Health Ins

Individuals can be insured by their country’s health insurance system if you are a citizen of the European Economic Area (EEA) or if your home country has a social security agreement with Germany.

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Around 90% of the German population is covered by public health insurance either compulsorily or voluntarily, with the remainder covered by private health insurance. In total, more than 73 million people are insured in Germany.

“There are three insurance options in Germany: public health insurance, private health insurance, or a combination of public health insurance and supplementary private health insurance.”

We can help you choose the best health insurance in Germany for your needs, whether you are an employee, self-employed or entrepreneur!

The public health insurance system is referred to by different terms. In German, it is called Gesetzliche Krankenversicherung (GKV) or statutory health insurance. Insurance companies are public insurers and not-for-profit corporations. They are also called health funds or Krankenkassen in German.

Self Employed Private Health Insurance In Germany

In Germany, all individuals are entitled to numerous insurance benefits. The 2009 health insurance reforms also allowed public insurance companies to offer individual health protection, such as special supplemental benefits (optional rates or premium refunds) and bonus programs.

In Germany, legal or public health insurance is based on the principle of solidarity. This means that policyholders pay according to their income and therefore different rates regardless of age or state of health. In general, all statutory health insurance funds (krankenkassen) cover 95% of the same benefits without paying a premium. The main difference is usually in the service they provide.

Public health insurance was based on gross income and the additional contribution rate was set equally for all health insurers. However, this changed during health reforms from January 1, 2015. The change meant that health insurance companies were no longer allowed to charge unit amounts, but that each fund would increase individual contributions by one additional percentage. This partnership is made up of two equal parts shared between the employer and the employee.

The fund share of 7.3% for employer and employee (14.6% in total for 2023) is the same for all public health insurance funds. Additional contributions vary from fund to fund. Until 2023, the average (excess) contribution rate is 1.6%. It currently ranges from 0.0% to 2.7%. For employees, this contribution is also shared between the insured and the employer, but students, self-employed people and people without income pay the entire additional contribution themselves.

Health Insurance In Germany

Since January 1, 2009, health insurance has been compulsory for everyone in Germany, regardless of profession, income or ethnic group. It is important to distinguish between compulsory health insurance and the compulsory insurance ceiling.

A compulsory insurance ceiling of €69,300 per year or €5,757 per month for 2024 allows employees to switch to private health insurance. Others, such as civil servants, self-employed workers and certain groups of students and self-employed workers, must enroll in private health insurance or voluntarily join the public health insurance system in Germany.

Compulsory public health insurance in Germany is for anyone who does not fall under voluntary or private health insurance options.

Voluntary public health insurance in Germany is aimed at civil servants, self-employed workers, self-employed people and employees whose income exceeds the compulsory insurance threshold of €69,300 per year, or €5,575 per month for 2024. students can choose. Between legal health insurance and private health insurance.

What Does Health Insurance Not Cover?

The health insurance premium is based on gross gross income. The calculation criteria are explained in more detail below.

Family members of the insured person can be included in public health insurance free of charge. This includes spouses, domestic partners and children up to 18 years old. Special conditions apply to children under 23 if they do not engage in paid activity, or without age limit, if they have a physical or mental disability. Children up to 25 years old can also be insured free of charge if they are still in school or in vocational training.

Spouses can only be included in affiliate insurance if they have no income, or if the monthly income from part-time self-employment is less than 1/7th of the affiliate’s income (for 2024 the maximum €485) or if they have a small job. With a maximum income of €520 for 2024.

In principle, students need health insurance as well as long-term care. The student rate is aimed at people who, due to their age, can no longer benefit from legal health insurance. It is possible for students to take out private health insurance instead of being part of public health insurance in Germany.

Health Insurance Plans ‘too Complicated To Understand’

The total gross income of the insured person serves as the basis for calculating the contribution. The applicable income for compulsory insured persons is:

As explained in the formulation of health insurance contributions above, compulsory public health insurance is charged a percentage based on their gross income.

However, voluntary policyholders are billed based on overall economic performance. This means that the following criteria are part of the calculation when determining their total health insurance contribution, or cost, under public health insurance (GKV):

Although there is a general contribution rate that most individuals will be charged, other rates may apply. The prices that insured persons will pay under public health insurance (GKV) are determined by their status. The following public insurance rates apply in 2023:

How Well Do You Know Your Health Insurance Coverage?

It is important to know that self-employed people pay their health insurance premiums based on their estimated income. If the amount is different from the actual income, you will get a refund or have to pay more.

In general, a normal contribution rate of 14.6% applies and includes the right to continued salary in the event of illness. It is effective from 43 days (6 weeks).

However, there are special cases in which policyholders pay a lower rate without being entitled to sickness benefit. The people who fall under these rates are:

A general health insurance contribution of 14.6% (until 2022) applies to all public health insurance funds (Crankenkassen). However, additional contributions vary, which will cause differences in health insurance costs between different providers. It is therefore recommended to review the list of public health insurance providers and their co-payments to determine the total cost. Annual savings can be in the triple digits.

Technicalities Of Health Insurance

In addition to cost, policyholders must take into account a few other criteria before choosing to subscribe to a public insurer:

Good health insurance companies provide easily accessible support or sometimes a contact person for urgent questions. Making an appointment with a specialist doctor and advice on medications are part of many health insurance plans.

In addition to the legally required health coverage in Germany, many public health insurance companies also offer additional benefits. For example, the costs of health insurance courses, alternative practitioners or professional dental cleanings are often partially or fully covered by the health insurance fund. It is important to note, however, that often only doctors and therapists who are contractual partners of health insurance funds are available.

Bonus programs offered by health insurance funds aim to promote your health. A variety of preventive care and treatments benefit you and the health insurance company. It’s also a great way to earn cash and non-cash rewards along the way.

Health Insurance: Crucial For Securing Both Financial And Physical Well Being In The Current Times

Health insurance companies are regularly tested by different organizations. The health insurance test evaluates the quality, benefits and additional services of many providers. Apart from that, the company as a whole is under scrutiny in terms of finances, transparency and delivery.

“There are many private and public health insurance funds (krankenkasse) in Germany and you are free to choose among them” Contribution limits and compulsory insurance limits

Although public health insurance is calculated on gross income, the assessment cap is the maximum insured amount that must be paid each month. The maximum insurance contribution in 2022 is €4,837.50 per month (or €58,050 per year). The assessment threshold is often decisive for members of public health insurance to switch to private health insurance.

The compulsory insurance ceiling, for its part, is the income ceiling which allows employees to switch to private health insurance. The current ceiling for 2024 is €5,575 per month (or €69,300 per year).

Wellbeing And Health Insurance — Hu International

The contribution threshold for voluntarily self-employed legally insured under public health insurance is €1,061.67 in 2022. This is a uniform hypothetical minimum income that applies to all voluntarily self-employed insured.

The contribution ceiling (maximum amount) is €4,687.50 per month

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