Die private und die gesetzliche Krankenversicherungen unterscheiden sich grundlegend in den verschiedenen Systemen, die ihnen zugrunde liegen. Zunächst handelt es sich bei der PKV um ein privatrechtliches Versicherungsunternehmen, das in Konkurrenz zu anderen Anbietern am Markt steht.
So ist die PKV einerseits darauf angewiesen, Kunden durch interessante Angebote, günstige Tarife und umfangreiche Angebote zu gewinnen, kann andererseits jedoch Anträge ablehnen, wenn die Voraussetzungen für die private Krankenvollversicherung nicht erfüllt sind oder die Aufnahme des Antragsstellers ein zu hohes Risiko bedeuten würde. Die GKV hingegen hat überwiegend Mitglieder, die pflichtversichert sind und muss prinzipiell jeden aufnehmen.
Kostenerstattungsprinzip – PKV:
Die PKV agiert nach dem Kostenerstattungsprinzip, was bedeutet, dass der Versicherte Vertragspartner des Arztes oder Therapeuten ist und die Abrechnung zwischen Versicherungsnehmer und Versicherungsgesellschaft erfolgt. Der Versicherte schießt einen Behandlungsvertrag mit seinem Arzt und stimmt mit diesem die erforderliche und gewünschte Behandlung ab. Der Arzt erstellt eine Rechnung, die der Versicherte bei seiner Versicherung einreicht. Nach Prüfung der Rechnung erstattet die Versicherung, je nach Tarif, den gesamten oder den erstattungsfähigen Anteil der Rechnung an den Versicherten.
Kostenerstattungsprinzip – GKV:
Die GKV rechnet nach dem Sachleistungsprinzip ab. Das bedeutet, dass sie mit demjenigen abrechnet, der die Leistung erbracht hat, wobei die möglichen Leistungen vorgegeben sind. Ein weiterer Unterschied ergibt sich in der Berechnung der Beiträge. Die private Krankenversicherung bedient sich des Äquivalenzprinzips, kalkuliert die Beiträge also risikogerecht. Faktoren, die über die Beitragshöhe entscheiden, sind der gewünschte Leistungsumfang, das Geschlecht, Alter und Gesundheitszustand des Versicherungsnehmers bei Vertragsabschluss und das sich daraus ergebende Risiko für die Versicherung.
Beitragsberechnungen:
Die Beitragsberechnung bei der gesetzlichen Krankenversicherung erfolgt anhand des Einkommens, die Höhe ergibt sich aus dem jeweiligen Beitragssatz der Krankenkasse. Der Beitrag zur PKV beinhaltet neben dem Anteil, der das Risiko und die Kosten gegenwärtiger Erkrankungen abdeckt, einen Sparanteil. Mithilfe dieses Sparanteils werden sogenannte Alterungsrückstellungen gebildet, die höhere Kosten im Alter ausgleichen. Die GKV basiert auf dem Umlageverfahren. Das bedeutet, dass diejenigen, die jünger sind oder höhere Beiträge zahlen, damit die Kosten mittragen, die ältere, kostenfrei Versicherte oder Versicherte mit geringem Einkommen verursachen.
Kostenerstattung bei der PKV – Pro:
- Mit einem Teil der Beiträge werden Rücklagen die Steigerungen der Beiträge abfangen sollen
- Wer wenig krank ist kann je nach Tarif auch Beiträge zurückerstattet bekommen
Kostenerstattung bei der PKV – Contra:
- Rechnungen werden vom Versicherungsnehmer bezahlt und nach Prüfung rückerstattet
- Mit steigendem Altern steigen auch die montalichen Beiträge bei der Krankenvesicherung
- Es lohnt sich oft nicht mit höherem Alter in eine private Krankenkasse zu wechseln
Fazit:
Bei den privaten Krankenkassen (PKV) erhält man zwar oft die besseren Leistungen. Dafür müssen Rechnungen vorab vom Versicherugnsnehmer bezahlt werden. Die Kosten werden dann im Nachinein erstattet.
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