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In Germany, the health insurance system is based on the principle of social insurance. Insurance coverage is based on and operated with a dual system consisting of statutory health insurance (SHI/GKV), in German referred to as Gesetzliche Krankenversicherung, and private health insurance (PHI/PKV) referred to as Private Krankenversicherung. Since 2009, anyone taking up permanent residence in Germany is required to take up health insurance covering at least hospital and out-patient medical treatments. Health insurance is also required for short-term stays in Germany, so a VISA will not be issued unless valid health insurance is in place.
Persons can be insured under the health insurance system of their country if you are a citizen from the European Economic Area (EEA) or if your home country has a social security agreement with Germany.
Approximately 90% of the German population is either a mandatory or a voluntary member of the public health insurance, while the remaining are insured under private health insurance. A total of over 73 million persons are insured in Germany.
“THERE ARE THREE OPTIONS TO BE INSURED IN GERMANY; PUBLIC HEALTH INSURANCE, PRIVATE HEALTH INSURANCE, OR A COMBINATION OF PUBLIC HEALTH INSURANCE AND SUPPLEMENTAL PRIVATE HEALTH INSURANCE”
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Although public health insurance is calculated on the gross income, the assessment ceiling is the maximum insurance contribution one has to pay per month. The maximum insurance contribution is €4,837.50 per month in 2022 (or €58,050 per year). The assessment ceiling is often decisive for members of the public health insurance to switch to private health insurance.
The compulsory insurance limit, on the other hand, is the income limit that enables employees to switch to private health insurance. The current limit for 2022 is €5,550 per month in 2023 (or €66,600 per year).
“GERMANY HAS MANY PRIVATE AND PUBLIC HEALTH INSURANCE COMPANIES (KRANKENKASSE), AND YOU ARE FREE TO CHOOSE ANY OF THEM”
Every employed person can take out private health insurance as long as the regulations for voluntary health insurance applies to them. This includes students, self-employed persons, and civil servants. Employees can also qualify under the voluntary health insurance if they earn more than the annual wage limit of €66,600 for 2023. This compulsory wage limit is recalculated each year.
Both self-employed and freelancers can choose private health insurance. In fact, public health insurance providers are not obligated to cover third-country nationals, thus many are forced to choose private health insurance.
Self-employed persons and freelancers cannot change to public health insurance once they are insured privately. Only by becoming an employee, one can switch to public health insurance. Unlike employees in public health insurance, the cost of private health insurance is payable in full for self-employed persons and freelancers.
Civil servants can be privately insured without any prerequisites and level of income. In many cases, civil servants are also entitled to assistance from their employed, the same way as employees with statutory health insurance.
Civil servants' private health insurance cost is great because their employer covers between 50% to 80% of the cost. Additionally, spouses and children also receive a state subsidy.
The only prerequisite for employees to become eligible for private health insurance is the annual gross income limit (JAEG). This is great for high-earning employees who can benefit from non-income dependent insurance coverage while continue to have the benefit of the employer covering half of the contributions.
The difference, benefits, disadvantages and regulations between private and public health insurance in Germany can be difficult to understand. The following questions will help you understand if a private health insurance is right for you.