The ins and outs of health insurance

Having health insurance is obligatory in Germany, but there are considerable differences between private and public coverage. Joe Morgan explores the healthy options for your wallet.

The ins and outs of health insurance

Getting to grips with health insurance in Germany can be a tough challenge for expats, especially those from the United Kingdom, where everyone can count on the publically funded National Health Service. But taking the time to learn about the different health care options available and how they meet your circumstances is crucially important if you have made Germany your home.

While Germany has one of the best healthcare systems in the world, the ageing demographics of the population is likely to make medical insurance become an increasingly important issue, as the costs of insuring the population inevitably rises. According to statistics from the German Federation of Health Insurance Companies (BKK), the number of employees aged 55 and older in Germany increased by 49 per cent from 2000 to 2010.

For employees of German companies, obtaining health insurance is not too complicated. Workers in Germany who are employed by a company will be automatically covered by a gesetzliche Krankenkasse (statutory health insurer), providing they earn under €4,190 a month. This way the cost of funding a medical insurance plan is shared roughly 50/50 with an employer that sorts out all the paper work on behalf of a worker.

AOK is the largest statutory health insurer in Germany, ensuring about 24 million people under the 13 regional branches, making it responsible for the health of about a third of the German population. Other leading statutory insurers include KKH-Allianz, which insurers about two million people with 114 service centers throughout Germany, and the consistently well-ranked Techniker Krankenkasse.

Those who fall ill can normally expect their employer to pay six weeks’ full salary. After this period, the government statutory health insurer pays a percentage of a sick person’s income, up to approximately €2,250 a month as statutory sick pay (Krankengeld) for up to 78 weeks.

Those who are self employed or out of work can pay voluntary health insurance contributions to a statutory Krankenkasse. This is calculated at a rate of 14.9 percent of a person’s income. However, calculations are made based on a minimum income of €1,916.25 a month, resulting in a monthly charge of €274.02.

For many self-employed people in Germany, taking out private health insurance is an attractive option. The cost of private medical insurance varies, depending on a person’s age, gender and state of health. But private medical insurance is usually only for the self-employed, government officials or salaried workers who have an annual income of above €49,500.

Those looking for a private health insurance policy can consult with an independent agent or compare policies online using a Versicherung-Vergleich service. For example, and have an online portals enabling visitors to compare private insurance policies. Those using this service will find that it does not have an English language option, making Google Translator a useful tool for non-German speakers. Unlike statutory schemes, a private health insurance policy does not automatically cover a policyholder’s family. Additional fees will be levied for insuring other family members such as children.

Alternatively, expats living in Germany can take out an international health insurance plan. While these schemes can be less costly that private medical insurance offered by providers in Germany, applicants should scrutinize the small print for caveats and conditions, which may exclude important areas of cover. These could exclude cover to those who have pre-existing conditions, illnesses or injuries.

Those earning a freelance living as an artist or writer can apply to join the Künstlersozialkasse (KSK), a scheme introduced to integrate self-employed freelance artists and writers into the statutory social insurance system. The KSK is not a conventional insurer, operating a model where funds paid into the scheme are redistributed between freelancers. Professions eligible for the scheme include performance artists, musicians, journalists, along with teachers of art, music and journalism.

The scheme pays half of a policyholder’s social security contributions (as a percentage of their income), including pension contributions and Krankenkasse. Those who wish to apply to join the scheme should consider enlisting the help of a consultant to help with the paperwork, which of course has to be completed in German. Those applying will have their chances of success enhanced if they hold a membership of a professional trade body and can provide detailed evidence of their work.

“I had to prove I earned my ‘main income’ from journalism,” recalls a KSK scheme member. “When I asked what that meant on the phone, I was told ‘about €800 to €1,000 a month’. You basically send in your contracts and invoices for the last few months and they assess you.”

One key prerequisite for medical insurance cover under the Künstlersozialkasse scheme is that the creative professional must obtain a minimum income of €3,900 a year from their self employed/freelance work.

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Monkeypox in Germany: Two teens ‘among new infections’

Two teenage boys between the ages of 15-17 have reportedly been infected by monkeypox, as the number of cases in Germany continues to grow.

Monkeypox in Germany: Two teens 'among new infections'

German news site Spiegel Online first reported the new cases – which are an anomaly for a virus as it has mostly affected gay men – following an inquiry to the Robert Koch Institute (RKI). 

They are among a total of 2,677 people who are confirmed to have contracted the virus in Germany to date. There have not been any fatalities.

Out of these, only five cases were women, according to the RKI. The public health institute said that it does not release information on individual cases.

READ ALSO: EXPLAINED: How Germany wants to contain the monkeypox

The disease – which is not usually fatal – often manifests itself through fever, muscle aches, swollen lymph nodes, chills, exhaustion and a chickenpox-like rash on the hands and face.

The virus can be transmitted through contact with skin lesions and droplets of a contaminated person, as well as through shared items such as bedding and towels.

Many of the cases known so far concern homosexual and bisexual men. However, affected people and experts have repeatedly warned against stigmatising gay communities.

How fatal is the disease?

The first monkeypox cases were reported in Germany on May 20th, as the disease continued to spread in West Europe.

At the weekend, the first two deaths outside of West Africa were reported in Spain.

READ ALSO: WHO warns ‘high’ risk of monkeypox in Europe as it declares health emergency

The RKI has urged people returning from West Africa and in particular gay men, to see their doctors quickly if they notice any chances on their skin.

According to the latest estimates, there are 23,000 monkeypox cases worldwide, and Europe is particularly affected with 14,000 cases.

There have been 2,677 monkeypox cases in Germany as of August 2, 2022. Photo: CDC handout

About eight percent of patients in Europe have been hospitalised so far, reported the World Health Association on Monday, mostly due to severe pain or additional infections.

In general, the mortality of the variant currently circulating in Europe is estimated to be low.

READ ALSO: More cases of monkeypox ‘expected’ in Germany

Will a vaccine make a difference?

Since July, a vaccine has been authorised in 27 EU member states and in Iceland, Liechtenstein and Norway. 

The Standing Committee on Vaccination (STIKO) recommends vaccination against monkeypox in Germany for certain risk groups and people who have had close contact with infected people.

So far, the German government has ordered 240,000 vaccine doses, of which 40,000 had been delivered by Friday. 

Around 200,000 doses are set to follow by the end of September. 

The German Aids Federation (DAH) on Friday called for one million vaccine doses, stressing that the current supplies will fall short of meeting need.

“The goal must be to reduce the number of infections as quickly as possible and to get the epidemic permanently under control,” explained Ulf Kristal of the DAH board in Berlin on Friday.

But this is only possible, he said, if as many people at risk of infection as possible are vaccinated.

“We don’t assume the epidemic will be over when the doses available so far have been vaccinated,” Axel Jeremias Schmidt, Epidemiologist and DAH Consultant for Medicine and Health Policy, wrote in a press release.

As long as there are monkeypox infections, he said, people who are at risk must be offered vaccination.