Tarifwechsel & Tarifwechselrecht: right to switch tariffs

What is the difference between Tarifwechsel and Tarifwechselrecht?

A Tarifwechsel (tariff switch) is the move itself: you change from one private health insurance tariff to another and stay with your insurer. The Tarifwechselrecht (right to switch tariffs) is the legal right behind it. Your insurer has to accept a switch into another of its tariffs with the same type of cover, and you cannot sign this right away.

What do you keep when you switch tariffs?

Your Altersrückstellung (ageing provisions), the reserve built up from your premiums over the years, moves into the new tariff in full. The insurer credits it when it calculates your new premium. Rights you have already built up move with you too, for example Wartezeiten (waiting periods) you have already served.

Your health counts as it was assessed when you joined. A switch into a tariff with the same or lower benefits therefore comes without health questions and without a new Risikozuschlag (risk surcharge), however your health has developed since. A Risikozuschlag you already pay stays in place.

When can the insurer ask about your health?

Your insurer can ask about your health only for benefits the new tariff adds on top of your current cover. For that extra part, it may add a Risikozuschlag, exclude the extra benefit or set a waiting period for it. You can avoid the Risikozuschlag and the waiting period by agreeing to exclude the extra benefit instead. Your existing cover stays as it is either way.

A lower Selbstbeteiligung (deductible) also counts as an extra benefit. A higher deductible lowers your premium and needs no health questions; before you switch, clarify how the way back works in your tariff. The same applies to any benefit you drop: adding it again later can mean a new Gesundheitsprüfung (health assessment).

Which tariffs can you switch into?

You can switch into any tariff of your insurer that covers the same areas of care as your current one, such as outpatient, inpatient and dental treatment, and for which you are eligible. The law (§ 204 of the Insurance Contract Act, VVG) calls this gleichartiger Versicherungsschutz, similar cover. Tariffs reserved for a group you do not belong to, for example civil servants, are not open to you.

The right is not limited to tariffs your insurer still sells: older tariffs closed to new customers can be options too. One limit applies. Since December 2012, new tariffs are calculated the same for men and women (unisex). Once you move from an older gender-based tariff into a unisex tariff, you cannot go back. Switching into the Basistarif (basic tariff) follows its own conditions.

When does a Tarifwechsel beat an Anbieterwechsel?

A Tarifwechsel beats an Anbieterwechsel whenever your ageing provisions or your health history would cost you something at a new insurer. A Tarifwechsel keeps everything you have built up. An Anbieterwechsel (switch to another insurer) moves only the part of your ageing provisions that matches the Basistarif; the rest stays with your old insurer.

• Ageing provisions: kept in full with a Tarifwechsel. With an Anbieterwechsel, only the Basistarif share moves

• Health: no questions for the same or lower cover with a Tarifwechsel. A new insurer assesses your health from scratch at your current age, and conditions that came up since you joined can mean a surcharge, an exclusion or a refusal

• Waiting periods: none for the cover you already have with a Tarifwechsel. A new insurer credits them only where the cover is comparable

The gap grows with every year in the contract. The older you are and the longer you have been insured, the more ageing provisions are at stake, which is why switching insurers from around 50 onwards often does not pay. Your insurer reports the share that would move, the Übertragungswert (transfer value), once a year.

An Anbieterwechsel can still be worth comparing early in a contract, while your ageing provisions are small and your health is good. The sensible order is the same either way: first see which tariffs your current insurer has for you, then compare them with the market.

When is a Tarifwechsel worth checking?

A Tarifwechsel is worth checking whenever your premium or your needs change:

• After a premium increase. From age 60, the Beitragsanpassung (premium increase) letter already names cheaper tariffs. If you are thinking of leaving, the Sonderkündigungsrecht (special right to cancel) gives you two months from receiving the letter, so there is time to check the internal options first. See also what to do after a premium increase

• When your income drops. A tariff with fewer benefits or a higher deductible lowers the premium before payments become hard

• During parental leave. Raising the deductible for that time is a switch to lower benefits without health questions; clarify beforehand how you return

• When you want more cover. The same right works upwards, for example adding a single room in hospital, with health questions for the extra benefit only

How does a Tarifwechsel work in practice?

1. Get the options. Use the tariffs named in your premium increase letter, or ask your insurer in writing which tariffs you can switch into. Insurers that have signed the PKV association's switching guidelines undertake to answer within 15 working days and to name cheaper tariffs from age 55 at every premium increase

2. Check whether the list is complete. Under the same guidelines, insurers may show you a selection instead of all tariffs, but have to say so. If it is a selection, ask for the full range

3. Compare benefits, not just premiums. Look at what you would give up, how the way back works, and whether a premium increase is already fixed for the target tariff

4. Apply in writing. If the new tariff adds benefits, answer the health questions for that part truthfully

Do you need a broker for a Tarifwechsel?

No. You can apply to your insurer directly, and the insurer carries out the switch. A broker helps when the choice is not obvious: several tariffs with different benefits, the question of what you would give up, and whether a switch to another insurer would serve you better. With us, advice on a Tarifwechsel costs you nothing, like all our advice. Talk to us before you decide.