Statutory health insurance – elective tariffs – with deductibles
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The statutory health insurance funds also have the option of offering their insureds optional tariffs with a deductible.
Example:
The insured person assumes the risk of paying up to EUR 500 of his treatment costs per year as a deductible. In return, he receives a premium of EUR 350 from his health insurance company in the following year.
If the insured person remains healthy throughout the year, he or she receives a premium of EUR 350. If treatment costs are incurred, they are offset against the premium and only any remaining balance is paid out. If the treatment costs are higher than the possible premium of EUR 350, the insured person must reimburse the health insurance company for the excess (in this case a maximum of EUR 150).
In the opinion of the Federal Fiscal Court, such premiums represent premium refunds that reduce health insurance contributions and thus reduce the special expenses deduction.
These bonuses are thus to be treated differently from bonus benefits that statutory health insurance funds grant their members to promote health-conscious behavior.
(For further comments and information, please see our Information Letter 12/2018).
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