Where to find private health insurance for 65 y.o. expat retiree

Hmmm this is a good question. The details of insurance can be complicated. Normally you would be too old to join the public health system on your own. But I don’t know if they can exclude someone by their age if they are being included as a non-working spouse. My wife for example is 63 and they cannot just drop her off of my insurance in a couple of years because of her age - but she was already in the system.  I’m wondering who has told you what? Your German girlfriend should be in contact with her provider and they should be able to give an answer. If they say you cannot be insured with her then I doubt you have any recourse. Then you would simply have to ask private companies and get an offer.

Thanks Tom. Naturally we are hoping I can "jump on" once we marry. And even THAT is not that easy either!! Indeed she has called her provider and they are supposed to get back with her.  They did say it "may be complicated".  Don't know why it has to be ya know? It's like..you guys (government) require insurance, so...just INSURE us!  Shouldnt have to fight to give people your money right?
We're also working o  PVT ins. quotes too btw. Yet another web of complications to unravel. Ufff.    Thanks.

Yes, German health insurance regulations are a jungle that nobody - not even the insurance companies themselves - understand fully.
I helped a few people (none in your age, though) to get insurance here and found that for the same question you can get radically different answers from different insurers. (So do ask around until you get one that fits you!)
Also, there are health insurance consultants whose only job it is to get people into the public scheme (which at your age will be far cheaper). They are normally engaged by the social security authorities, because they’d otherwise have to pay expensive private insurance premiums for the people getting assistance (e.g. HartzIV). Such consultants would certainly also help you (probably for a fee). Your girlfriend can ask around on a Krankenkassenforum (google that!) to find them.
As for the cost, I can give you a rough idea:
- Free for married spouse of a public scheme member - as long as you have no own income (incl. worldwide and passive income).
- Approx. 15% of your income (subject to a minimum of approx. €170 and a max. of approx. €750/month) if you yourself join a public insurance (which might be difficult above 55 years old) and are not employed in Germany.
- Approx. 7.5% of your employment income if you work here (your employer pays the other half and worldwide or passive income do not count in this case).
- A premium based on your age, health, pre-existing conditions and the coverage you opt for - which will certainly be more than in the public scheme (amounds in excess of €1000 or even €2000/month are common if you join at advanced age).
- And then there is the infamous “base tariff” (Basistarif), that all private insurers must offer (by law) to everyone not insurable otherwise, but no insurer wants to (because it’s loss-making due to mostly hopeless cases falling into it) - so you’d have to bash your way through (possibly with the help of a lawyer) to get it. It offers similar coverage to the public scheme (except you cannot cover dependents for free) and costs as much as the maximum rate of the public scheme (i.e. approx. €750/month).

One more hint: You can realistically solve this issue only after moving to Germany (as insurers will not give you definitive assurances or decide about your membership before that) and even then you have three months to sort it out. (Once you join,though, you will be retroactively charged from the day you arrived.)

beppi wrote:

One more hint: You can realistically solve this issue only after moving to Germany (as insurers will not give you definitive assurances or decide about your membership before that) and even then you have three months to sort it out. (Once you join,though, you will be retroactively charged from the day you arrived.)

One should point out that one will be retroactively charged AND covered. Some people panic and think they need to get a policy from abroad to cover them until the paper work is done in Germany. This is not true if you are moving here rather than just visiting  - for which one would take a travel health insurance.

Oh yes, this is an important detail that I actually forgot to mention - shame on me!

Well, beppi & Tom...as of now I did get a couple of quotes on private ins. from a broker.  Short of it is, my meds for Cholesterol,  hypertension, and my preventive medicine for diabetes, is EXCLUDED.  Got a hunch that will be the case with virtually all private insurers, correct?  That said, IF I get private insurance at all, and end up having to buy my own meds on my own, does anyone have an idea what the cost of statins and blood pressure meds in particular would cost me? Obviously, much like in the states, I will need to get a German doctor to make the prescription order for me to take to the Apotheke to buy them, no doubt?
Thanks.

Each private insurer decides individually about exclusions and surcharges. Thus you may try to contact more of them (there are hundreds!) and maybe you find one that suits you better.
Also, there are no exclusions in the public insurance scheme, so you may try to get into that. (It may not be easy at your age!)
Getting prescriptions and buying medicine on your own cost will probably be far more expensive than in the USA. There are no cheap online pharmacies and medicine costs are regulated (i.e. you pay the same wherever you go). You could contact a pharmacy and ask about the cost of your specific medicine.

This sounds very strange! With German insurance it is not normal to exclude anything but certain benefits can mean a higher premium on a private policy; like if one is entitled to a private room during a hospital stay. Or of course, elective surgery will not usually be covered under a basic plan.

But with medications, even under public options, there is usually a copay. For generic medications it is usually low but if one wants a more expensive specific brand name medication that is seen as not necessary then it can be higher. I don’t know so many details about private policies but can imagine that more expensive policies might include the higher priced medicines. But to simply exclude basic medicines for such common conditions doesn’t even sound legal. Even the private policies have to follow many government regulations and cover most basics. Yet such details are beyond my level of knowledge. But again, it really makes sense to get a definitive answer if you can get on your wife’s public policy before signing up for something else.

And yes, one needs a doctor’s prescription for most medications. Even pain relievers and some other medications that don’t require a prescription can only be bought in a pharmacy rather than a drug store due to safety regulations. A recent development is online pharmacies being allowed in Germany. One would still need a prescription but supposedly, they can offer better prices – but how much and for which things I have no idea.

beppi wrote:

There are no cheap online pharmacies.

No experience with them, so not sure what they are allowed to sell or for what price(s) but online pharmacies have been approved in Germany . I see ads on TV for one called Doc Morris…

Tom: Surcharges AND exclusions are allowed at private insurers - and in my own experience they ally them liberally. My wife got any treatment for wisdom teeth excluded and I was surcharged for a backbone problem I didn't even know about. That (and by then having kids) was why we changed back to the public scheme at the next opportunity.

Hi guys!... Just got off the phone (thank God for WhatsApp) with my sweet German G.F., she sent me a link to two online pharmacies to address the drug cost issue especially if I have exclusions. DocMorris was one of them..price is actually GOOD!....about the same as I'm currently paying in the states with my Rx insurance!  So at least one ray of hope.

And yes, we are gonna go through a long long list of PVK's til we find one that suits our need and budget.  Thanks for all your thoughts and support guys. We just went through a traumatic event together recently so we need all the good news we can get.  Also, she's gonna sit down with her public ins. agent next week and.try to get me on hers, obviously won't be til we're married though. But we gotta be sure b4 I go movimg over there.
Thanks again
I'll probly be back with more questions!

What is excluded from basic policies would be elective procedures or say expensive medicines when there is something much cheaper they consider as a standard treatment. But with medications this is also the case with public options. A doctor might suggest a more effective medicine but the system will only pay up to the amount they would for the cheaper standard treatment. One can still get the more expensive one if they want but there will be higher copay.

But medications are often much cheaper in Germany than in America even if one paid it totally out of pocket. And it’s not like they can say they pay no medication for common ailments like controlling high blood pressure because it is an “existing condition”.

Where most people find standard private or the public options to fall short is for dental treatments. With public insurance I get 2 checkups with basic cleaning a year; cavities can be filled with amalgam and a basic repair if a tooth breaks. But intensive cleaning, implants and other things will be paid out of pocket. If a crown is necessary, they will pay part of the cost for the simplest metal one, ceramic or gold will cost much more. Thus a lot of people get supplemental insurance that covers a lot of the dental work. Or one hears of people needing a mouthful of implants going to Poland or the Czech Republic where they can find well trained dentist for much cheaper.

To add to Tom's information about dental treatment:
There are huge price differences for these "elective" treatments (and thus the co-pay) between dentists. You don't need to go to Poland or Czechia! There are webistes like https://www.2te-zahnarztmeinung.de to find cheaper dentists.

beppi wrote:

To add to Tom's information about dental treatment:
There are huge price differences for these "elective" treatments (and thus the co-pay) between dentists. You don't need to go to Poland or Czechia! There are webistes like https://www.2te-zahnarztmeinung.de to find cheaper dentists.

I think it pays to shop around in such a situation but I've known people that had good results in Poland and Czech Republic - although I would not suggest going to countries like Romania or Bulgaria although they might be even cheaper. And even in Germany one has to watch out. I’ve heard that some will do implants for much cheaper but then use substandard materials from China that lead to problems. Such medical devices are not always as reliable as one might think. The testing and certification of some things is not what it should be.

Hi guys,

so this is an old thread, I know, but I have a similar question: my mom is 70, retired (pension from back home in the US), and would want to move with me to Germany now that I got a job there (yay!). She has a permanent EU residency in Austria, so she'd be entitled to move - as long as she has health insurance.

From what I gathered online, there's no option for her to pay into the public insurance, hence she'd need a PKV. The thing is - how the hell do I figure out whether a PKV covered the stuff that is necessary for her residency title?

Also, what's the rough cost to expect - I mean she's 70 and not the fittest (needs heart meds and is breast cancer survivor, so needs those meds as well), so I'm expecting a a couple hundred Euros (that's what it costs here in Austria). Same for Germany?

Alternatively, anyone know how stuff is handled when you have a dual citizenship? B/c we're also Bosnian citizens, and Bosnia and Germany have a health insurance agreement, where they cover each other's citizens and then charge each other.

Last but not least, I'm expecting I'll need a lawyer to manage all of this. Anyone have any recommendations for one in the Stuttgart area?

TIA!

Unless she is in a public health insurance in her current (or original) country, you are right: She will not be admitted into the public scheme any more.
Private health insurance (from an accredited German provider) is suitable for all visa and residency purposes, so no worries here.
The cost depends largely on the risk she presents to the insurer - and at old age plus pre-existing conditions (which can also be excluded from coverage, if the insurer wants), this will not be cheap. I don't think "a couple hundred Euros" will be sufficient, but you better get quotes from some insurers.
Double citizenship does not give any advantages if both are non-EU.

So I've been reading a lot more on the thing before posting the question and a few things come up:

She is paying into the Austrian public insurance system. It would be akin to the German 'freiwillige Einzahlung' from what I can determine, even tho here they call it 'private Einzahlung' (but there are actual private insurers here - we had to have one the first six months b/c the public one's coverage doesn't vest until you've been here 6 months). But once she moves outside of Austria, she isn't eligible to do that anymore.

As for the US, she used to get Medicare since she retired before we left, but since that was not accepted here, we just decided to disenroll her - it wasn't worth it since we don't plan on moving back to the US.

Oh and fun part - we used to live in Germany from 1992-1999. Back then she was insured through the AOK, so a public insurance.

I honestly think I need a good immigration lawyer b/c the whole situation is so damn particular. But I wanna know what people's experience is before I go and hire someone:  I have no trouble paying 500 Euros for someone to just handle it, as long as it can be handled. If she has no option but a PKV, then so be it.

P.S. If anyone has any recommendations for immigration lawyers in or around Stuttgart, I'd be so happy to get them.

I don't know any immigration lawyer, but you can find all lawyers registered in Germany on this website of their trade organisation:
https://www.bea-brak.de/bravsearch/search.brak
I doubt that any of them takes care of your health insurance matters (that is not a lawyer's job - and there isn't much to be earned). I also think you underestimate lawyer's costs in Germany: just €500 will not get you very far!

Like Beppi mentioned, I doubt this is a case for a lawyer although possibly complex. I would say one has to approach the AOK again and ask there as a start. But I have to mention that having permanent residency does NOT necessarily mean she can move to Germany, so you better double check on that. An Austrian citizen can move to Germany if they can support themselves, not necessarily one with residency. And a family reunion visa is only for spouses and minor children, not parents. Not saying you are wrong about your situation - but get it confirmed!

@Tom & Beppi: Thanks to you two for the input.

@Tom: She has a EU long-term permanent residency card. So as long as she meets the general requirements from § 5 AufenthG, I think it is (financial self-sufficiency, place to live, health insurance, etc.), she is entitled to a residency card in Germany. EU law mandates that they give her a permit, and it has been transposed into German law under  § 38 AufenthG:

"(1) Einem Ausländer, der in einem anderen Mitgliedstaat der Europäischen Union die Rechtsstellung eines langfristig Aufenthaltsberechtigten innehat, wird eine Aufenthaltserlaubnis erteilt, wenn er sich länger als 90 Tage im Bundesgebiet aufhalten will. § 8 Abs. 2 ist nicht anzuwenden."

I have yet to verify for how long the permits in Germany are issued, but that's really the only question. (I am a lawyer myself and spent the last six years writing a dissertation on the national and European provisions related to aliens and asylum law in Germany, Austria, and Sweden, so I'm pretty confident on her right to resettle. I'm certainly willing to take the any issue to the CJEU if I must...tho I hope I never have to.)

The issue is, as I said, how much she has to pay for health insurance.

OK, like I mentioned, contacting the AOK would be wise. I think she could not normally  join at her age BUT since she was insured through them before and then left Germany rather than switched to a private insurance while here, then you might actually have a good chance. If they accept her then all is good. If not, then you can simply inquire from private providers. I think rejection by the AOK and a too high of quote from private providers is the first step before even considering a lawyer.