Plan change within private health insurance: your right to switch and the process

§ 204 VVG sets out the right to switch within your own insurer at any time. Your ageing reserves are kept in full. With the same scope of benefits, no health questions may be asked.

With a higher scope of benefits, case law of the Federal Court of Justice allows health questions for the extra benefits, possibly with a risk surcharge. A rejection of the application is not legally permitted.

The process follows several steps:

• Analyze the plan: record the scope of benefits, the deductible and any existing risk surcharges of your current plan.
• Define the scope of benefits: you decide which benefit profile the new plan should have.
• Ask for plans: send a written request to the insurer for all available plans with this benefit profile.
• Compare options: set the plans side by side by premium, deductible and benefit details.
• Apply: apply for the switch and ask for a written confirmation with the effective date.

The plan change under § 204 VVG has the structural advantage that your ageing reserves are kept in full. When you change insurer, only the share calculated at Basistarif (i)BasistarifA statutory social plan that every private insurer must offer. Its benefits are comparable to statutory health insurance, and its premium is capped at the statutory maximum contribution.More about Basistarif → level is transferred, which applies to contracts from 2009, and full health questions are mandatory.

As a rule, the internal switch is worth it first, and a change of insurer only if the insurer has structural problems.

From over 5,000 applications with health questions and advice sessions that we have supported, a pattern emerges. People often consider a plan change within private health insurance only after several premium increases. We recommend that existing customers check their plan against the insurer's current plan generations every three to five years. You can often save 15 to 30 percent of the premium with comparable benefits.

For young people in stable health, a switch to a plan with a higher scope of benefits can also make sense. If you have pre-existing conditions, we recommend an anonymous risk enquiry first.

A confirmed plan change applies permanently from the effective date. A one-sided withdrawal is not provided for. If you want to switch again, you can submit another application under § 204 VVG. A return to the old plan is not guaranteed if it is no longer open to new customers.

Yes. § 204 VVG applies to all private health insurance contracts, regardless of the year they were taken out. Only the transfer of ageing reserves when you change insurer, not in an internal switch, differs according to the 2009 cut-off date.

With the same or a lower scope of benefits, agreed surcharges remain as far as they concern the area that is still insured. If benefits are reduced, surcharges for the dropped components can lapse. This needs to be clarified with the insurer case by case.

Once the complete application has arrived, processing typically takes two to six weeks. The switch takes effect at the next possible date. The confirmation letter should state this date clearly.

Yes. The policyholder can submit the application directly to the insurer. The added value of a broker lies in the full analysis, because insurers do not always name all available plan generations when you ask yourself.