Your health insurance options in Germany
If you are not covered by your home country’s health scheme or a worldwide private plan, you need German health insurance (Krankenversicherung). There are two types of health insurance: state (gesetzlich) and private (privat). In practice, many people have no choice. Employees earning up to DM 78,300 a year (DM 6,525 a month) are compulsorily (pflicht-) insured in one of the approximately 1,000 health insurance funds (Krankenkassen) that comprise the state scheme. Contributions vary between 11 and 15 percent of one’s salary, with a further 1.7 percent for nursing care insurance (Pflegeversicherung). The employee and employer each pay half. Employees can choose between the many funds, among which are general ones for certain regions (Allgemeine Ortskrankenkassen, AOK) and company funds (Betriebskrankenkassen, BKK). The latter are open to everyone and are usually cheaper.Over 90 percent of the benefits are standardized across funds. These include visits to the doctor, hospital stays, basic dental treatment, prenatal care and long-term sick pay. There is, however, variation in provision of complementary therapies such as homeopathy. For a summary of the many funds, rates and benefits, see Finanztest, September 2000 (www.warentest.de). If you want to change funds, contact your insurer.
If you earn more than DM 78,300 a year, you can either remain in the state scheme on a voluntary (freiwillig) basis or take out private insurance. In either case, your employer pays half. If you go from being employed to self-employed, you can usually stay in your state fund on a voluntary basis. Other self-employed people must usually take out private insurance. In either case, you pay the full contributions unless you are an artist or publicist (including journalists). For these groups, the Künstlersozialkasse (KSK) will pay half (Tel. [04421] 3080, www.kuenstlersozialkasse.de).
If you have a choice between state and private insurance, think carefully. Private insurance allows you to choose the services you want, and the rates are usually cheaper for young, healthy people without dependants. Families, however, are often better off in the state scheme because one policy covers non-working spouses and children, too. With private insurance, each family member needs his or her own policy. It is extremely difficult to get back into the state scheme once you have gone private.
As a private patient, you can go to any doctor; if you are in the state scheme, you are restricted to those with authorization to work for health insurance funds. Such doctors usually have a sign outside their practices saying Alle Kassen. As a member of the state scheme, you can take out additional private health insurance (Zusatzkrankenversicherung) to give you better coverage — e.g., a single room in hospital, higher sick pay or dental treatment (e.g., crowns) not paid in full by the state scheme.
Private health insurance is normally valid worldwide, whereas the state scheme covers you only in EU countries, Switzerland, Tunisia and Turkey. Before you leave for such countries, however, get a certificate (Auslandskrankenschein) from your insurance fund. Otherwise, you will be treated as a private patient. Also, take out travel health insurance (Reisekrankenversicherung), which costs as little as DM 12 a year and provides extra coverage, usually for trips of up to six weeks.
