Notlagentarif: emergency tariff in German private health insurance

What is the Notlagentarif?

The Notlagentarif (emergency tariff) is the minimum cover German law sets for private health insurance when premiums go unpaid. Your contract is not cancelled: a private insurer may not cancel full health insurance that meets the duty to be insured, so the contract is suspended and continues in the Notlagentarif until the arrears are settled. You stay insured throughout, with cover for urgent treatment.

The rules sit in § 153 of the Insurance Supervision Act (VAG) and § 193 Abs. 6 to 9 of the Insurance Contract Act (VVG); the ban on cancellation is § 206 Abs. 1 VVG.

How do you end up in the Notlagentarif?

Only through a fixed reminder procedure set out in § 193 Abs. 6 VVG:

1. First reminder. Once you are two months' premiums behind, the insurer has to remind you. From then on, a late-payment surcharge of 1% of the arrears applies for every month started

2. Second reminder. If, two months after the first reminder, you still owe more than one month's premium including surcharges, the insurer reminds you again and warns you of the consequences

3. Suspension. If, one month after the second reminder, you still owe more than one month's premium, the contract is suspended from the first day of the following month, and you are insured in the Notlagentarif

The suspension does not happen, or ends, if you or the insured person need state support under the German social code, such as Bürgergeld (basic income support) or Sozialhilfe (social assistance). The job centre or social welfare office confirms this on request.

What does the Notlagentarif cover?

Only treatment for acute illness and pain, and care in pregnancy and childbirth. Children and young people are also covered for check-ups under the statutory screening programmes and for vaccinations recommended by STIKO, Germany's standing vaccination committee.

If your tariff reimburses a percentage of costs, the Notlagentarif pays 20%, 30% or 50%, whichever is closest to your agreed rate. The insurer may suspend supplementary policies for the same period. Risikozuschläge (risk surcharges), exclusions and deductibles do not apply while you are in the Notlagentarif.

What does the Notlagentarif cost?

Every insurer sets one uniform premium for everyone in its Notlagentarif, regardless of age or health, calculated only to cover the costs of that tariff. Up to 25% of each monthly premium is taken from your Altersrückstellung (ageing provisions). That lowers what you pay while you are in the Notlagentarif. The insurer has to explain in writing what this means for your future premium when it moves you, and the sooner the arrears are settled, the less is taken from the provisions.

How do you get back to your old tariff?

By paying everything you owe: all arrears, late-payment surcharges and collection costs; a tariff switch does not end the suspension. Your contract then continues in your previous tariff from the first day of the month after next, at that tariff's current premium and with your remaining ageing provisions. You return with the cover you had before and without new health questions.

How can you avoid the Notlagentarif?

Act before the second reminder, and ask your insurer about instalments early. A Tarifwechsel (tariff switch) into a cheaper tariff at your insurer or a higher Selbstbeteiligung (deductible) lowers the premium without new health questions. If you need state support, the premium in the Basistarif (basic tariff) can be halved.