Living Without Health Insurance: "We're the Serfs of the Doctors"
- Author: Bernhard Albrecht
- Approx. Reading Time: 10 minutes
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Famed actor Heinz Hoenig, 22-year-old Constantin S., and his mother Cornelia all share an unfortunate commonality - they don't have health insurance.
Their struggles have been in the public eye for almost a year, following numerous media reports and the podcast of Hoenig's wife Annika. Last April, Hoenig fell ill gravely and spent five months in various hospitals. His treatment costs collected to more than 100,000 euros, a sum that his family was able to pay off thanks to generous donations from Hoenig's fans. Further procedures are still needed.
Unlike the Hoenigs, there are no donations for the S. family. A serious illness requiring costly treatments would likely bring their family to financial ruin. They've been living near the poverty line for years and due to a unfortunate string of events, they also have no claim to social assistance.
The stern magazine learned about their predicament after an email from Cornelia S. expressing: "It's not just the homeless or the rejecters of the solidarity community who are affected, but also people like me and my family," said S. I visited the family twice, once a year ago and more recently last week - only to find that nothing had changed in their precarious situation.
No Insurance Cancellation, but Loopholes Persist
In theory, situations like the S. family's should be nonexistent. It is a legal obligation for German citizens to have health insurance from an insurance company. This obligation also carries a right: no one should have their insurance canceled, leaving them unprotected. The legal foundations were set between 2009 and 2013. Laws, however, often have loopholes. Cornelia S. and her now severely disabled 22-year-old son Constantin slipped through one of these cracks.
- Health Coverage
- Insurable Status
- Health Care Barriers
Insurance Basics in Germany
- Statutory and Private Insurance: Residents in Germany must have insurance, offering either state-funded or private options.
- Legal Consequences: Failing to have insurance may result in legal complications, such as for residency registration or obtaining a visa.
Potential Loopholes
- Switching Insurance Types: High-income individuals can choose between state and private insurance. However, making the switch can be difficult, as not everyone has this flexibility.
- Exemptions: Certain professions, like civil servants or self-employed individuals, can opt for private insurance, but this isn't available to all.
Anwartschaft (Holding Policy)
- Temporary Absence: If residents are temporarily leaving Germany, they can request a Holding Policy to temporarily freeze their public insurance. This preserves future eligibility but doesn't provide coverage during the absence.
- Limitations: The Holding Policy doesn't apply to individuals moving within the EU or EEA, and additional insurance is required for medical needs during absence.
Uninsured Scenarios
- Unemployment Benefits: People who are receiving unemployment benefits (unemployment assistance or Bürgervölkerleistung) automatically receive public insurance. Those not receiving these benefits have the option of selecting either state or private insurance, but this may involve costs.
- Internships and Employment Status: Those accepting unpaid or low-paid internships may have different insurance options, depending on their student or employment status.
Implications for the S. Family
- Legal Compliance: To avoid legal repercussions, the S. family must adhere to the obligatory health coverage requirement.
- Insurance Options: They'll need to consider the costs and benefits of state versus private insurance based on their financial situation.
- Specific Situations: If they are abroad temporarily, a Holding Policy may be an appropriate solution to preserve future eligibility for public insurance advantages.
In essence, while there are no direct loopholes for avoiding health insurance in Germany, understanding the system and choosing the appropriate insurance type based on individual circumstances can help manage costs and remain law-abiding.
- Bernhard Albrecht's article sheds light on the struggle of those without health insurance, including Heinz Hoenig, a 22-year-old Constantin S., and his mother Cornelia.
- Despite being a legal obligation for German citizens, people like the S. family can still find themselves uninsured, slipping through the cracks in the system.
- Science and medical advancements have made treatments for chronic diseases like chronic kidney disease, cancer, and various medical conditions expensive.
- Without insurance, a serious illness can lead to financial instability, as seen with the S. family who have lived near the poverty line for years.
- The S. family's predicament highlights the need for affordable and accessible health insurance options for everyone, regardless of personal financial status.
- In Germany, residents have the choice between statutory and private insurance for their health coverage, but making the switch can be complicated.
- Understanding the insurance system and selecting the most cost-effective option based on individual circumstances can help manage costs and remain law-abiding.
- Personal finance management plays a crucial role in ensuring one can afford the cost of health insurance and other necessary expenses, such as nutrition, workplace-wellness, fitness and exercise, mental health support, and debt management.
