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HEALTH INSURANCE

German healthcare – everything you need to know

Getting health insurance in Germany is one of the biggest priorities when moving here - and mandatory for any visa-seekers. But how does it all work?

German healthcare – everything you need to know
Photo: obs / Initiative "Cholesterin persönlich nehmen. Risiko senken zählt".

Germany is often touted as a model for healthcare – especially since it created the very first universal healthcare system in the late 1800s, under Otto von Bismarck.

Since it is compulsory here, you’ll find it quite hard to be hired as a freelancer or get any kind of visa without it. So here are some of the most important things to know.
 
Private versus public – there’s a difference
 
A health insurance card for AOK, one of Germany's statutory health insurance providers. Photo: DPA.
 
Germany has two different systems of healthcare – the statutory and the private. Statutory health insurance – more often called “sickness funds” – is required for everyone earning less than €4,462.50 per month, or €53,550 per year, and what you pay as a contribution is adjusted for how much you earn. Certain people may opt out, like those making above this threshold or those who are self-employed.
 
The statutory system is based on the idea that “the cost of healthcare is shouldered primarily by the better-off”, according to the Mannheim Institute of Public Health.
 
The main difference is this: Statutory insurance contributions are based on income and the benefits you receive are according to need. Private insurance premiums are based on your risk (younger people may pay less, for example), and the benefits you receive are according to what’s in your contract.
 
Some 90 percent of the German population is covered by statutory sickness funds, according to the German Medical Association.
 
 
Private versus public – pros and cons
 
If you’re self-employed, an older or long-term student or a high-earner, you may be trying to decide between public or private.
 
The benefit of statutory insurance is that your contributions don’t change as much over time, instead being based on your income. But because private premiums are based on risk, this can sometimes be more favourable for younger people.
 
Private insurance holders also get certain perks when visiting the doctor. They may get priority in setting up appointments and in consulting the head doctor. But private companies also require you to pay upfront and then will reimburse you, whereas statutory firms receive the bills themselves.
 
For more detailed information see this report.
 
Health insurance for freelancers, artists and other creative types
 
Artist Niklas Klotz. Photo: DPA.
 
Self-employed artists, writers, journalists and musicians can apply for a very special health insurance group called the Künstlersozialkasse (KSK). The state-funded KSK acts as a sort of employer to pay half the amount of your insurance for pensions, health and even nursing care.
 
You first have to apply to join and be considered a part of “the artistic and/or publishing” worlds.
 
The KSK “considers as an artist someone who creates, performs, or teaches music as well as performing arts or visual arts. A publisher… is someone who is working as a writer or journalist, or in a similar manner to a writer or journalist.”
 
Some of the professions the KSK includes on its application are copywriters, graphic designers, emcees and translators (though this depends on what you’re translating – something more artsy or journalistic is what they’re looking for).
 
Health insurance for students

Students at the University of Heidelberg. Photo: DPA.

Germany has social insurance agreements with other EU and European Economic Area countries that any student with statutory health insurance in their home country can also get coverage at a statutory insurer in Germany with their European Health Insurance Card.
 
Some foreign private companies are also recognized in Germany, according to the German Academic Exchange Service (DAAD), so it’s best to contact your local insurance provider to find out.
 
And for those outside the EU, German statutory insurers are obliged to offer students discounted rates up until the age of 30 and until the end of their 14th semester. These contributions are around €80 per month.
 
Once you turn 30 or have been studying for longer than 14 semesters, you’ll have to pay a higher rate. If you surpass these thresholds and no longer get the discount, you can also turn to private companies, which sometimes offer student rates themselves.
 
 

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For members

HEALTH INSURANCE

Why more than 20 million people in Germany face higher health insurance costs

Several German health insurance companies have raised their rates this year, pushing up the costs for customers.

Many people are facing higher health insurance contributions this year.
Many people are facing higher health insurance contributions this year. Photo: picture alliance / dpa | Jan Woitas

According to a study by the comparison portal Check24, around 21 million people with statutory health insurance (gesetzliche Krankenversicherung or GKV) have had to pay higher contributions since the beginning of the year after several organisations raised their additional contributions. 

A total of 19 of the 97 statutory health insurance providers in Germany have increased their additional contributions, the comparison portal found.

It means more than a quarter of the 73 million people with statutory health insurance in Germany have to pay higher additional contributions. 

According to Check24, the higher additional contributions can cost an insured person in the most expensive case an extra €261 per year.

Among those to have raised their additional contributions include AOK Baden-Württemberg and AOK Bayern, which have both increased the additional contributions from 1.10 percent to 1.30 percent. Check24 has published the full list of additional contributions here.

Customers affected receive a letter in the post letting them know when their contributions are increasing. Health insurance providers justify raising their rates by pointing out rising costs in the health and care system. The pandemic has also put significant strain on providers. 

READ ALSO: How to make the most of reward schemes on your German health insurance

A total of 67 health insurance providers are keeping their individual additional contribution the same. And as many as 11 health insurance funds lowered their contributions – although most of these already had comparatively high rates.

In 2021, Techniker Krankenkasse (TK), the largest statutory health insurance fund in Germany with around 8.2 million members, raised its additional contribution significantly.

The contribution went up to 1.2 percent from 0.7 percent. Average earners saw additional monthly costs of about €10 extra, while self-employed people had to pay up to €288 more per year. 

TK has not raised its rates this year. 

Can you switch health insurance?

If your health insurance company increases the additional contribution, those insured have a special right of termination until January 31st, 2022.

They can apply for the change up until this date, and they will then become a member of the new health insurance provider from April 1st after the statutory two month change-over period has expired.

Insured people also have the right to change their statutory health insurance fund every 12 months.

The cost of public health insurance in Germany is a fixed salary percentage of 14.6 percent, while the reduced contribution rate for employees without entitlement to sick pay is 14.0 per cent.

Beyond that, however, health insurance providers set an additional contribution.

The contribution assessment ceiling for statutory health insurance (GKV) – up to which contributions are levied – remains unchanged at €58,050 per year in 2022, as in the previous year.

Check24 said that switching providers can save employees up to €624 per year depending on their income.

Self-employed people pay both the employee and employer contribution and can therefore save up to €1,248 euros per year by switching, the analysis found. 

However in a representative YouGov survey only 11 percent of respondents in Germany said they had recently changed their insurance provider or would do so in the foreseeable future.

Most of the benefits provided by statutory health insurance organisations are identical.

READ ALSO: EXPLAINED: The three new services covered by German health insurance

However, there are some differences in the voluntary benefits, including dental health (professional dental cleaning and discounted dentures), vaccinations (flu vaccinations for under 60s and travel vaccinations), various cancer screening examinations and osteopathic treatments.

“In addition to the financial relief, insured people can also secure higher subsidies for professional dental cleaning or other additional benefits by switching,” said Dr Daniel Güssow, Managing Director of statutory health insurers at Check24.

Vocabulary 

Additional contributions (die) Zusatzbeiträge

Right of termination – (das) Kündigungsrecht 

Benefits (die) Leistungen

We’re aiming to help our readers improve their German by translating vocabulary from some of our news stories. Did you find this article useful? Let us know.

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