Plan optimization: lower your premium without losing benefits

Insurers regularly launch new plan generations, often with a better balance of premium and benefits than older ones. Existing customers automatically stay in their original plan until they actively apply for a change.

The saving here is typically 15 to 25 percent, sometimes more. What matters is a detailed comparison of the scope of benefits, not only a comparison of premiums. When you ask in general terms, the insurer often names only a few alternatives.

Before you plan a switch to a new plan generation, it is essential to check whether your possible claim to the Standardtarif is kept. As a rule, the Standardtarif (i) is only open to people who already had private health insurance before January 1, 2009 and who meet the other requirements. A plan change made without thought can mean that you lose important access requirements or financial advantages.

A higher deductible lowers the monthly premium by typically 5 to 15 percent. A sample calculation for orientation:

• Starting point: annual deductible €500
• Increase to: €1,500
• Typical premium saving: 10 to 12 percent

This makes sense for healthy people who rarely use benefits, not for people who need treatment often each year. No new health questions are needed for this, because the scope of benefits goes down.

A risk surcharge from the health questions is not necessarily permanent. If the reason heals or your health improves for the long term, the surcharge can be reviewed and, at best, removed. A classic example is hay fever. After successful hyposensitization, the reason for the surcharge can disappear.

It is important that you start the review yourself, because the insurer does not check this on its own. Your policy document shows whether a surcharge applies to you. In individual cases, this route can save ten percent or more.

Reducing individual benefit components, for example the share for an alternative practitioner or the percentage for dentures, typically saves 3 to 8 percent per component. However, the reduction is permanent. Adding the component again later requires new health questions, possibly with a risk surcharge.

Dropping a component only makes sense if you really do not use it, for example a Krankentagegeld (i) that no longer plays a role in retirement.

From over 5,000 applications with health questions and advice sessions that we have supported, a pattern emerges. A successful optimization often combines a switch to a newer plan generation with a moderate adjustment of the deductible. We recommend carrying out a plan optimization every three to five years, because the insurer's range of plans changes and new generations keep coming.

If you have a chronic illness, be careful about dropping components. Here, premium stability counts for more than the saving. If you are young and under 40, choose your plan with the long-term premium development in mind.

You apply to the insurer in writing, stating your current plan and the plan you want. If the scope of benefits is the same or lower, the insurer has no right to health questions. In practice, we recommend sending the application by registered mail and asking for a written confirmation.

The insurer cannot reject a switch to a plan with the same or a lower scope of benefits, because this right is set out in law under § 204 VVG. If the scope of benefits is higher, it can ask health questions for the difference and, if necessary, set a risk surcharge.

In principle, yes. For civil servants entitled to state support, the plan is designed for the share that the Beihilfe (i)BeihilfeThe state healthcare allowance for civil servants. The Beihilfestelle pays a fixed share of medical costs, the Beihilfesatz, and private insurance covers the rest.More about Beihilfe → does not cover. A plan change does not affect this entitlement. The new plan must still fit the principle of state support plus private cover.

Helpful documents are the policy document with the plan name and premium, the overview of benefits, the details of your deductible and information on any agreed risk surcharges. An overview of the benefits you used in the last one to three years helps you decide which levers make financial sense.

Existing contracts in a closed plan continue. A closed plan no longer accepts new customers, which in the long run can lead to higher premium adjustments. In this case, a new analysis under § 204 VVG is worthwhile.

If the internal optimization is not enough, there are other options. The Standardtarif is an option for people insured before 2009 who meet the requirements. The 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 → is for special cases, with a premium no higher than the maximum contribution of statutory health insurance. A return to statutory health insurance is only possible under strict conditions and is in practice ruled out from age 55. Only take these routes after an individual review.