BKK health professions: What insured persons should consider



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Closure of the BKK for health professions: What insured persons should consider

The company health insurance fund BKK for health professions will be closed at the end of the year. According to the health insurance fund, the insured have already been informed of the closure via a membership newsletter. Affected people must now look for a new health insurance company. Some not insignificant aspects should be considered.

This year, the second health insurance company is closing due to insufficient financial resources and has to face bankruptcy beforehand. Up until the end, the board of directors of the BKK had sought a solvent fusion partner for health professions. The Federal Insurance Office (BVA) had given the fund the prospect of continued operation only in the event of a merger. Since all attempts in this direction failed, an end to the operating license was inevitable. According to the Federal Ministry of Health and the health insurance associations, scenarios such as the closure of City BKK should not be repeated. Individual health insurance companies such as the AOK or the DAK have already announced that they will admit former members of the BKK to health care professions without hesitation. However, insured persons should carefully examine advertising promises made by health insurance companies before making a change.

If a fund closes, the insured must look for a new provider of statutory health insurance. According to the current legal situation, all health insurance providers must accept new members as well as their co-insured partners or children. An examination of the state of health as with private health insurance is prohibited. When City BKK closed in the summer, individual cash registers tried to reject membership applications on the phone. They often used flimsy and unlawful arguments. For example, it was said that the "xyz" fund did not have certain therapies in its repertoire or allegedly did not take them over completely. If such a conversation can be proven, the health insurance company faces severe fines. From January 1st, the Ministry of Health wants to punish such illegal practice with up to 50,000 euros. The Federal Insurance Office has also announced that it will sanction any violation in this direction with "all available means". Some health insurance companies and the Federal Association of Statutory Health Insurance Funds (GKV) have assured that such a situation as in the days of the City BKK will not recur. However, it remains to be seen whether lip service will actually work in practice. Anyone who is already “brushed off” on the phone should complain directly to the Federal Insurance Office. In such a case, it is important to note the name of the employee, the time, the day and the content of the conversation.

Insured persons have to look for a new fund
As of December 31, 2011, the BKK closed for health professions. By January 14, 2012, all former members must have received confirmation of admission from the new health insurance company. If you cannot independently take care of a new admission, you are looking for a new fund, because there is a legal obligation to health insurance in Germany. The employer, the job center or the pension insurance provider is based on the previous insurance (section 175 (3) sentence 2 SGB V). If no previous insurance can be determined, another health insurance provider is selected. This measure is intended to ensure that there are no periods of insurance loss. However, those affected should not let the scepter be taken out of their hands and seek a new health insurance fund as independently as possible. Until the day of closure, all ongoing health care benefits are paid for by the BKK for health care professionals until the change.

In contrast to the free economic market, all claims and liabilities of the BKK for health care professions vis-à-vis the service providers (e.g. doctors, clinics, pharmacies) must be met until closure. This means that insurance cover is available until a change has been made. In principle, the following applies: If health services are provided, the contractual partners are also remunerated. This also applies to all settlements after the closure. The community of company health insurers is responsible for the costs.

The health insurance companies are currently endeavoring to have their public image brightened up. Numerous checkouts emphasize a smooth process. For example, the press spokeswoman for the BKK federal association Christine Richter told the consumer portal "Test": "It goes without saying that the insured members of the BKK are welcomed to other occupational health insurance companies for health care professions!" Association of substitute health insurance companies. Richter asked the members of the fund concerned to look for a new fund as soon as possible so that the transition can be carried out without any problems.

Health insurance selection should be made carefully
When choosing health insurance, BKK healthcare professionals should pay particular attention to the service, additional offers such as premiums and additional contributions. The cash registers differ only in these points. It should be noted that 133 of the 156 health insurers are currently not demanding any additional contributions from their insured. Some of them, such as the BKK Gesundheit, the DAK and the BKK Axel Springer, want to waive the additional contribution currently being levied from the second quarter of 2012 after a completed merger. However, it is still unclear whether the announcement is realistic because the BVA has not yet given its approval. A concrete decision is not expected until January. Although the DAK is already advertising with the argument that the fund will soon be "free of additional contributions", the DAK can only express this with a guarantee if the supervisory authority has given its full consent. Anyone who still switches to the new "DAK Gesundheit" should note that there is no special right of termination if the additional contribution is not abolished as announced. Then you have to wait eighteen months for the regular termination right to take effect. In addition to the regular contributions, the DAK currently requires an additional contribution of eight euros per month. It remains unclear what additional benefits the newly merged DAK Gesundheit will provide. Here, too, the BVA still has to agree.

Additional contribution, service and bonuses
The additional contribution should not be the sole criterion for choosing the new fund. Around 95 percent of providers' health services are the same because they are set out in the service catalog, but there are differences in service, premiums and additional offers. Special additional services include bonus programs, patient training, diet courses, offers for the chronically ill or optional tariffs. (sb)

Read on:
Health insurance additional contributions 2012 the exception
BKK for health professions is finally closed
No additional contribution to DAK Gesundheit?

Image: pauline / pixelio.de

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