PKV -> GKV after UK retirement age and Brexit

[hh-sailor]

To clarify
PKV = Private Krankenversicherung (Private Health Insurance)
GKV = Gesetzliche Krankenversicherung (Statutory Health Insurance)

I am privately insured and want to change to statutory health insurance.

So I took out private health insurance some 20 years ago for all sorts of reasons.
I'm now still living in Germany and paying rather large monthly premiums for this PKV.

I missed the opportunity to change back to the GKV before becoming a greybeard at the age of 55.
(I understand that I should of reduced by income - that would have allowed me to change from private to statutory )

I'm now coming up to pension age for the UK and next year will actually receive one.
This entitles me to NHS treatment, I believe.

There is a clause allowing a return to the GKV for those people who can show that they have statutory health insurance in another EU country.
This used to include the NHS in the UK - but then came Brexit.

Can anyone point me at the correct part of the Withdrawl Agreement to say this is still valid / no longer valid ?

[PandaMunich]

There is a clause allowing a return to the GKV for those people who can show that they have statutory health insurance in another EU country.
This used to include the NHS in the UK - but then came Brexit.

Can anyone point me at the correct part of the Withdrawl Agreement to say this is still valid / no longer valid ?

This only applies to people who draw a non-German public/government pension and do not also draw a German public pension, see the section "A pensioner" on this European Union website: https://europa.eu/youreurope/citizens/h ... dex_en.htm

• Healthcare in the country where you live
  • If you receive a pension from the country where you live, and this pension gives you the right to healthcare benefits, then you and your family are covered by that country's health insurance system — even if you are also receiving pensions from other countries.
  • If you do not receive a pension or any other income from the country where you live: you and your family will receive medical treatment in the country where you live, provided that you would be entitled to medical treatment in the country that pays your pension.
    - You should request an S1 form (former E106 form) from your health insurance institution in the country that pays your pension.
    - When you arrive in your new country, register your S1 form with the relevant health insurance institution. This document establishes your right to full healthcare coverage in your country of residence.
  Sample story
  Make sure you know which healthcare system covers you
  
  Nicolas lived in France and worked there for most of his career, except for a few years he spent in Italy working as a waiter when he was younger.
  
  When Nicolas retired, he moved to Italy. His pension is therefore made up of 2 parts: an Italian pension reflecting the years he worked in Italy and a French pension for the years he worked in France.
  
  As Nicolas lives in Italy AND receives an old age pension from Italy, Italy will cover his healthcare expenses. He is no longer part of the French system.

This is why some people, e.g. former UK military, avoid gathering German pension months, exactly so as not to draw a German public pension, but just their UK pension when they retire.
--> come pension-age, they will get free cover in the German public health system (but only in the health insurance part, not in the Pflege = long-term nursing part), through a form S1 issued by the NHS.

I assume that you will also draw a German public pension, so that path isn't open to you.
All you could do is move to another EU/EEA country with mandatory public health insurance, e.g. the Netherlands, Austria or Ireland, stay in that country's public health insurance system and could then return to Germany and within 3 months of returning join any German public health insurance you like by presenting the form E 104 (or if that country is more advanced, it can transmit its new incarnation, the SED S041 (SED = structured electronic document) to that German public health insurer when it asks them for it), they would have to accept you.
See chapter 4 in here: https://www-finanztip-de.translate.goog ... r_pto=wapp

Going by this Haufe article, the UK still "qualifies" as such an eligible country social security wise: https://www.haufe.de/personal/haufe-per ... 11753.html

Summary:

1. move back to the UK
2. live there for more than one year
3. get the E104/S041 from the NHS
4. move back to Germany
5. present that E104/S041 to any German public health insurer you like and they have to accept you as a member

[hh-sailor]

Many thanks, Panda for the explicit and complete answer.

Yes, I have a German pension. So my chance getting the NHS to pay my German GKV are now zero.

I have to work out if a sojourn in Ireland or the Netherlands would be possible or even worthwhile.

Thanks again for the details...even though not what I'd hoped for.

Warning to younger people coming to Germany:
If you're going to stay here through retirement, get the full story of how much health insurance costs. An agent can't predict the future, but us oldies can sure give you current examples.

[kiplette]

This is why some people, e.g. former UK military, avoid gathering German pension months, exactly so as not to draw a German public pension, but just their UK pension when they retire.
--> come pension-age, they will get free cover in the German public health system (but only in the health insurance part, not in the Pflege = long-term nursing part), through a form S1 issued by the NHS.

How do Pflege contributions work? Do you only get out in proportion to what you put in, or does paying them at all get you the same access to Pflege?

I know you can pay Pflege contributions separate from KK Beiträge, both kids#3&#4 do, but does it make sense and is it even possible to back pay extra Pflege contributions if that gets you more access in the end?

Asking because we will have less than 10 years paid when the S1 hopefully kicks in, at which point we will continue to pay the contribution like kids#3 and #4, assuming it is the usual 3% -ish.

[PandaMunich]

You get the same access (so it's an "all or nothing" scenario) as everybody else, but only if you, or the person through which you have Familienversicherung, contributed at least 2 years within the last 10 years.

This is laid down in § 33 (2) SGB XI: https://www.gesetze-im-internet.de/sgb_11/__33.html

and is described on the German Ministry of Health website: https://www.bundesgesundheitsministeriu ... sen%20sein.

• Voraussetzung für Leistungsansprüche
  Um Pflegeleistungen in Anspruch nehmen zu können, muss die beziehungsweise der Versicherte in den letzten zehn Jahren vor der Antragstellung zwei Jahre als Mitglied in die Pflegekasse eingezahlt haben oder familienversichert gewesen sein.

• Prerequisite for entitlement to benefits
  In order to be entitled to long-term care benefits, the insured person must have paid into the long-term care insurance fund as a member for two years in the ten years prior to the application or have been insured as a family member.

[kiplette]

Woohoo!

Thank you for your clear information as always.

We can just carry on as we are, then.

And make sure we top up the S1 when it comes, with Zusatzpflegeversicherung, I guess, otherwise after 10 years we'll have lost our Pflege rights.

Or I suppose one could hang on for 8 years and then pay 2 years of Beiträge for the Zusatzpflegeversicherung, and continue that pattern.

Although that seems kind of cheeky unless you are really struggling financially.

[PandaMunich]

I know you can pay Pflege contributions separate from KK Beiträge, both kids#3&#4 do, but does it make sense and is it even possible to back pay extra Pflege contributions if that gets you more access in the end?

Asking because we will have less than 10 years paid when the S1 hopefully kicks in, at which point we will continue to pay the contribution like kids#3 and #4, assuming it is the usual 3% -ish.

Do your children have public (= soziale) Pflegeversicherung?
Because that (usually) only comes with public health insurance (gesetzliche Krankenversicherung): https://www.bundesgesundheitsministeriu ... erung.html
Though I remember Starshollow writing that it is also possible to get public Pflegeversicherung without public health insurance, but that the Krankenkassen "don't like" giving it to you, i.e. that you have to force them.
Only public (= soziale) Pflegeversicherung is governed by the Sozialgesetzbuch (§ 33 SGB XI), i.e. only public Pflegeversicherung follows the rule that 2 years of contributions are enough.

Private Pflegeversicherung, i.e. the one offered by one of the private insurers like Allianz, will have its own eligibility rules, you would have to ask them directly.

[kiplette]

Oh, OK, these two are Bund so they have that weird arrangement with the Kleine Anwartschaft and a Pflichtzusatzpflegeversicherung, which mine do through the BWV which gives reasonable value. The underwriter is Continentale, so it is private.

Kid#4 did in fact ask our Barmer dude if he could do it through them, and our chap said theoretically yes, but it would be expensive (the 3% thing) and he'd be better going with the private ones in their situation. Which was very fair.

For them, they'll just seamlessly slide back into the normal public KK when their Dienstzeit is over, as I understand it. As long as they have no dependants I think it's fine.

With dependants, I think the BW system is proper dodgy.

For us grownups, we are Barmer at the moment, paying the massive Beiträge incl. Pflege. When we hopefully switch to the S1, at the proper time, we would stay with Barmer as I understand it, and hopefully they would be OK with us continuing to pay just Pflege ourselves? I suppose we'll ask when the time comes.