2023-06-16 15:24:22
Excellent healthcare is part of everyday life in Germany. The German health system is one of the best in the world and takes care of the physical and mental well-being of society with a wide range of services. One pillar of our healthcare system is compulsory insurance, which obliges all citizens to take out health insurance through a statutory or private provider. In addition, there are supplementary health offers such as private insurance cover via supplementary insurance or preventive measures for health education and prevention.
The so-called health issues are closely linked to comprehensive health care. They include a catalog of questions that analyze the general physical and mental state of health, record chronic diseases and take into account the individual lifestyle with regard to potential health risks. While statutory health insurance companies are obliged to accept people with significant health risks in the form of previous illnesses or unhealthy lifestyle habits, private insurers can attach their own conditions to the insurance cover offered. If you want to take out private health insurance, you not only have to overcome economic hurdles, you also have to meet the requirements of an insurer in terms of health issues.
Pre-existing conditions and personal lifestyle are not only important when potentially switching to private health insurance, but also, for example, for people who want to take out disability insurance. The application is usually linked to health questions that insurance companies want to use to determine the risk with which an occupational disability can occur. Not only the acceptance of the insurance application depends on the risk assessment, but also the amount of the contribution, which is based on different risk groups.
But which previous illnesses are relevant for a health check? How do they affect insurance coverage and how can individual lifestyles affect care within the German healthcare system?
Chronic pre-existing conditions in health issues
Chronic pre-existing conditions can affect insurance coverage because they can affect the medical care required and the risk of deteriorating health.
When analyzing chronic previous illnesses to determine the insurance risk, not only the type of illness is taken into account, but also the degree of severity at the time the insurance begins. Chronic diseases such as Asthma, migraine, allergies, obesity to a small extent and a predisposition to inflammation are usually not taken into account in mild cases. If potential policyholders are more severely affected, these chronic pre-existing conditions can have a negative impact on the application or the amount of the insurance.
Other chronic pre-existing conditions raise the hurdles for taking out insurance and are often associated with high insurance premiums.
These include diseases such as:
- Hypothyroidism (e.g. Hashimoto’s)
- Chronic high blood pressure (hypertension)
- neurodermatitis
- Lipedema and Lymphedema
- Vein weakness, varicose veins
- disc prolapse
- BWS-, HWS- or LWS-Syndrom
- Scoliosis and other congenital deformities
- Diabetes mellitus (type 1 and 2)
- Severe ametropia (usually from 8 dioptres)
- Tinnitus / sudden hearing loss
- Benign tumors
- Healed cancers
- Chronic dental diseases
- Orthodontic Treatments
- Chronic metabolic diseases
- severe asthma
- Severe allergies, especially food allergies
- Depressive illnesses and burnout
Many serious chronic illnesses, which severely impair the general state of health and may even have a negative impact on life expectancy, are often an exclusion criterion for taking out private supplementary health insurance.
Typical chronic pre-existing conditions that can severely affect insurance coverage include:
- Acute cancers
- HIV
- Severe depressive illnesses up to the risk of suicide
- Chronic mental disorders (eg, schizophrenia)
- severe epilepsy
- Addiction, especially to drugs and alcohol, possibly including nicotine
- Severe cases of diabetes mellitus
- Severe cases of Crohn’s disease
- Malignant tumor diseases
- Have suffered a heart attack or are at increased risk of a heart attack
- Have suffered a stroke or are at increased risk of having a stroke
- Multiple Sclerosis
- Severe chronic diseases of the musculoskeletal system
- Chronic spasticity
- Severe chronic diseases of the metabolic apparatus
Which chronic previous illnesses are relevant for the insurance cover and to what extent they are taken into account for a health check depends on the type of medical care chosen and on the guidelines on which the insurer bases its application check. Depending on the severity of the illness, the general health history of the patient, the prognosis for the development of the illness and the basic requirements of the respective insurance company, a serious chronic illness can lead to the rejection of the insurance application, or at least to an increase in the premium in order to reduce the risk of to balance the solidarity of policyholders.
The truthful and detailed answering of all health questions, especially chronic pre-existing conditions, is one of the policyholder’s obligations when the application is submitted and forms the legal prerequisite for the effectiveness of an insurance contract. If chronic pre-existing conditions are concealed during the health check or changes that require notification during the term of the contract, this can have serious legal consequences for the policyholder, which can range from an increase in the premium to a reduction in benefits to termination of the contract or claims for damages on the part of the insurer.
Lifestyle as a factor in health assessment
It is not only chronic diseases that are important for health care. The basic lifestyle of a person also has a great influence on physical and mental well-being, a health prognosis for the future and potential life expectancy. Most insurers eject as part of the health exam
therefore also take a look at the habits and external influences that help shape the life of an applicant. are important for a healthy lifestyle specifically smoking and the use of drugs and alcohol. Numerous empirical medical studies have already shown that such habits have a lasting impact on physical and mental health and can have a negative impact on health prognosis and life expectancy.
Overweight and chronic obesity are also considered risk factors in the health check and, depending on the severity and prognosis, can lead to an increased insurance premium and, in serious cases with already recognizable health effects, even to the rejection of the insurance application. A lifestyle revolving around exercise and physical activity is closely linked to the aspect of being overweight, but also to the health of the cardiovascular system and the musculoskeletal system. Regular healthy exercise can have a positive impact on a healthy relationship between fat tissue and muscle tissue, on a healthy musculoskeletal system and a strong cardiovascular system. Sufficient exercise also helps to reduce stress and can help to minimize the risk of mental illness.
Stress and a high level of stress in everyday life are also among the influencing factors that can be relevant for a health check. People in management positions, single parents or other groups who are often exposed to a high level of stress in everyday life are considered to be more susceptible to stress-related mental illnesses such as exhaustion depression, burnout or comparable impairments.
The extent to which lifestyle and its potential effects on general health are taken into account in a health check depends on the insurer and the desired health care.
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