Germany has a reputation for having one of the best healthcare systems in the world. Approximately 85% of the population are mandatory or voluntary members of the public health scheme, while the rest have private health insurance. Since 2009, all German residents must have either state or private health insurance. Germans receive three mandatory benefits - health insurance, accident insurance, and long-term care insurance, which are co-financed by employers and employees. There are two main types of health insurance - public insurance and private insurance.

1. INSURANCE IN GERMANY
SIRTRARASAN BHARATHIDHASAN

2. ABSTRACT
• Germany has a reputation for having one of the best health care
systems in the world, providing its residents with comprehensive
health insurance coverage
• Approximately 85% of the population are mandatory or voluntary
members of the public health scheme while the rest have private
health insurance
• Since 2009 it has been mandatory for all residents of Germany to
have either state or private health insurance
• It is now illegal to be uninsured

4. • Germans are offered three mandatory health benefits, which are co-
financed by employer and employee: health insurance, accident insurance,
and long-term care insurance.
• Accident insurance for working accidents (Arbeitsunfallversicherung) is
covered by the employer and basically covers all risks for commuting to
work and at the workplace
• Long-term care (Pflegeversicherung) is covered half and half by employer
and employee and covers cases in which a person is not able to manage his
or her daily routine
• There are two separate types of health insurance: public health insurance
(Gesetzliche Krankenversicherung) and private insurance (Private
Krankenversicherung)

6. Government Health Insurance System (GKV)
• Most German residents (approx. 70 million people) are members of the
government health system
• If a person’s gross salary is less than 56,250 Euros per year, or 4,688 Euros
per month in 2016 then membership in the GKV is mandatory.
• The government health insurance scheme is administered by approximately
120 Krankenkassen and they charge the same basic rate of 14.6% plus a
possible median supplemental rate of 1.1% of a person’s eligible gross salary
• The maximum monthly premium is 775 EUR [425-Employee and 350-
Employer]

7. • The medical benefits provided include in-patient (hospital) care as
a ward patient with the doctor on duty at the nearest hospital,
out-patient care with registered doctors (Kassenärzte) and basic
dental care
• There is no coverage for private doctors or surgeons, a private
room in hospital, alternative/homeopathic medical care, dental
implants, and vision products for adults or any medical benefits
outside of Europe

8. Benefits of Statutory Health Insurance
The benefits of statutory health insurance change often. Some of
the treatments covered are (as of 2015):
• Medical and dental treatment, with free choice of doctors and
dentists
• Hospital treatment
• Drugs, dressings, complementary treatment, and aids such as
hearing aids and wheelchairs
• Sickness benefit (Krankengeld)

9. • Measures for the prevention and early detection of certain
diseases
• Preventive dentistry and in particular individual and group
prophylactic measures
• Orthodontic treatment, normally only up to the age of 18.
• Immunizations
• X-rays

10. • Patients covered by the state insurance system still need to pay 10
EUR per quarter year in case they need medical help in a period of
3 months
• 10 EUR are paid for the first doctor’s visit during a quarter of a
year. If a person doesn’t make any visits in a quarter year, no
payment is required
• For multiple visits during a quarter of a year the price is still 10
EUR paid at the first visit
• The dentist costs another 10 EUR for the first visit per quarter.

11. Additional contribution
In the following cases, a person will have to an additional
contribution to treatments and medicines (as of 2015):
• The cost of dentures 20 - 70% of these costs may be paid by the
state.
• A share in the cost of in-patient preventive treatment and
rehabilitation, out-patient rehabilitation, and in-patient hospital
care (€10/day for a maximum of 28 days)
• 10% of the cost of prescription drugs and dressings, minimum 5
EUR and maximum 10 EUR

13. Private Insurance
• It is based on an individual agreement between the insurance
company and the insured person defining the set of covered
services and the percentage of coverage
• It depends on the amount of services chosen and the person's risk
and age of entry into the private system
• It is used to build up savings for the rising health costs at higher
age (required by law)

15. • Private health plans cover a wider choice of medical and dental
treatment and provide broad geographical coverage
• The private medical insurance market is served by about 40
German insurance companies
• Per person cost of full medical insurance is based on the level of
benefits chosen, as well as on entry age and any pre-existing
medical conditions.
• The government insurance premium also covers a person’s non-
working dependents, whereas the private medical insurance
premium is generally paid for each person covered
• German private health insurance companies are not allowed to
cancel your policy if you submit claims and are also required to
put 10% of your premiums aside as a provision towards keeping the
cost stable when you retire.

17. References
• http://www.howtogermany.com/pages/healthinsurance.html
• https://www.justlanded.com/english/Germany/Germany-
Guide/Health/Health-insurance
• http://www.germanyhis.com/compulsory-health-insurance-
germany/
• http://www.internationale-
studierende.de/en/prepare_your_studies/entry_into_germany/he
alth_insurance/
• https://www.gkv-
spitzenverband.de/english/statutory_health_insurance/statutory_
health_insurance.jsp