The Comprehensive Guide to Changing Plans in Private Health Insurance

Changing plans in Private Health Insurance (PKV) is a topic that concerns many insured individuals. Especially if you feel that you’re paying too much or your current health needs are not optimally covered, a change could make sense. In this comprehensive guide, you’ll learn everything you need to know about changing plans, from the prerequisites to the benefits to the practical steps you should take.

Why should You Consider Changing Plans in Private Health Insurance?

There are several reasons why you should consider changing your plan in PKV:

1. Cost savings: Over the years, premiums in your current plan may increase. Changing plans offers you the opportunity to save costs without sacrificing important benefits.
2. Needs-based insurance coverage: Your life circumstances can change – be it through marriage, birth of a child, or a career change. A new plan can better fit your current situation.
3. Improved benefits: New plans often offer better and more modern benefits that are not included in older plans. These may include improved preventive check-ups or alternative healing methods.

Prerequisites and Legal Framework

When changing plans in PKV, there are some legal frameworks you should be aware of:

• Right to change: As an existing customer, you have the right to switch to an equivalent or higher-value plan at any time. This is regulated in § 204 of the Insurance Contract Act (VVG).
• Transfer of aging provisions: If you switch within your insurance company, you take the accumulated aging provisions with you. These provisions significantly reduce the premium in old age.
• No new health check: When switching to an equivalent plan, the insurance company may waive a new health check. However, for a higher-value plan, they may require a health check or impose risk surcharges.

The Process of Changing Plans: Step by Step

To successfully change your plan in PKV, you should follow these steps:

1. Information Gathering:

• Request plan overview: Contact your insurance company and request an overview of the offered plans and their benefits.
• Consumer protection and advice: It’s advisable to also seek information from consumer protection agencies or independent insurance brokers. They can help you keep an overview and find the best plan for your needs.

2. Needs Analysis:

• Define desired benefits: Consider which benefits are particularly important to you. For example, do you want a single room in the hospital, higher reimbursement for dental prostheses, or better preventive check-ups?
• Consider financial situation: Ensure that the new plan is also financially sustainable in the long term. A cheaper plan with poor benefits could become more expensive in the long run if you have to bear high health costs yourself.

3. Plan Comparison:

• Use of comparison portals: Online comparison portals can provide an initial orientation. They list various plans and their benefits, giving you a better overview.
• Expert Advice: An independent insurance broker can specifically help you find the optimal plan. They take into account your individual situation and needs.

4. Application:

• Fill out the Application Form: After deciding on a new plan, you must submit a formal application to your insurance company. This is usually done in writing or online.
• Answer Health Questions: Be sure to answer all health questions truthfully. Providing false information can result in contract penalties or loss of insurance coverage.

5. Review by the Insurance Company:

• Risk Assessment: Your insurance company will review the application and may conduct a risk assessment. For higher-value plans, there may be another health examination.
• Risk Surcharges and Waiting Periods: If health risks are identified during the review process, the insurance company may impose risk surcharges or establish waiting periods for certain benefits.

6. Review Contract Details:

• Read New Contract Terms: Carefully read the contract terms of the new plan. Pay particular attention to the benefits, premium amount, and any waiting periods.
• Clarify Questions: If anything is unclear, you should inquire directly with your insurance company or insurance advisor.

Pitfalls and Common Mistakes when Changing Plans

Changing plans in private health insurance can offer many benefits, but there are also some pitfalls you should avoid:

• Short-term Perspective: A cheaper plan may seem attractive at first glance, but you should always think long-term. A plan with low premiums but poorer benefits can end up being expensive in the long run due to high out-of-pocket costs.
• Overlooking Important Benefits: Make sure the new plan covers all the benefits that are important to you. Savings from switching should not come at the expense of quality.
• Incorrect or Incomplete Information: Providing false information in health questionnaires can lead to serious problems later. Always be honest and complete when answering questions.

Examples of Successful Plan Changes in Private Health Insurance

To show you what a successful plan change can look like, we have compiled some examples:

• Case Study 1: Lisa, 34 Years Old: Lisa took out private health insurance shortly after her training. She notices that her monthly premium is constantly increasing and consults us about a change. Through our advice, she finds out that she can switch to a plan that covers her most important benefits while saving 100 euros per month.
• Case Study 2: Markus, 42 Years Old: Markus wants to change his plan to get better coverage for alternative healing methods. After extensive consultation with us and a comparison of plans, he switches to a slightly more expensive plan. However, he now enjoys more comprehensive benefits and is more satisfied in the long run.
• Case Study 3: Sabine, 50 Years Old: Sabine discovered that her private health insurance only covers a small portion of dental prosthesis costs. After intensive research and a conversation with us, she finds a new plan that offers better benefits in the area of dental prostheses. The new plan costs her 20 euros more per month, but the savings and better coverage pay off in the long term.

For whom a Plan Change is not Worthwhile

Despite the many advantages, there are also situations where changing plans is not the best option:

• Poor Health Condition: If your health condition has significantly deteriorated since you took out your private health insurance, a new health examination for switching to a higher-value plan could lead to high risk surcharges. In this case, it might be advisable to stay with your current plan.
• Low Aging Reserves: Insured individuals who have only recently switched to private health insurance or have not yet accumulated many aging reserves could suffer financial disadvantages when switching to a new plan.
• Complex Insurance Structure: Sometimes, changing plans is more complicated and less advantageous due to unclear insurance conditions or a particularly individual insurance solution. In such cases

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