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Health Insurance

Last activity 27 September 2020 by beppi

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JonnyVo

So a nice fun topic. I'd like to ask all expats recieving SSC and SSDI from the states if they are paying out of pocket for health insurance. My wife works and before she changed to a different company our health insurance was combined so it came automatically out of her work check. I'm not recieving any income such as SSDI or SSC....however I am a disabled VET. Since the switch over to a different company they've been billing me a based on their projection of how much a disabled vet gets from the states. It's absouletely destroying us finacially and we are out of other options. All the local employers are only pushing for black workers and we all know thats not legal so Options People??? Whats your go to solution for this? Legal companies you would recommend to contest this? I have several Vet buddies not paying out of their disability so I'm a bit stumped as to why we are getting shafted.

beppi

I have no idea what SSC, SSDI or VET (Veterinarian or WWII Veteran?) are, but they are probably not German terms and thus do not matter for your status and obligations here.
In Germany, everyone (with VERY few exceptions, who can prove they have an equivalent foreign insurance) must be health insured in a German institution.
For those with no or very low own income (world income is counted here and the threshold is €450/month as far as I know) and a spouse who is member of the public scheme, there is the option to be covered free of charge under the spouse's insurance. This is independent of employer, so would not change if your wife changes job (unless she also changed to a prvate insurer, coincidentally at the same time as changing job).
All others must be insured on their own merit and cover the premiums from their own pocket. If you join the public scheme in such a situation, they charge a percentage of your income, subject to a minimum (approx. €170/month) and a maximum (approx. €750/month). If you cannot or do not prove your actual world income, they often use an assumed income, which seems to be your case if I understand your post correctly. The rules for this are very complex and you'd need an expert to contest such an evaluation. Not a lawyer: They cannot earn from such disputes and thus aren't interested! Better contact the "Versicherungsombudsmann", a kind of oversight agency for insurance matters (offering a free service). But do not expect this to be solved easily, quickly or at all in your favour!

beppi

If you become destitute due to high (compulsory) health insurance premiums, you may qualify for governmental assistance (ALGII or HartzIV) - provided your visa type allows it (dependents of German spouses generally qualify, those of foreign spouses not - a measure to prevent "subsidy tourism").

TominStuttgart

This post is very confusing and much of it doesn’t make sense to me. Number one, health insurance is not through  company group insurance like in the States. NOT how it works here. The rule is that an employer has to pay half of the cost of an employee’s health care. But say one change companies, the health care stays the same!

If your wife has a public option and you are not getting an income then you are automatically covered for free. Nobody makes an estimate of what other people in the US might get as benefits. Only actually income/benefits are considered.  And this is to be clarified with the insurance provider NOT your wife’s employer. It has nothing to do with them. If your wife has a private option then you will not be covered. But you would probably be eligible for a public option on your own depending on your age. Again, this must be clarified with the insurance providers not the employer.

And no, German companies do hire people black and deny them the employer contribution towards healthcare. This would be impossibly risky and since income gets reported to the tax authorities they would certainly get caught and fined. Sounds like you are making some very unlikely assumptions based on a misunderstanding of how things work. But say your wife is one of the 10% in Germany that was allowed and chose a private insurance option; then it is possible she might have worked for a company that additionally paid for a policy for you. This is possible although I don’t know how likely but not a requirement. If this was the case and she has changed to a company that doesn’t give this benefit, then it was her mistake not to calculate this factor when accepting the job. 

But if you are covered by a private option then it is based on age and a few other factors and not on income or supposed benefits. A public option would look at income, not free if you make over a certain amount. But like mentioned already, they would never look at what others in the States might be getting; only at actual income/benefits being received - unless there is pretty strong evidence that you somehow must be getting benefits from the States and deliberately refusing to report it.

beppi

Tom explained it very well above - thanks!

TominStuttgart wrote:

And no, German companies do hire people black and deny them the employer contribution towards healthcare. This would be impossibly risky and since income gets reported to the tax authorities they would certainly get caught and fined.


I assume you mean "German companies do NOT hire ...".
Sorry, but I interpreted the OP's mention of "black" as a statement about discrimination of couloured people (which does certainly happen here, too, but seldom, simply because there are very few Blacks in Germany).
If he meant "Schwarzarbeit" (literally "black labour", but I didn't know the colour is also used for "illicit" in English): It does exist in Germany for occasional engagements by private employers like once a week home cleaning or small household repairs, but never for long-term jobs.

JonnyVo

Very informative. OK so you're correct, they're always attempting to get me as a SchwarzArbeiter. As far as insurance goes I do have private that I pay monthly for back stateside. I asked them and this does extend worldwide. Typical scenario in the doctors office so out of pocket and getting reimbursed, easy. As far as my wife, she works at a grocery store with an endless Contract. When I first moved here I was added to her insurance, however she got convinced to go to a different company by a friend of hers resulting in them looking at me as independent. As a result they estimated based off of the extra money she puts in her bank monthly from me and boom there's an estimate. What I'm trying to figure out is why I'm paying for insurance that I've already got. I have a network of providers that cater specifically to my demographic  ie veteran. As a result they accept my coverage which is full. I'm asking why am I dumping out a few hundred extra euro for something I don't use...? The only extra insurance I've bought here has been dental and visual. Other than that meh. Lol. Thanks for the input guys!!

TominStuttgart

beppi wrote:

Tom explained it very well above - thanks!

TominStuttgart wrote:

And no, German companies do hire people black and deny them the employer contribution towards healthcare. This would be impossibly risky and since income gets reported to the tax authorities they would certainly get caught and fined.


I assume you mean "German companies do NOT hire ...".
Sorry, but I interpreted the OP's mention of "black" as a statement about discrimination of couloured people (which does certainly happen here, too, but seldom, simply because there are very few Blacks in Germany).
If he meant "Schwarzarbeit" (literally "black labour", but I didn't know the colour is also used for "illicit" in English): It does exist in Germany for occasional engagements by private employers like once a week home cleaning or small household repairs, but never for long-term jobs.


Yes; i made a typo; I meant do NOT hire black. And yes, this expression in American Englsih refers to working either illegally or off the books.

TominStuttgart

JonnyVo wrote:

Very informative. OK so you're correct, they're always attempting to get me as a SchwarzArbeiter. As far as insurance goes I do have private that I pay monthly for back stateside. I asked them and this does extend worldwide. Typical scenario in the doctors office so out of pocket and getting reimbursed, easy. As far as my wife, she works at a grocery store with an endless Contract. When I first moved here I was added to her insurance, however she got convinced to go to a different company by a friend of hers resulting in them looking at me as independent. As a result they estimated based off of the extra money she puts in her bank monthly from me and boom there's an estimate. What I'm trying to figure out is why I'm paying for insurance that I've already got. I have a network of providers that cater specifically to my demographic  ie veteran. As a result they accept my coverage which is full. I'm asking why am I dumping out a few hundred extra euro for something I don't use...? The only extra insurance I've bought here has been dental and visual. Other than that meh. Lol. Thanks for the input guys!!


I still don't understand if your wife has  private or public insurance? Were you added under the provision of family insurance for a public option, which is free if you don't work or get financial benefits. Or is she privately insured and the previous company was paying for a separate policy for you in addition as a voluntary benefit.  Because, a partner cannot be "added on to" a private policy, not how it works. 
If you have coverage from the States that actually works and meets German standards, (something which is rather rare) then it certainly doesn't make sense you would pay twice.

beppi

There are almost no foreign insurers (outside of the EU) that meet German requirements - the sticking point is usually unlimited coverage without upper limit per disease or timeframe.
So, in the eyes of the German system, you have no (appropriate) health insurance and thus need to get (and pay for) a German one.
You should cancel the foreign insurance, as you cannot get out of the German one - and paying double makes no sense!

I still don’t ynderstand how you dropped out of the (free) dependent’s coverage with your wife. Changing job makes NO difference to that, only (foolishly, in your case) changing insurance system (from public to private) would.
Which insurer is she (and you) with?

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