Additional sites with information about health insurance, especially for students, are listed below. This is information only and we are not responsible for information found on the links.

A comparison of German Private Health Insurance and the Government-funded Health System (GKV).

 

As of 2009, all individuals living in Germany must have health insurance.

You will be issued a health insurance card with a photo and electronic chip. As of now, the chip only contains your name, birth date and address - nothing about your state of health or which doctors you have visited. Discussions are ongoing if the chip should contain more information for ease of service at the cost of privacy.

To help you decide if private health insurance or government health insurance is most appropriate for your situation, please read below.


There are some basic differences between private health insurance and the government health system. The most important differences are listed below:

1. Calculation of contributions/premium

2. Medical benefits

3. Choice of medical practitioner and hospitals

4. Reimbursement of costs

5. Provisions for older age

6. Refund of premiums

1. Calculation of contributions/premium:

A private health insurer calculates your premium based on age, gender, any pre-existing medical conditions as well as the options you choose for your coverage. Each insured person has his or her own premium.

Please go to  www.pkv.de/statistiken to learn more about the methods of basic risk evaluation.

Membership in the government health system is mandatory if your gross annual salary is below 49,500 Euro. The basic rate of the Government health system is 15.5% of your eligible gross salary to a maximum monthly income limit of 3,712.50 Euros (2011 figures).

2. Medical benefits:

In private health insurance each insured person has his or her own premium based on individually selected options. The benefits are part of the contract and will be permanently guaranteed as long as the insurance is in place.

Government health system benefits are regulated by the German Code of Social Law (SGB). Consequently your benefits are prone to any amendments by the government.

3. Choice of medical practitioner and hospitals:

Private health insurance offers a choice of doctors and hospitals.

The government health system offers a selection of registered doctors. If further treatment is required the doctor will usually refer you to the nearest hospital.

4. Reimbursement of costs:

With private health insurance you generally pay the bill first and then submit it to the private insurer for reimbursement. Alternatively you could forward the bill to your insurance company and they may pay it directly. The costs for hospitalization may be paid directly to the hospital by the private insurer.

The government health system pays your bills directly. When visiting the doctor or when being admitted to the hospital you have to present your health insurance card. Generally you will not receive bills but you will have to make a 10 Euro co-payment once a quarter and smaller co-payments for prescriptions.

5. Provisions for older age:

Private health insurance companies are required to put 10% of your premiums aside as a provision towards keeping the cost stable at retirement.

Benefits from the government health system are subject to change.  They might increase the basic premium rate if their expenses increase to a level higher than their earnings. Alternatively they could limit their benefits.

6. Premium refund:

With private health insurance it is possible to receive a partial refund of your premium if your costs are low.

Refunds are not usually found within the government health system.