Is the deductible for private individuals worthwhile?
the essentials in brief
- With a deductible on the medical bill private health insurance can lower their rates.
- Self-participation can pay off especially for freelancers and entrepreneurs: Often the savings in the premium is above the excess.
- For private health insurance workers, however, these tariffs are inappropriate: the savings are lower because they also affect the employer’s share.
- The deductible can also be limited to individual components of private health insurance – for example, on dentures.
- It may be difficult to return to tariffs without a deductible – or only at extra cost.
So go ahead
- Check in which amount an own contribution brings a significant contribution savings.
- Think about whether you use it regularly, or whether you drive it really cheaper.
- Keep in mind that when you go to the doctor more often, you do not find it easy to lower your old age excess.
- Also, check whether you alone benefit from a high contribution savings or even your employer.
The idea is good: if you carry a part of the risk yourself, you can insure yourself more cheaply. What is useful in car insurance or liability and works well, is also offered by health insurance. But are such deductible rates for privately insured persons leasing?
The devil is as so often in the detail: If the contract with a private health insurance (private health insurance before a co-participation, can bring high savings . Often, the insurance premium falls more heavily on the year, as the costs increase through the own contribution in the same period. Those who rarely go to the doctor during the year can sometimes even save more than 1,000 euros a year. However, the cost advantage is quickly consumed when the insured once an expensive supply must take. It is therefore advisable to agree an upper limit for the deductible instead of a percentage of own contribution without cover.
Employees hardly benefit from the deductible
The deductible is not worth it for all: freelancers and entrepreneurs can save significantly, since they alone have to bear the full premium for their health insurance. For private insured employees, however, a deductible worthwhile much less, because the employer pays them each month a subsidy to health insurance. The employer assumes up to 50 percent of the contributions. In contrast, the insured person pays the own contribution in the deductible tariff in full.
Different variants of the deductible
Depending on the provider privately insured can choose between different variants of a deductible. The higher the retention, the greater the monthly savings. At the same time, however, the cost risk in the event of illness also increases. The co-investment may also include various services such as outpatient treatment or dentures. In addition, health insurers offer different forms of deductibles:
Complete co- payment – The co-investment applies to all areas of the health insurance, ie outpatient, inpatient and for the dental tariffs. The complete deductible is the usual model in the so-called compact tariffs of private health insurance. However, the insurers partly waive the deductible for preventive medical check-ups (medical and dental care).
Deductible only in one insurance area – In the so-called module tariffs of private health insurers, the retention is limited to the respective tariff area. For example, the insured person can only agree to the deductible in the service module for outpatient services. For a hospital stay or dental treatment, the private patient then does not have to contribute to the costs.
Percentage Excess – In this variant, also known as a quota excess, the insured person pays a certain percentage of the cost – up to a specified maximum limit. The percentage excess is a typical model for deductible rates in outpatient medical care. For example, the insured person must pay 40 percent of the doctor and medicines costs, but not more than 2,000 euros per calendar year.
Advantages and disadvantages of own contribution
The biggest advantage of the deductible in private health insurance is the contribution savings. With deductibles tariffs reduce the costs for the insurance companies: Then the insured, namely no longer pay small bills. In addition, many patients with deductible rates consciously in the acceptance or rejection of offered medical services. The resulting savings are passed on by insurers to their customers.
But there are also a number of disadvantages of self-participation: The employer subsidizes the private health insurance of his employees with up to 50 percent of the monthly contribution. Self-payers do without money from the boss. Even with the income tax return, there may be a disadvantage: The insured person can deduct his contributions for a private health and long-term care insurance up to the amount of the universal service as special expenses. The deductible reduces this monthly contribution and thus also reduces the tax savings. Who pays out of his own pocket, can settle only in exceptional cases as an extraordinary burden. This regulation was confirmed in November 2016 by the Federal Finance Court in Munich
Excess is worthwhile especially for healthy people
Privately insured persons who, like entrepreneurs or self-employed persons, fully pay their insurance premiums themselves, benefit most from a deductible tariff. In addition, a personal contribution also makes sense for the insured, who rarely go to the doctor anyway. This applies in particular to the module rates in private health insurance. The deductible is then usually only in the outpatient service area, ie visits to the doctor and medicines. However, the saving potential is especially great there.
With the compact tariffs covering all areas of private health insurance, the higher the deductible, the lower the relative contribution savings. For both tariff models, you, the policyholder, should therefore check exactly how much your annual savings in relation to the excess actually are. Before determining the level of co-participation, you should also consider that your health may deteriorate in the future.
Return in tariffs without deductible sometimes difficult
It is usually easily possible to convert a tariff to a higher deductible. However, the opposite approach is not quite as simple: if the deductible is to be repealed or reduced, the insured must usually provide detailed information on the current state of health. In the case of health complaints, the health insurer may refuse access to a tariff with a lower deductible or charge a surcharge on the premium.