Those who can no longer pay their high premiums should find out in good time. Because there are more loopholes back into the statutory coffers than you think.

Year after year, it becomes more expensive for those with private health insurance: sometimes they have to cope with a hefty ten or even 15 percent premium increase. Sometimes they get away with a lower surcharge, like in early 2022.

But the bitter truth is that anyone who opted for private insurance at a young age must now “expect the premiums to double every ten to 12 years,” emphasizes Daniela Hubloher from the Hesse consumer advice center.

It is only after marriage and starting a family that many people realize that the status as a private patient, which was favorable at first, is expensive in the long run – and is a bond for life. It’s not possible to quickly get back on the legal track when things get expensive with children or in old age. “Nevertheless, there are more ways to check out than you might think,” says Bastian Landorff, health expert at the Bavarian consumer center. An overview of the most important exit opportunities.

If well-earning employees want to get rid of private insurance and slip into a statutory fund, there is the following door opener for them: They must consistently reduce their income before their 55th birthday. The decisive factor is that the income falls below the annual income limit (JAEG). It is currently 64,350 euros gross per year or the equivalent of 5362.50 euros per month. In 2023, the amounts will increase to 66,600 euros, i.e. 5550 euros per month. This also includes regular special payments such as bonuses, Christmas or holiday bonuses.

If an employee’s income slips just one euro below this limit, they are no longer allowed to remain in the private sector and are immediately subject to statutory health insurance (GKV), as Landorff explains. The children can also return to the non-contributory family insurance. The salary reduction does not even have to be maintained for a very long time. From a purely legal point of view, one day could be enough to terminate the private contract with the insurer, as Kaja Keller, labor law expert at Gansel Rechtsanwälte in Berlin, explains.

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But many cash registers then cause trouble. “A reduction in earnings of more than three months should be enough to get back into the cash register,” says Landorff. Anyone who was already privately insured on December 31, 2002 must even reduce their salary to below the special gross salary limit of EUR 58,050 per year. In 2023, the value will rise to 59,850 euros. A salary waiver must always be well calculated. Not everyone can afford that. The closer your income is to JAEG, the more it can be worthwhile. Those who are willing to change may continue to remain in the statutory system even if their salary later turns out to be lavish again. You can then insure yourself voluntarily.

Since 2019, the so-called bridge part-time work, i.e. a temporary reduction in working hours, has been a real option to get under the JAEG – and thus out of the private health insurance and into a health insurance company. However, this does not work for every employee. Only those who have been working for more than six months in a company with more than 45 employees have a legal right to a guaranteed return to full workload and old salary.

Anyone who is one of the 14 million people who work in smaller companies is dependent on the goodwill of their boss when it comes to part-time work. Another option: Arrange a working time account with the company. For example, 25 percent of the salary flows into this, while the employee continues to work full-time, but is only paid 75 percent. Even this reduction in earnings is often enough to make you immediately subject to compulsory insurance.

The accumulated credit can then be used for paid time off, up to a full year of sabbatical. A third option for those who earn just above the JAEG hurdle: Invest part of the gross salary directly in a company pension scheme by deferred compensation. This can also significantly depress the annual gross and trigger compulsory insurance in the GKV.

Another way back into the cash register can be through non-contributory family insurance. This solution is independent of age, so it can also be interesting for those over 55. A privately insured person must be married to a partner with statutory health insurance or live in a registered civil partnership. What matters most is income.

Those who are willing to change may bring little or no money home. Since June 2022, the following has applied: more than 570 euros per month are not permitted with co-insurance, with a mini-job a maximum of 520 euros (since October 2022). All income counts, including rental and interest income. “This can help couples where one wants to retire prematurely,” explains Landorff. Even a pensioner who temporarily lowers his income through the flexible pension can also be insured.

A rather exotic route for older people leads via other European countries. In countries like France, Austria or Denmark there is compulsory health insurance, which is equivalent to the German health insurance system. If someone moves to the Netherlands to work, for example, they have to take out health insurance there, whether employed or self-employed, young or old, high or low earners, as Stiftung Warentest emphasizes.

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The contract with the private health insurance company must be canceled beforehand. If the employee comes back, he can go into a German cash register. Voluntary work in the Federal Volunteer Service can also pave the way for a return. Anyone who registers for a voluntary social or ecological year becomes subject to compulsory insurance. A bitter way out of the private system is unemployment. Anyone who loses their job and receives unemployment benefit I automatically ends up in health insurance.

It is particularly difficult for the self-employed and freelancers to get rid of expensive private insurance before their 55th birthday, says Hubloher. As long as they work full-time independently, they cannot return to the cash register. One option is to give up the company and look for a permanent position for less than EUR 64,350 gross per year. “In practice, this is usually not feasible,” Landorff dismisses. In 2023, the rate will rise to 66,600 euros.

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Another option: Become subject to insurance via a part-time job and practice self-employment as a part-time job. “That often causes trouble, especially if there are still employees,” says the expert. Next option: Temporarily run the company on a low flame so that the profit is demonstrably less than 520 euros per month. “Thorough advice is necessary,” recommends Landorff.

Hubloher advises that anyone who wants to save and return to the cash register shouldn’t put things off for too long, advises: “Up until the early 40s, a switch still makes sense, but as you get older it often no longer pays off.” have, Keller also urges early planning. Whether it is worth leaving the private sector depends not only on the contribution savings, but also on the point in time.

Because only those who were at least 90 percent member of a health insurance company or co-insured in the second half of their working life can get into the cheap health insurance of pensioners in old age. If the change comes late in life, insured persons must voluntarily take out statutory or private health insurance again in old age. And that can get expensive. Anyone looking for a way out of private health insurance can get inexpensive advice from the consumer advice centres. Specialist lawyers for social law, pension advisors and the health insurance companies themselves also offer support.