Since 2009, all persons who live permanently in the Federal Republic of Germany have been obliged to have health insurance. Health insurance is also required for short-term stays in Germany, otherwise a visa is refused.. In contrast to the USA, the local system offers great advantages, because it prevents a case of illness from leading to financial ruin. However, this form of security is associated with high costs. In this article you will find useful information on which form of health insurance is the right one for you and what advantages and disadvantages the various forms of health insurance generally have.
Specific features of the German health insurance system
The German health insurance system is characterised by the division into statutory health insurance funds (GKV) and private health insurance funds (PKV). Almost everyone has access to statutory health insurance funds, while private health insurance companies have certain conditions.
Nationals of countries in the European Economic Area (EEA) and countries with which the Federal Republic of Germany has signed a convention on social security can remain insured under the health insurance scheme of their home country. However, compared to Germany, the scope of services covered may vary considerably from one country to another, so that an own contribution or additional insurance may be necessary.
Statutory health insurances
Gesetzliche Krankenversicherung is a statutory insurance scheme in German (commonly known as state insurance). There are around 130 state health insurance funds in Germany. These can be characterised as follows:
- The State health insurance funds have a fixed contribution rate
- The scope of benefits is unified – very similar for each insured person
- Additional services, e.g. dental, outpatient and hospital services, can be obtained in private clinics or surgeries for an additional fee.
- All state insurance benefits are covered by the health insurance fund, the settlement is made non-cash (only the health insurance card needs to be presented).
- Hospital treatment is paid 10 euros per day, with a maximum of 28 days stay.
- In the case of chronic illnesses, you may be exempt from fees if they amount to more than 2% of your annual income.
Statutory health insurance companies offer only basic protection. In recent years, many benefits have been restricted in order to prevent rates from increasing. The monthly contribution depends on the income of the insured person.
The advantage of a statutory health insurance is that the contributions for seniors are kept within a manageable financial framework and that there is family insurance.
A disadvantage is that many doctors accept only or preferably privately insured patients, since doctors earn very little from statutorily insured patients.
Private health insurances
Private health insurance in German is private Krankenversicherung. These are characterized by the fact that:
- The contributions are determined individually on the basis of age, gender, health status and insurance coverage.
- The scope of insurance is determined individually
- Treatment costs are reimbursed, i.e. the bill received at the doctor’s surgery is passed on to the insurance company.
- In the case of private insurance, a separate premium is paid for each family member (unlike the State health insurance funds, where non-working family members are insured free of charge).
Private health insurance companies offer some advantages over statutory health insurance companies. Private health insurance is also generally cheaper for high earning employees and self-employed than voluntary membership in the SHI system. An example of this is the cost of dental treatment. Professional dental cleaning is important for healthy oral hygiene. However, these costs are not covered by a statutory health insurance, as they are not regarded as necessary treatment. Private health insurance companies also pay up to 100% for dental prostheses, while the SHI only pays a small lump sum.
It is also an advantage that the preferred treatment of privately insured patients in the doctor’s surgeries also increases the selection of potentially contactable doctor’s surgeries in the surrounding area.
What documents are required to take out health insurance in Germany?
In order to conclude a contract with an insurance company in Germany, you must have the following documents with you:
- valid identity document
- certificate of registration
- a contract of employment or a document certifying the declaration of economic activity
- German bank account
How to find the best private health insurance?
For many people, the insurance industry is difficult or impossible to understand. So if you decide to take out private health insurance, you should do some good research beforehand. Here it helps to compare different offers. The use of a PKV computer is a valuable tip here. Sites such as www.pkv-rechner-1a.de offer this for example. In this way one can be sure to find the best offer for its current need. Beside a consultation there is also still a commission payment for tipster.