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Parental allowance and health insurance

09.05.2017

An important topic for the receipt of parental allowance is the health insurance status during parental leave or the receipt of parental allowance. This article shall briefly and concisely present the most important case studies and provide a few tips:

Basically, parents who receive parental allowance are insured free of charge under the statutory health insurance scheme. However, this only applies if they were previously compulsorily insured (and are on parental leave while receiving parental allowance).

The situation is different for those with voluntary and private health insurance: The last person to experience this was a single mother who - as a good earner - was voluntarily health insured before receiving parental benefit. On 30.11.2016, the Federal Social Court (BSG) ruled that: The person concerned must also pay voluntary contributions to their health insurance scheme during the period in which they receive parental benefit (Az. B 12 KR 6/15 R).
Before giving birth, the mother involved had an income above the annual income threshold and decided to voluntarily take out health insurance at the statutory maximum contribution. During parental leave she had to continue to obtain voluntary health insurance on the basis of the minimum assessment basis. The Federal Social Court considered this to be legal - but only just as the schedule report states. The Court found that the legislature had respected the extreme limits of its freedom to organise itself. The discrimination against compulsorily insured health policy holders - in other words against employees with lower incomes - is obvious.

§ 192 SGB V, which bears the heading "Continuation of membership of compulsory insurance providers", regulates that the membership of compulsory insurance providers is maintained. As long as there is a claim to sickness benefit or maternity benefit, or one of these benefits is received in accordance with statutory provisions such as parental benefit or parental allowance, or parental leave is taken, or care support allowance is received.

Tip for affected people:

For high earners who are in a similar situation to the claimant, it may be worthwhile to reduce their wage already during the so-called assessment period - to an amount below the annual wage limit.. It may be sufficient to conclude an agreement with the employer on deferred compensation in favour of an occupational pension scheme in order to achieve this. It may also be worthwhile to allocate part of the earned income to a long-term company account. The only important thing is that compulsory insurance in the statutory health insurance arises again. This will then also be retained during the period when the parental allowance is paid.

Finally, it should be noted in the judgment that this procedure is only consistent, since again no flat-rate deduction for health and long-term care insurance is made from the gross parental allowance when determining the fictitious net parental allowance. Since however most parents affected are in the maximum amount of the parental allowance even with a lump sum deduction (1.800,- EUR basic parental allowance) this fact does not really console.

Better situation for married people

For parents with voluntary health insurance who are married and have a legally compulsorily insured spouse, the problem outlined above does not arise by its way. The persons affected are family insured in the period of the parental allowance  free of charge over their spouse.  Ergo: Marriage can be worthwhile for financial reasons here as well.

Too complicated? - Our tip

The parental allowance rules can be complicated. Make it easy and, like many other parents, use our services to get the most out of your parental allowance. We offer you many possibilities to make your application for parental leave as easy and uncomplicated as possible:

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