Health costs are exploding: PKV relies on individual solutions!

Health costs are exploding: PKV relies on individual solutions!

In view of rising health costs, private health insurance (PKV) is under pressure. Klaus G. Leyh, Chairman of the Insurance Chamber, emphasizes the need for a long-term strategy to overcome this challenge. A central concern is the performance guarantee, which ensures that contractually agreed services cannot be reduced. In addition, contributions should be adjusted accordingly in the event of increases in expenditure caused by medical progress. This is supported by cost-conscious tariff design and by promoting efficient performance management, for example through cooperation in the area of ​​medical aids. Urgent investments in preventive health measures are also on the agenda to advance early detection of diseases.

Another aspect that Leyh highlights is the increase in the number of people insured in company health insurance (bKV). This has grown by over 50% since 2020: in 2024, over 2.5 million employees in 56,500 companies in Germany will benefit from an employer-financed bKV offer. The increase in the number of insured people was 20% last year, while premium income has remained stable for eleven years - without price wars.

Company health insurance in focus

The bKV also offers the option of upgrading tariffs and also insuring family members. This form of insurance uses the funded method to counteract demographically-related cost increases in health and nursing care insurance. PKV policyholders have currently saved over 340 billion euros in retirement provisions, which underpins the stability and future security of PKV.

One of the decisive advantages of those with private health insurance compared to those with statutory health insurance is full private patient care, the freedom to choose a doctor and the guarantee of individual adjustments to insurance coverage. While benefit cuts and higher contributions to control costs often occur in statutory health insurance (GKV), such measures are not permitted in private health insurance. The development of retirement provisions serves to compensate for the aging factor and to guarantee long-term stability of contributions.

Demographic challenges

The demographic development in Germany is showing a dramatic change: fewer and fewer younger people are compared to a growing number of older people. Older people cause significantly higher health costs, which the private health insurance company has to take into account in its pricing and contribution policy. For example, a 40-year-old is less likely to get sick than a 60 or 80-year-old, which leads to different insurance costs. In order to meet these challenges, the PKV creates old-age provisions so that younger insured people pay more in their contributions but can benefit from credits to reduce contributions when they get older. [HC Consulting AG] reports on the increasing expenses that accompany the aging of the insured and on the trends that the GKV uses to control costs, such as benefit cuts and premium adjustments. The PKV, on the other hand, has taken a stable path to offer its insured persons comprehensive and reliable health care.

The discussion about health care and the requirements for private and statutory health insurance remains a central topic. Insurance companies must find innovative solutions that not only meet current needs, but are also sustainable in the long term. In a changing demographic environment, this is a challenge that must be overcome.