Anwartschaftsversicherung: cover for a break from private health insurance

The Anwartschaftsversicherung (i) in private health insurance is a contract status that keeps an existing contract in force during a break. The cover is suspended, but the contract itself remains. This has a decisive advantage: when the contract resumes, there are no new health questions. If you cancel the contract instead and want to take out a new one later, you must go through the full admission process again, including a risk assessment based on your health at that time.

The dormant policy typically applies when someone has to join statutory health insurance for a time or moves abroad.

The small variant is the cheaper option. It protects you from being treated as a new applicant with new health questions when you return.

The large variant costs noticeably more, but keeps building up your ageing reserves. If you return to the contract after the break, you pay the same calculated base premium as before the break, plus the insurer's regular premium adjustments in the meantime.

You can take out a dormant policy for the duration of several situations:

• compulsory insurance in statutory health insurance
• a claim to family insurance in statutory health insurance
• a claim to free medical care
• a stay abroad
• occupational disability or incapacity to work within loss of earnings insurance

As soon as the reason no longer applies, you must report this within two months. If you report it on time, your cover is revived from the date on which the condition ended.

Several situations make an Anwartschaftsversicherung (i) sensible:

• Duty to switch to statutory health insurance: if you are an employee and your income drops below the Jahresarbeitsentgeltgrenze, or you start a new job subject to compulsory insurance, you automatically become compulsorily insured in statutory health insurance.
• Longer stay abroad: if you go abroad for more than six months and receive cover there through your employer or a travel health insurance, you can pause your private health insurance instead of canceling it.

When the dormant phase ends, the insurer reactivates the contract. With the small variant, the premium is recalculated based on your current age at the time you resume. With the large variant, the basis of calculation remains, because the build-up of ageing reserves was not interrupted. The premium development therefore depends largely on the variant you choose.

If you return with the small variant after a long break of more than three to four years, you notice the ageing effect: the premium starts higher, because no further ageing reserves were built up for these years.

A dormant policy is not a plan change. With a plan change under § 204 VVG, your cover stays active, but the scope of benefits changes. A dormant policy, by contrast, suspends your cover. During this time, the contract gives you no cover. For your current cover you need another health insurance, for example statutory health insurance or a travel health insurance.

The dormant policy has clear limits:

• No cover during the break: if you fall ill during this time, the dormant private policy does not reimburse you.
• No credit for the waiting period if you later switch to another insurer. The dormant policy only concerns the existing contract.
• No reduction of statutory contributions: if you become compulsorily insured, you pay contributions to statutory health insurance regardless of whether you keep a dormant policy.

The choice between the small and the large variant depends on two factors: the expected length of the break and the value of the ageing reserves you have built up. If you pause briefly and are young, the small variant serves you well. If you are older and have already built up considerable reserves, the small variant risks a noticeable jump in premium when you resume.

In our advice work, we often see: a poorly chosen variant later costs a lot of ageing reserves or unnecessarily high monthly premiums. We recommend making the decision based on concrete premium data and a realistic length of break.