Saturday, October 20, 2012

Fall In The Private Health Insurance Contracts

Consumers should read the terms of PHI just before completion

A private health insurance does always what is stipulated in the insurance contract. Insurance premiums in the contract does not commit or limited in the amount of the refund, in case of sickness insurance must pay the difference in cost themselves. Limited is a limit to top it!

For this reason, officers and officials pay close contender before a health insurance on the contract terms. Only a health expert can help out contract traps.

A few examples and excerpts are given from insurance operations, in case of illness of the insured can be very expensive when signing a false insurance tariff.

Excerpt from insurance conditions of some insurance companies:
  • Recoverable amount is the
  • Insured percent tariff level and go
  • Supporting apparatus including
  • Cradles, night splints,
  • Body prostheses, wheelchairs
  • (620,-EUR invoice amount is
  • 100%), orthopedic shoe inserts,
  • Additional costs for orthopedic shoes,
  • orthopedic body braces,
  • Trusses, compression stockings,
  • artificial eyes, hearing aids,
  • electronic larynx

→ caution when providing benefits only a maximum of 620 euros will be paid for as a wheelchair!

Ill for instance of multiple sclerosis and need an electrically powered wheelchairs, costing in excess of € 10,000 are quickly reached. This provider does but only to a maximum of 620 euros. That means you have to pay the rest yourself.

Sample speech therapy and occupational therapy
Not insured: No speech therapy by speech therapists, occupational therapy not by occupational therapists

Need an example speech therapy after a stroke that is not insured, because you will not be listed in the contract conditions. Again, you remain on the cost of treatment even sit.

Example insurance conditions psychotherapy
Reimbursement inpatient psychotherapy for 30 days

Often hospitalization for 40 days in special cases to take up to six months. If you due to a mental illness, more than 30 days of hospitalization, you must bear the cost themselves.

How the consumer can see from the examples above, a detailed consultation is important so that it in case of illness also have the protection of Him secures comprehensive.

Switch To Private Health Insurance

What will change for the insured as a private insured?

Those who plan to switch to a private health insurance (PHI), has to be aware of some things before that will change with respect to its health insurance. This Decision should therefore not be made hastily and thoughtlessly.

Preferential treatment in surgeries

For some, the main reason for the change in the PHI. It is no secret that physicians in private patients deserve better, and so is not this preferential treatment as a surprise.

Subsequent reimbursement

After the change of the statutory health insurance to private health insurance you have to adjust accordingly the cost of outpatient treatment must initially pay themselves. This will of course be refunded later, after you have submitted the bills to the insurance company.

No family insurance

Who changes to private health insurance as a parent must also thought to make the child, because children are not exempt mitsichert. The child must not only be privately insured, if the partner is still legally insured in and you yourself as a "breadwinner" earned less than the annual income limit. This currently amounts to 50,850 euros per year (as of 2012).

Lower contributions

Who changes as a young, healthy person in private health insurance pays, reduced contributions. The reason is that the data on the age, occupation and medical history will be taken. The danger at the age now to pay huge sums to be largely unfounded, because the insurer to aging reserves forms.

Broader benefits

As a member of PHI enjoy more comprehensive services, such as psychotherapy or dental procedures. Of course, such things are changing at PHI previously agreed in the insurance contract.


Anyone within a year his insurance does not cost money, that is not submitting invoices and prescriptions, receives a portion of its contributions refunded. Chance also offer health insurance to this already, so that a change to private health insurance is not because of mandatory.


For compulsory health insurance is nothing new, you pay a deductible when a part of his treatment costs covered itself in contrast with SHI for the posts lower.

Change within the private health insurance

For choosing the right provider you should take your time, because who would later move to another private health insurance, it may not be as easy as between insurers. Here you need to consider in the contract notice periods and held minimum contractual period.

Return to the GKV

Who once in the private health insurance can not easily return. The change from PKV to GKV is subject to many conditions and aims specifically to prevent exploiting the advantages of both systems and avoiding the disadvantages.

Stress - The Spice Of Life

Restriction of stress and timely reduction of the stress hormone levels are critical.

"Stress is the spice of life!" Said decades ago, Hans Selye, the" father of stress research ", while the man who coined the term" stress "as we now use" invented ". What he meant was clear: Stress is not always unhealthy, on the contrary. A degree is one of them into an interesting life. But as the case of a spice so: it is not accompanied with the big scoop, but carefully metered, so the food is not inedible.

The salty soup

But unfortunately this is on an increasing number of people the case. With an excess of stress, only part of the story. At least as important, is that all too many, the "spice", ie reduce the distributed stress hormones, do not or at least not sufficient, for example, with movement. An effective stress management must therefore both take in the view, a limitation of the stress hormone production as well as a prompt reduction the stress hormone levels.

The stress hormone production - a useful device

The vast majority of stress hormone production takes place in the adrenal gland. This facility is very useful because it gives us extraordinary danger in phases with an additional portion of energy supplies, we can also use in those situations very well. The problem now though is that we have learned to throw the stress hormone production even when no real danger to life, but perhaps "only" an argument with the boss or spouse., The final authority for this is our cerebral cortex, which is the place . which hosts all our thinking This includes especially our self-talk, so our assessment of the situation in which we are just the good news. also thinking can be trained, so we can learn to restructure our thoughts so that we for a such training in similar situations to experience significantly less stress than before.

Reduce stress

Health problems occur, especially if the stress hormone levels is permanently increased. So it's also about this timely deconstruct. The most effective way to do this is still movement. Ideal is moderate aerobic exercise such as Jogging, cycling or Nordic walking. In addition, relaxation techniques such as progressive muscle relaxation can help.

Conclusion: Do not fear stress

Of course, I fully realize that my conclusion far easier said or written than done. Nevertheless: If on the one hand creates, with the pressures of his everyday work around so that they a degree, respectively, and on the other hand ensures that his stress hormone levels is always degraded quickly again need not worry from stress-related health problems to have. This is perhaps even an effective training or other professional assistance is necessary, but we are by no means the mercy of stress. In meaningful dose level can therefore quite accept him as what it should be: "the spice of life".
With wide spectrum of symptoms can be applied to occupational therapy and support this positive. You will, for example, successfully used in pediatrics to treat developmental delays of children and adolescents in the motor and the cognitive level or cognitive problems. Also associated with neurological disorders such as stroke, multiple sclerosis and Parkinson's disease, occupational therapy is used to train skills and as much as possible to regain independence. The treatment can also be carried out in the home. About this advantageous option informs the practice of occupational therapy Elisabeth Brechtel from Cologne.

Therapy in a community setting

The focus of occupational therapy are exercises that help the patient to regain the ability to act, and thus the greatest possible autonomy and independence. This relates to the everyday life in the home as well as professional life. Occupational therapy sessions do not necessarily take place in practice. Especially for people who are physically very limited, it is possible also in the form of home visits.

A treatment in the home has the great advantage that the patient can be treated in their usual environment. Practical life problems are also very common in the home environment, so it may be advantageous to carry out occupational therapy as a home visit. The occupational therapist can get a picture of the home environment and provide ideas to transform this. The conversion to furniture or the use of tools can significantly contribute to the facilitation in the field of freedom of movement. Home visits can also take place in nursing homes and other facilities.
In old age or sickness you are usually no longer able to care for themselves completely independently. A lot of care would then remain in their home and learn a skilled nursing. A home care service combines both. Before this, however, can be approved for care must be determined. The medical service of the health checks for this on behalf of the public health care, whether the application is justified to demand for care. To the visit by the MDK (Medical Service of the Health Insurance Funds)  you can prepare yourself. The nursing service dolphin from Mannheim explained.

Care diary as a preparatory action
If a request for maintenance services at the public health care provided, commissioned this. The medical service of the Health Insurance (MDK) to check whether a dependency exists in the sense of long-term care law For evaluating the MDK expert comes home. To be well prepared for the visit, it is advisable to perform before a nursing journal in which all maintenance activities are recorded with a precise timetable. This gives the reviewer a more comprehensive overview of the areas where help is needed, as often is the case and how much time the nurse needed for this. In addition, all medical records should be available and findings of the patient. It is advantageous even if a caregiver who best know the necessary care about it, be present at the examination.