German Health Insurance Schemes
Types of German Health Insurance Schemes are
State health insurance (Gesetzliche Krankenversicherung (GKV) / Krankenkasse): The most common of the German health schemes. Some 88 percent belong to a statutory health scheme and around nine percent are privately insured. State health insurance contributions are based on your gross income (around 14% with an income cap). State health insurance insures the family at no extra charge. Your spouse or partner and, up to a certain age, your children are covered by your insurance - provided that their collective income does not exceed 340 EUR a month and they do not have their own insurance.
The most popular state health insurances are the AOK, BEK, BKK, DAK and KKH. Since 1996, anyone is free to choose between the different state healt insurances.
Your insurance company will issue you a health insurance card, which you have to take with you whenever you visit a doctor, dentist or specialist.
Private health insurance (Private Krankenversicherung (PKV) / Privatkasse): The private option if you qualify to be let in (employees with an income of more than 40.500 per year, self-employed etc.). If you are allowed to take a private health insurance, you should compare the advantages and disadvantages of both systems before making your final decision. Once you've opted out of the state insurance scheme, it is almost impossible to go back.
Private health insurance contributions are based on individual risk profiles, not on income. Older people and risk-groups generally pay higher contributions.This is due to a calculation of the average cost for medical treatment for different groups.
Private health insurance schemes mayprovide more extensive cover, including the option of private or semi-private hospitals, alternative therapies (such as acupuncture and herbal treatments), glasses and contact lenses and other treatment that may not be available under the state scheme. Private insurances don't expect you to pay any additional co-payments (Zuzahlungen) for medicines and treatment as in the state scheme. Some doctors restrict their practices only to private patients (Privatpraxis).
If you are insured through the state system, you only pay a nominal fee for treatments and medicines as these are directly paid for by your insurance company. If privately insured, you pay fees and medicine costs and send receipts to your insurance company for reimbursement.
The health insurance schemes are regulated by the government.
Health insurance is mandatory for all employees and students in Germany, so you will not be able to start working or studying without it. An EU agreement guarantees free medical treatment for EU citizens in Germany. Since the 1st June 2004, European citizens who are travelling within the European Economic Area are given a European Health Insurance Card, which simplifies the procedure when receiving medical assistance during their stay in a Member State. For long-term residence in Germany you have to exchange the card for a local health insurance scheme.
Health insurance contributions are split between employers and employees, independent on whether you opt for a statutory or private insurance schemes. Students are offered special student insurance schemes with lower rates.
Long-Term Care Insurance
In January of 1995, long-term care insurance (Pflegeversicherung) was added to the social insurance system in Germany. Citizens covered by statutory health insurance automatically have long-term care insurance too. Citizens having a private health insurance and entitled to general hospital care, must now have private long-term care insurance as well. People who belong to the state health care system on a voluntary basis, can apply to be exempted from the state long-term insurance, provided they have equivalent coverage from a private insurance company.