How does Germany's healthcare system work?

The German health system is divided into two types of coverage: private insurance and state insurance, the latter being also called the public system. However, unlike the SUS (Unified Health System) in Brazil, this "public" system is paid.

Germany's healthcare system is admired for the reputation of hospitals and clinics, but the differences between private and statutory insurance generate criticism in Germany, and it is even mandatory for citizens to have health insurance. Even people who are not native to the country, but who will spend some time there, need to purchase travel insurance. This requirement is decisive in the approval of visas and permits. Without a valid document in Germany, your visa will be denied.

Private health insurance in Germany can only be taken out by people who receive a gross annual value of more than 60,750 euros. The "public" (state) system is financed by a fund that accumulates contributions made by employers and employees.

Private health insurance

Called in Germany as Private Krankenversicherung (PKV), German private health insurance, as stated earlier, is only available to those who have an annual income starting at an x value. Students, freelancers, and others who do not have a job in Germany end up being the exception, and insurers generally offer special packages for this group of people.

In general, the biggest difference between private and state insurance is the waiting time for care, as having private insurance, care is provided according to the patient's need, unlike the public, where the wait is longer.

How much does private health insurance cost in Germany?

The value of insurance varies according to some factors, such as the age of the insured, medical history (health status), and profession, among others. Normally, private health insurance is cheaper than public health insurance when the policyholder is young, and it becomes much more expensive as the policyholder ages.

A young person aged between 20 and 30 years can pay an average of 200 euros per month in private health insurance, while an elderly person in the purchase the same insurance will pay around 1500 euros per month, that is, one big difference.

State health insurance and the principle of solidarity (public)

The statutory health care system, called Gesetzliche Krankenversicherung (GKV) in Germany, is run by more than 100 independent insurers (Krankenkassen) that function as non-profit associations. Everyone who has a job in Germany and receives a (gross) amount of less than € 60,750 per year is entitled to state health insurance.

The contribution rate, calculated on the gross salary and almost always discounted directly from the payroll, has been fixed at 14.6% since January 2015. The amount is divided between the employer and the employee, that is, both parties pay 7.3%. The higher the salary, the higher the contribution amount.

Care and medication

Unlike private insurance, where the insured has the right to choose the doctor of their choice and can make an appointment in a short period, who has statutory insurance, depending on the city, waiting for a specialist can take a few months.

However, when the patient needs assistance, the patient is first seen by a general practitioner, known as a family doctor (Hausarzt), who has a more flexible schedule.

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When visiting the doctor, it is necessary to take the electronic health card, the Krankenversichertenkarte. This card contains personal and insurance data, and in general, has a seal indicating that it can be used in other countries of the European Union, such as Israel and Turkey. In that case, you must obtain a note from the medical service and ask the insurer for reimbursement.

Regarding medicines, regardless of whether the insurance is private or state, there is coverage with the expenses, being necessary to pay only a fee of approximately 5 euros. However, there are some exceptions, such as medicines that have an aesthetic purpose. Besides, the medicine must be prescribed by the health professional for the coverage of its costs to be valid.

Do you want to know more about the health system in other countries? Keep following the blog. Be sure to check out the previous articles here.

Source: Eurodicas | Made for minds