If you are trying to find the right health coverage in Germany, and you´ve heard that existing health conditions can affect your choice, you´ve come to the right place!

In this article, we´ll talk about:

The effects of existing medical conditions on private health coverage

How is this different from public insurance?

The effects of existing medical conditions on private health coverage

If you apply with existing health conditions, there may sometimes be surcharges, exclusions or a denial of coverage. Why is that the case? Health insurance providers are funded through the monthly contributions they collect from the insured community. That way, if you ever need medical treatment, the provider will rely on this funding to cover you.

To get to a ballpark figure of how much funding will be needed to cover you, the provider does an initial assessment of your health when you apply. As some medical conditions are often tied to further treatment, the provider may adapt the coverage. These changes are made systematically, and the providers invest a lot of time into checking if the changes are justified.

When is private insurance not an option?

There are a couple of health conditions and treatments that always lead to a denial of coverage. Among these are asthma, arthritis, autoimmune diseases, cancer, diabetes, ADHD, mental health conditions and recent or longer-term psychotherapy. For (the combination of) other diagnoses, the providers are happy to check once the application is handed in.

What happens if I apply to Feather´s private health coverage with medical conditions?

If your medical conditions are not on the list above, our team will do an individual check within 1 - 3 days once you hand in your application. If no changes are required, the coverage will automatically be activated - not every condition will result in a change to your original quote or coverage!

Otherwise, the following changes can be suggested:

  1. Risk surcharge
    If you have certain conditions like knee issues, it is likely that further treatment will follow. To ensure that there´s enough funding to cover your treatment, a surcharge can be added.

  2. Exclusion of coverage
    You still enjoy a low monthly cost and pay out of pocket if you ever really need a certain treatment (for example, the replacement of a missing tooth). Please be aware that exclusions and risk surcharges may be combined.

  3. Denial of coverage
    The provider denies coverage if there are certain (combinations of) conditions, since it is likely that a lot of costly claims would be made. If you cannot be covered, the Feather team will help you find an alternative!

To make sure your personal circumstances are considered fairly, we cannot provide concrete information about any changes before your application is handed in - each contract is processed on an individual basis. Please be aware that private health insurance providers will not negotiate on any changes once you’ve received your revised health insurance plan.

How does the system benefit applicants without existing conditions?

On the flip side, applicants who are healthy (or only have a few minor conditions) benefit from a lower monthly cost tailored to their medical needs. That is why many applicants can save money when choosing private over public health insurance, where the monthly cost is only based on your income and thus often much more expensive.

Can´t I just omit existing conditions from the application to get covered?

We strictly advise against doing so. Insurance companies are really good at digging up hidden information and if it turns out that information has been left out, they will cancel the coverage. To make sure you have the right coverage from the start, our team is here to help you take the right decision.

How is this different from public insurance?

Under public health insurance, pre-existing health conditions do not play a role for the eligibility. As a result, many people with (severe) pre-existing conditions chose public insurance to make sure they are covered. Naturally, the public insurance providers still need to make sure that they have sufficient funding to cover them, especially since there are no risk surcharges. That is why each member pays a certain percentage of their income (around 14% or 7% that is split with the employer).

If you are not sure whether it is worth applying to private insurance, the Feather team will support you in taking the right decision.

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