-performance tariff than in the GKV, and if you start early, usually at a lower price. In addition, you receive a PKV lifelong performance promisewhich statutory health insurance can never give you as a budget-driven plaything of politics. For the assessment of the price / performance ratio PKV vs. GKV, it is of course also important how the contribution will develop in the future. We do not have a crystal ball, but try to give you a few facts here in order to better assess this question.

First of all, an official statement from Federal government dated May 30, 2016 (BT-Drs 18/8590) on a request from the Greens on the burden of pensioners with private health insurance contributions: "According to the WIP, the proportion of privately insured persons who pay a premium that exceeds the maximum contribution of the statutory health insurance was 0.5 percent of those insured in 2012.“Only one in 200 people insured with private health insurance pays more than the maximum contribution in the GKV!

Premium calculation in the private health insurance

One thing must be said clearly: the Private health insurance does not get more expensive in old age because the insured gets older!

First of all, health insurance expenses - statutory or private - naturally increase with age. Here is an overview from the Federal Insurance Office of the benefits expenditure in the statutory health insurance system depending on age:

However, getting older (and thus sicker) is not really surprising, but factored into the PKV. That is why the premiums for private health insurance and most supplementary insurances are calculated in such a way that they theoretically (without "medical inflation", see below) remain constant for a lifetime. The contribution is calculated taking into account life expectancy, i.e. at a young age the contributions are higher than the actual costs, the higher costs of private health insurance in old age are derived from this saved capital, the so-called "Aging provision“Paid. See the following graphic "Premium calculation in the private health insurance„:

Medical inflation

Medicine is becoming more expensive every year, regardless of whether it is publicly or privately insured. The Main reasons:

  • longer life expectancy (each year longer costs about twice as much as the previous one) and
  • new treatment options / medical-technical progress

More recent studies assume that the demographic effect and the medical-technical progress will each increase health expenditure by approx. 1% p.a. In addition, effects such as increasing "supply-induced demand" must be taken into account (see in detail the brief analysis by the Scientific Institute of Private Health Insurance "Development of premium income in private health insurance and statutory health insurance" from 11/2016 "- WIP 11/2016 for short). Health expenditure in Germany increased by a total of 87% from 1994 to 2014, while the gross domestic product only grew by 59% in the same period. As a precaution, you should therefore use a general "Inflation rate medicine"From an average of approx. 5% per year consider.

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Quote from the linked answer by the Federal government dated May 30, 2016 (BT-Drs 18/8590) on a request from the Greens: "The cost increases that have also been observed in the field of private health insurance in recent years are largely due to the general expansion of services in connection with medical-technical progress and the increase in life expectancy. These changes also affect the cost development in the statutory health insurance to the same extent. This is why the premium development in statutory and private health insurance has been very similar in recent years. The private health insurance contributions rose by around 2.5 percent per year between 2008 and 2014 (see the response of the federal government to the small question on Bundestag printed matter 18/5956, p. 3, answer to question 5) and thus developed over this period somewhat less dynamic than the contributions in the statutory health insurance.

If one compares the development of the performance data in the private health insurance and in the statutory health insurance over a period of 10 years from 2007 to 2017, one finds that the Statutory health insurance expenditure (plus 45.6%) increase significantly more than in private health insurance (plus 38.2%)!

Development of contributions and reductions in benefits in statutory health insurance

Development of contributions to statutory health insurance

2021 rises Maximum contribution to statutory health insurance with a general contribution rate of 14.6%, an average additional contribution of 1.3% and a care contribution rate of 3.05% of EUR 890.63 in 2020 928.80 EUR, plus various additional payments for which GKV insured persons have to pay for themselves! See also our page Social insurance values ​​2021 The maximum contribution for statutory health insurance will therefore increase by 2021 compared to 2020 4,29%. The increase in the maximum contribution from EUR 853.05 in 2019 to 2020 was 4.4%.

1970 was the maximum contribution 50.31 EUR (8.2% from BBG in the amount of 7,362 EUR p.a.)! From 1970 to 2021 this is the maximum contribution to GKV annually on average around 5.77% up (1970: 50.31 EUR, 2021: 928.80 EUR). You can see the course of the individual years in the PDF file "Development of GKV contributions 1970 - 2021" linked here and in the following graphics:

Does it make sense to look so far into the past (up to 1970) in order to forecast the future? We think so. An assistant doctor who can switch to private health insurance at 28 and receive a regular pension from the pension fund (plus additional income subject to statutory health insurance contributions) usually receives long-term income above the statutory health insurance contribution ceiling (BBG 2021: EUR 58,050) and pays in the GKV thus permanently the maximum contribution. If you think 52 years into the future (28 years + 52 years = 80 - i.e. still well below the statistical life expectancy), then you should also look 52 years into the past for a prognosis.

Would the GKV not in addition to their contribution income massive tax subsidies received (2016: EUR 14 billion - co-financed by all privately insured persons!), these premium increases would be significantly higher. In 2016, each GKV member would have to pay an average of around 21.60 EUR more per month without these subsidies from the state treasury! Despite one Sixfold (!) this federal grant of EUR 2.5 billion in 2007 over the past 10 years EUR 14.5 billion in 2017 (WIP 11/2016) it was not possible to slow down the increase in the GKV contribution! Here are the exact figures for the federal grant to the health fund from 2004 to 2017.

It will be exciting to see to what extent the amount of these grants will result Corona / Covid 19 empty state coffers can be maintained!

Reductions in statutory health insurance benefits and structural problems

In addition, were in the statutory health insurance Services considerable shortened and Co-payments introduced / increased (see reductions in GKV benefits), which primarily affects the elderly and the sick. This is intended to counteract the increase in costs in the healthcare system at the expense of the patient.

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This graphic shows you at a glance how Reductions in benefits from the statutory health insurance with clear Premium increases went along. Most recently, in November 2015, for example, arthroscopic surgery for knee osteoarthritis (gonarthrosis) was deleted from the statutory health insurance's catalog of services because this surgery was supposedly useless. This results in a saving of approx. 7 billion euros! Further rationing measures in the statutory health insurance are to be expected.

(c) Signal Iduna 2015

Very important: the GKV works according to a "Reverse pay-as-you-go system“: She first spends money and then lets young professionals pay. Have you ever wondered where ours come from Population structure will the young GKV contributors come in the future? Here is an explanatory video. In 2050, a third of our population will be 60 years or older! On this demographic change the GKV is in no way prepared, while the PKV has made provisions through the aging provisions described.

According to more recent model calculations (see WIP 11/2016), due to the increase in the proportion of the elderly population as a result of constantly low birth rates with increasing life expectancy and increases in expenditure due to medical-technical advances in the year 2050 with a GKV contribution of 25% to be expected! Some studies predict significantly higher values! Here are the increases in the GKV contribution that various renowned experts forecast by 2050 (quoted from "The PKV in the low interest phase"):

(C) PKV Association 2018

Reports with headings like "Statutory health insurance in need: Higher contributions and rising cash deficits threaten". Even the National Association of Statutory Health Insurance Funds itself expects significant increases in the additional contribution that has now been levied by almost all statutory health insurances, which is not capped and had to be borne by the insured person without employer participation until 2019.

In October 2019, an IGES study on behalf of the Bertelsmann Foundation predicted statutory health insurance companies a Deficit of almost EUR 50 billion in 2040. To compensate for this, the general contribution rate on 16,9% may even be increased in the case of somewhat higher medical inflation 18,7%. The current financial reserves will be used up by 2031.

in the Corona year 2020 has that Deficit of the statutory health insurance by around two thirds or one billion euros increased to EUR 2.5 billion! (Health insurance companies with the highest deficit since 2003)

Private health insurance: premium development and old-age provision

Private health insurance is also becoming more expensive every year. Arbitrary or age-related increases are here however excluded by law. Contribution increases are only possible under legally stipulated conditions, e. B. with rising treatment costs and increasing life expectancy.

Especially Reductions in benefits are in the PKV excluded by contract. In contrast to the GKV, which lives “hand to mouth” and directly pays out contributions collected, so-called “aging reserves” are saved in the private health insurance, which finance the rising costs of private health insurance in old age. The total of these provisions in 2019 was around EUR 235.1 billion. Demographic development therefore does not play a role in private health insurance. However, cost increases due to increasing life expectancy and medical-technical advances also arise here, possibly even to a slightly higher degree than in the statutory health insurance system, since private health insurers often benefit from new medical knowledge earlier.

Contribution adjustment method ("BAP") Private health insurance

The video of the PKV Association embedded here clearly explains the mechanisms of premium development - please hide the somewhat promotional character.

That is why the contributions in private health insurance are increasing | PKV

In short form: According to the regulations of the Insurance Supervision Act, insurance companies may only adjust their premiums (i.e. increase or reduce) if the costs incurred deviate from the calculated costs by a certain amount in one year. If this threshold is not reached, adjustments may only be made if the value is exceeded in one of the following years. Then, however, the need for adjustments from previous years must also be taken into account. This is why private health insurance contributions often remain stable for a few years and then there is a larger contribution jump. These leaps are often discussed intensively in the media and fears of continually high premium increases are fueled. In fact, you should then look at the average of several years, which is usually within the framework described here, apart from a few outliers.

Development of private health insurance premiums

Here are a few Average numbers (!) to the contribution development in the private health insurance. Important: "Good" providers are well below these average values! The data is significantly distorted by individual providers such as Axa or Central, who have made premium adjustments well above average in various tariffs! And: Since the introduction of the very carefully calculated at the beginning University tariffs In 12/2012, premium developments were mostly much “flatter” than in previous years.

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In 2015, at the request of several left-wing MPs, the german Bundestag concerned with increasing private health insurance premiums in old age. Here is an overview of the Development of the average private health insurance contribution from 2008 to 2014 from BT printed matter 18/5956 of 9.9.2015:

Development of PKV contributions from BT Drucksache 18.5956 from 9.9.15

This corresponds to a Premium increase in the Average of all privately insured persons in Germany from 1.89% annually! During the same period, the Maximum contribution of the statutory health insurance increased from 599.40 in 2008 to 720.90 in 2014. This corresponds to a Average annual increase in GKV contributions of 2.67% - and this on the basis of significantly higher absolute amounts!

The Scientific Institute of Private Health Insurance has in November 2016 the following research results published (see WIP 11/2016 and Versicherungsbote 10/11/2016: "AOK, TK & Co more expensive than private health insurance") and the development based on data from the Federal Ministry of Health and the PKV Association from the premium income in GKV and PKV derived from the contribution burden for the insured:

"Of 2007 to 2017 In private health insurance, premium income per insured person increases by 35%. An increase of 37% can be observed in the statutory health insurance system. Thus, despite the expected premium increases in 2017, the premium burden on those insured with private health insurance increased to a lesser extent in the 10-year period under review than in the statutory health insurance scheme. Considered over the entire period, there is one average annual increase in the contribution burden of 3.2% in the statutory health insurance and 3% in the private health insurance.

Source and (C): WIP Institut 11/2016

“The burden per capita in the GKV including the federal grant is higher than the pure premium burden. With a federal grant, the rate of increase in income per capita in the statutory health insurance system is consistently higher than the increase rate in the private health insurance system in the period under review. Compared to 2007, an increase of almost 45% in the statutory health insurance system compared to 35% in the private health insurance system is expected, an average of one Increase of 3.8% in statutory health insurance compared to 3% in private health insurance.“

Source and (C): WIP Institut 11/2016

If you compare the Contribution development from 2011 to 2021In this period, too, the private health insurance performed better with an increase of 3.0% than the statutory health insurance with 3.3%. And that although the private health insurance also provides for old age with this money with aging reserves, while the GKV spends everything immediately again in a pay-as-you-go system!

Result of a study by the Berliner IGES institute out 6/2016: in the past eight years was the contribution development in the PKV With 2.4 percent less in the year than in the Statutory Health Insurance With 3.8 percent (Insurance messenger 7/12/2016)!

Results of a Study by the German Association of Actuaries (6/2011):

  1. nearly comparable annual premium increase in private health insurance and statutory health insurance of around 3% ... in the last few years (are) the Contributions in the statutory health insurance increased significantly more than in the PKV and
  2. the PKV Contributions from age 65 run away almost constant and decline in older ages then even again.
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