Start of cover in private health insurance: when your protection really begins

When you switch from statutory health insurance, check the start of cover in private health insurance carefully. What counts is the start of cover stated in the policy document. However, cover does not begin before the contract is concluded and not before agreed waiting periods have expired.

The first premium also plays an important role. If the first premium is not paid on time, the insurer can, under certain conditions, withdraw from the contract or be released from paying benefits for an insured event.

Waiting periods only apply in private health insurance if they were agreed. Under § 197 VVG, in comprehensive health insurance they may generally not exceed three months as a general waiting period and eight months as a special waiting period. For the consequences of accidents, the general waiting period usually does not apply. In addition, when you switch from statutory health insurance without a gap, previous insurance periods are often credited towards the waiting period.

You state the desired start of cover in the application. What matters, however, is that this date fits the end of your previous health insurance.

When you switch from statutory health insurance, you must pay particular attention to the notice period. If you are voluntarily insured in statutory health insurance, you can generally cancel your membership with two months' notice to the end of a month. Choose the start of private cover so that it follows on directly from the end of statutory cover.

A start of cover that is too early usually does not lead to better protection, but often only to unnecessary double contributions. This is why, when we advise on the application, we check which start date makes sense and how termination, acceptance, first premium and start of cover fit together cleanly in time.

Cover in private health insurance generally begins at the time stated as the start of cover in the policy document. The condition is that the contract has been concluded and no plan restrictions stand in the way.

Waiting periods can generally be agreed in private health insurance. By law, in comprehensive health insurance they may be no more than three months as a general waiting period and eight months as a special waiting period, for example for delivery, psychotherapy, dental treatment, dentures and orthodontics.

In practice, however, waiting periods often do not apply if you can prove uninterrupted previous insurance in Germany. If you switch directly from statutory health insurance or an existing comprehensive health insurance to private health insurance, your uninterrupted previous insurance period is usually credited.

It is still important: you must state planned, recommended or ongoing treatments correctly in the application. Crediting previous insurance periods does not automatically mean that every treatment already known is reimbursed without review.

Under § 175 SGB V, the notice period for statutory health insurance is two months to the end of a month. If you hand in your notice in March, you can leave statutory health insurance on May 31 at the earliest. The start of cover should then be set for June 1.

Important: only cancel your statutory health insurance once you have the declaration of acceptance from the new private insurer in writing. A rejected application after you have already canceled your statutory health insurance leads to an emergency that is hard to resolve afterwards.

Cover starts on the date in the policy document. If the first premium has not been paid when due through your own fault, the insurer does not have to pay until it is paid (§ 37 (2) VVG). With direct debit, the premium is collected automatically on the due date. With a bank transfer, there is a risk of delay if the payment does not arrive in time.

We recommend direct debit for the first premium. For most insurers, proof that the direct debit mandate was given is enough as the anchor for activation.

When a child is born, it can, under certain conditions, be insured retroactively from birth in a parent's private health insurance. It is important that you register the child within two months of the birth. In addition, the insurer can require that the insured parent has already completed a certain minimum period of insurance. This must be at least three months.

The Kindernachversicherung is particularly important, because with timely registration the child can generally be covered from birth, and no health questions are required for the application. The benefits may not be higher or more extensive than the cover of the insured parent.

If you switch from an existing private health insurance to another insurer, plan the start of cover particularly carefully. What matters is that the new contract follows on directly from your previous comprehensive health insurance.

If you switch without a gap, previous insurance periods must generally be credited towards possible waiting periods, provided you apply for the new cover in time. Even so, have the crediting of your previous insurance checked and documented explicitly before the contract starts.

In our advice work, we often see applicants cancel their statutory health insurance too early and then wait for the declaration of acceptance. We recommend this order:

1. Anonymous risk enquiry and choice of insurer.
2. Submit the application and wait for the declaration of acceptance in writing.
3. Cancel your statutory health insurance with a date that matches the chosen start of cover.
4. First premium: set it up for collection by direct debit.

If you work through these steps in the right order, you avoid the most common pitfalls around the start of cover.

The start of the contract is the date set in the contract on which the first premium is due and cover begins. It is confirmed in the insurer's declaration of acceptance. Full protection for all other benefits only applies after the waiting period has expired.

In exceptional cases, a retroactive change is possible, for example if an application was processed late because of a mistake by the insurer. The rule is the start set in advance in the application. If you want an earlier date, you must actively request it in the application and agree it with the insurer.

During this gap, you bear all medical costs yourself. In addition, returning to statutory health insurance later can be more difficult. You can avoid a gap with precise timing between canceling your statutory health insurance and the start of cover.

With an internal plan change within the same private insurer, there is no new start of cover and no new waiting period. The existing contract is converted, and your previous insurance period is kept. This is a key advantage of a plan change compared with switching insurers.