7 Myths about private health insurance

Myth 1: Private health insurance is too expensive in old age

When it comes to private health insurance premiums, many people think of high financial burdens in retirement. In fact, some cheap tariffs could lead to private health insurance becoming unaffordable in old age. But ottonova’s private health insurance tariffs are made to last and have various mechanisms built into the tariffs, that will help reduce your premiums in old age:

• The ottonova tariffs are calculated in a particularly sustainable way, as they are based on a realistic actuarial interest rate of 1.25% (considering the current financial market and the investment regulations of BaFin).
• Private health insurance builds up a financial cushion for you with aging reserves to keep your premiums stable in old age.
• You can also lower the premium you pay in retirement today by adding our premium relief component to your premium (“BEK/Beitragsentlastung”): This allows you to reduce your contribution by, for example, € 200 per month from the age of 67.
• Mechanisms to reduce contributions in old age: From the age of 60, the 10 % statutory surcharge no longer applies, which will lower your contribution. Also, the daily sickness allowance ceases with the beginning of your retirement.
• There is a statistical distribution of risk in private health insurance, which means that the healthy pay for the sick. In statutory health insurance, the young pay for the old or high earners pay for low earners. Due to the increasing number of older people in Germany (demographic change), the system of public health insurance is becoming more and more problematic. In contrast to this, premiums in private health insurance are independent of demographic change.

In private health insurance, there are also premium increases, but insurers cannot set these arbitrarily. However, your premiums cannot increase just because you get older or ill.

But premiums in statutory health insurance (gesetzliche Krankenversicherung or short GKV) are also rising continuously - even more than in private health insurance (private Krankenversicherung or short PKV). An analysis by the Wissenschaftliches Institut der PKV (WIP) shows that private health insurance premium income rose by 3.1% between 2004 and 2024, while statutory health insurance recorded an increase of 3.8% in the same period. This means that private health insurance performs better in a direct comparison.

Myth 2: It only makes sense to have private health insurance if you know you leave soon

A lot of Expats think that private health insurance is only worth it when you take it out for a short amount of time. But that's not true. If you plan to stay longer than 5 years in Germany, private health insurance still can offer a savings potential.

By calculating your premium independently of your income, you could save up to 200 € per month compared to public health insurance and at the same time receive a higher range of benefits for your health! 

• Those who earn well share a maximum contribution of around 1,050 € per month (2024, childless, incl. additional contribution and long-term care insurance) in public health insurance with their employer - or bear the costs alone as a freelancer or self-employed person.
• In private health insurance, you could save up to €3,100 per year, because your contribution is calculated independently of your income.  
• In private health insurance, you can benefit from better coverage for your health: e.g. dental treatments incl. teeth cleaning, acupuncture, treatments by alternative practitioners and chiropractors to a much greater extent, dental prostheses, subsidy for glasses, chief physician treatment, preventive medical checkups without age limits, ... 
• Your contribution depends on your health status, the desired scope of benefits and your age of entry: the earlier you decide to switch to ottonova’s private health insurance, the lower your monthly premiums will be.

Myth 3: I can never switch back to public health insurance

People always say that you can never get out of private health insurance, but that's not true at all! Whether you can switch back to statutory health insurance depends mainly on your age and your professional status or income.

1. If you are over 55 years old, it is almost impossible to switch back to statutory health insurance.
2. If you are under 55, you can switch to statutory health insurance if your professional status and income change:

• You even have to switch back to statutory health insurance if your salary as an employee or salaried worker falls below the income limit that applied to you when you switched to private health insurance.
• Self-employed people can switch back to statutory health insurance if they are once again employed full-time and their salary is below the annual income limit (currently 73,800 euros).

Example:

You have become self-employed, are under 55 and would like more job security after a few years because the uncertain order situation as a self-employed person is too risky for you. So you decide to take on a permanent position again. In your new job, you earn e.g. 65,000 euros - i.e. below the current annual income threshold of 73,800 euros. This automatically makes you subject to compulsory insurance again and you even have to switch back to statutory health insurance.

Myth 4: Private health insurance is not worth it with a family

You think private health insurance is not worth it for families? That's not true!

Even with two children, you could still save money with ottonova. But what about coverage? For sure you only want the best for your loved ones. With private health insurance, you enjoy excellent medical coverage as a family, which is far above the level of public health insurance.

What benefits can children access with private health insurance?

Privately insured children can access exactly the same benefits as their parents. Here’s a selection:

• They will be seen quickly by specialist doctors and always receive the best treatment. At ottonova, you can even speak to a doctor whenever you need via video call – even in the evenings or on the weekend.
• Need medication? We’ll reimburse you for all prescriptions.
• If you’d rather turn to naturopathic treatments, private health insurance is the best choice.
• Your child needs to stay in hospital? Private insurance makes this exceptional situation far easier and less stressful, as many private tariffs include free rooming-in, allowing you to stay at your child’s side.
• Parents always want to do everything right – and double check whenever they’re unsure. The private insurance system allows you to get a second opinion free of charge.
• Straight teeth and clear vision are part and parcel of private health insurance: you will be reimbursed up to € 500 every 2 years for visual aids (depending on the chosen tariff) and up to 100 % of the costs of orthodontics.

Myth 5: Private health insurance kicks you out when you get sick

That's definitely not true! The myth that your private health insurance in Germany kicks you out if your health expenses are high or if you become sick quickly after the start of your contract is a persistent one.

BUT, no private health insurance company can kick you out just because you fall ill or have an accident. As long as everything was stated correctly when you applied (health questions), the contract is considered concluded and cannot simply be terminated by the insurance company because you fall ill.

And don't worry, your premium cannot be increased by the private health insurance company just because you may incur higher costs due to a sudden illness.

Generally speaking, premiums are adjusted (both in private and statutory health insurance) due to rising healthcare costs, but never for an individual customer. Premium adjustments are subject to strict legal requirements and may not be made arbitrarily.

So if you are suddenly diagnosed with an autoimmune disease such as type 1 diabetes, for example, your private health insurance company cannot kick you out or directly increase your premium because you are now incurring higher treatment costs. Ultimately, your health insurance is there to support you if you fall ill and to cover the costs of treatment so that you can concentrate on your recovery.

Incidentally, it's also not true that you generally can't switch to private health insurance if you have a pre-existing condition.

Chronic illnesses do not automatically lead to rejection. Even with a pre-existing condition, you often have the option of taking out private health insurance. Before you can take out a policy, the insurer will ask about your state of health and decide whether a risk surcharge is due.

However, as every illness is different and the assessment is individual, there is no guarantee that your application will be accepted. In the case of more serious pre-existing conditions, it may not be possible to take out private health insurance.

Myth 6: With private health insurance, I always have to pay the bills myself first

This is true: With private health insurance, you receive your bills directly from your doctor or therapist and then submit them to the insurance company.

But: If you opt for digital private health insurance that also has a well-functioning app, you can simply take a photo of the bill, upload it and have your money back in your account before it has to go to the doctor.

For particularly expensive treatments or a hospital stay, doctors' surgeries or hospitals can even settle the services directly with your private health insurance so that you don't have to pay the bill yourself.

Myth 7: Private health insurance is not worth it for women?

Private health insurance used to be a male domain and in the bisex tariffs women paid more than men. Since the introduction of unisex tariffs, however, this is no longer the case and as a woman you can benefit from private health insurance just as much as a man. 

Here is an overview of selected benefits of ottonova's private health insurance for women: 

• More preventive health benefits than in public health insurance - and generally not dependent on age. 
• Reimbursement of costs for prenatal classes, pregnancy and postnatal exercises
• More prenatal diagnostics 
• Treatment by a chief physician during a hospital stay  
• Faster access to a specialist: those with public health insurance wait an average of around 25 days for an appointment with a specialist, those with private health insurance only 12. 
• Treatment in private practices 
• Up to 100% coverage of dental bills 
• Old-age provision: With private health insurance, you make provisions for your old age with your contribution and thus protect yourself from excessive costs in old age. Unlike with public health insurance, you are less dependent on demographic change and rising health costs.