Should America stop offering unemployment benefits

Statutory health insurance for the unemployed

Anyone who pays into the statutory unemployment insurance is entitled to unemployment benefit I after a certain period of time. The state supports people without such a claim with unemployment benefit II or basic state security if necessary. We explain what each of these means for statutory health insurance.

  1. Receipt of unemployment benefit I
  2. Receipt of unemployment benefit II
  3. Receipt of basic security in old age and in the event of reduced earning capacity
  4. Private health insurance for the unemployed

Receipt of unemployment benefit I

Anyone who becomes unemployed and is entitled to unemployment benefit (ALG I) is required to be insured by law. The only exception to this rule is the unemployed who are 55 years of age or older.

For all others there is a compulsory insurance in the statutory health insurance (GKV). The Federal Employment Agency pays the contributions to the statutory health insurance. In principle, the unemployed person remains insured with the health insurance fund with which he was already insured before he became unemployed.

Recipients of unemployment benefit I do not have to pay the additional health insurance contribution themselves. The Federal Employment Agency pays the respective additional contribution to the fund.

If the recipient of unemployment benefit I has partners or children who are family insured through their health insurance, nothing changes in this free family insurance.

Insurance during blocked periods

The employment agency can impose a blocking period of up to twelve weeks - for example, if you quit your job yourself. During this time you will not receive any unemployment benefit I. Statutory health insurance initially continues for one month. From the second month onwards, the Federal Agency pays the health insurance contributions.

Receipt of unemployment benefit II

For recipients of unemployment benefit II (Hartz IV), the job center pays the costs of the health insurance, provided that they are legally required to have insurance. The job center also pays the additional contribution.

However, the job center does not pay the specific additional contribution of the fund with which the ALG II recipient is insured. Rather, it pays a flat rate that takes into account the average additional contribution of all health insurance companies.

The job center transfers the fixed lump sum for the insured directly to the health fund.

If the head of the household has a partner or children, the GKV family insurance has only been valid for children up to the age of 14 since 2016. All others from the benefit community become independent members of a health insurance company of their choice. However, the job center also pays the contributions for them.

Receipt of basic security in old age and in the event of reduced earning capacity

Anyone who has reached the statutory retirement age and is in need of help or is no longer able to work in the long term due to reduced earning capacity is entitled to basic state security under certain conditions. This benefit is intended to guarantee the welfare recipient an adequate livelihood.

The basic security is a benefit of social assistance. The legal regulations can be found in the Social Security Code (Sections 41 to 46b SGB XII).

Full disability

A full reduction in earning capacity is when one can pursue any gainful activity for less than three hours a day. Your own professional qualifications do not count here.

If the recipient of the basic insurance is subject to insurance, the contributions to statutory health and long-term care insurance are deducted from the creditable income. As a result, the need for the needy increases.

If the person in need pays the contributions to their health insurance themselves, they are taken into account as needs. This is often the case with people who have private health insurance (PKV) or who are voluntarily insured by the state.

In the case of statutory health insurance, the additional contribution from the respective health insurance fund is also taken into account in order to determine the level of basic security.

Contributions from privately insured persons

In the case of people in need with a private health insurance, the contributions are only paid in an appropriate amount. Contributions to a basic tariff or standard tariff are considered appropriate. These PKV social tariffs offer protection that is comparable to statutory health insurance.

Legal entitlement to the basic tariff

Health insurance is compulsory in Germany. Anyone who, as a recipient of basic security, does not have health insurance, but is also unable to take out statutory insurance, has a legal right to a basic PKV tariff. This applies, for example, to those in need who have lost their private insurance due to premium debts.

Better performance with a change of fund

If you are unemployed or receive basic security, you will not save anything by changing your health insurance company. The additional contribution is taken over or taken into account by the social welfare office in the amount of the need.

A change can still be worthwhile if the new health insurance company offers better additional services for the insured - such as an attractive bonus program or reimbursements for special preventive examinations.

Private health insurance for the unemployed

If privately insured people receive ALG I, they must take out statutory insurance for as long as they are younger than 55 years. However, you can be exempted from compulsory insurance if you have had private health insurance throughout the past five years. Such an application should be made within two weeks of the start of unemployment.

The Federal Employment Agency then pays a subsidy for private health insurance. This grant is as high as compulsory membership in statutory health and long-term care insurance would cost.

Alternatively, you can switch to statutory health insurance and at the same time take out private health insurance. This secures the current conditions of your contract. If you want to go back to private health insurance later, you can re-enter your tariff - without having to go through a new health check and lose your accumulated aging reserves.

No change from 55 years

Anyone who is 55 years of age or older is no longer required to take out insurance even if they receive ALG I. In any case, he remains privately insured.

Privately insured persons who receive ALG II (Hartz IV) keep their private health insurance. The ALG-II recipient can switch to the basic tariff with his insurance, the benefits of which correspond approximately to the level of the statutory health insurance. The contribution in the basic tariff is halved for the period of ALG-II receipt and completely covered by the job center.

If you do not want to change your tariff, the job center pays a maximum of half of the contribution in the basic tariff as a subsidy. If the actual private health insurance contribution is higher, the insured person would have to pay the difference himself.