Health insurance is extremely important, however, it is also extremely confusing. Here is a minimal overview of the major differences between public and private health insurance coverage in Germany.
The costs of the German health care system are high and rising. There have been many recent government reforms to reduce costs and to make hospitals more competitive, and there will be more reforms and major changes ahead. Keep this in mind, as the information below could be subject to change.
Government Health Insurance System – GKV
Approximately 85 percent of residents in Germany are members of the government health insurance system. It is mandatory to be a member of the GKV for individuals whose gross salary was less than €52,200 per year or €4,350 per month in the year 2013. About 140 government health insurance fund providers, or Krankenkassen, administer the government health insurance system. They charge a rate of 15.5 percent of an individual’s eligible gross salary; however, if someone earns more than a monthly income of €3,938 then they pay no higher than 15.5 percent of that. There is typically a minimum period of membership with any Krankenkassen of 18 months, after which an individual is allowed to switch to a different Krankenkassen after giving notice two months in advance.
The medical benefits provided by the GKV include in-patient hospital care, out-patient care with registered doctors, and basic dental care. Not covered by the GKV are private doctors and surgeons, a private room in a hospital, alternative medicine, dental implants, and vision products for adults. Any medical benefits outside of Europe are also not covered.
Dependents who live with the insured individual and who are not working are insured at no additional cost. Dependents need to be registered with the Krankenkasse in order to be insured.
To join the government health insurance system, simply register with any of the available Krankenkasse.
Private Health Insurance – PKV
There are approximately 40 private German insurance companies. Private health insurance typically has broader coverage, more options, and extra dental treatment. With private health insurance, cost is calculated based on the benefits chosen, age, and pre-existing conditions. Also, dependents will require an additional paid premium, as opposed to adding dependents at no cost with government insurance. Sometimes monthly costs can be reduced by agreeing to deductibles.
If an individual under the government insurance plan earns over €52,200 per year, they can opt to switch to private health insurance, as long as they give notice two months in advance.
So long as an individual can provide proof that their private insurance meets German government regulations, they can receive employee subsidies towards the cost of their health insurance policy and their premiums.
Some companies automatically enroll their employees into the government health insurance system. If an individual wishes to be privately insured, they should inform their company’s human resources department as soon as possible.
For those insured by the government health insurance system, if an individual wishes to purchase extra coverage, they may do so by purchasing a policy through a private health insurance company.
There is a lot more to the German health care system. For a more detailed understanding, there are qualified insurance brokers who specialize in expatriates who can be contacted.