The German Health Care System includes two different types of insurance, the compulsory insurance and the private insurance.
The private health insurance is only open to certain professions and at a certain earning. The system private health insurance differs from the system of the compulsory insurance. It is important to know who can choose the private insurance, where to look when choosing a private insurance and what Pros and Cons are there.
The basic principle of the private health insurance says that the amount per month depends on the age and health status of the person who wants to be insured. It is possible to take individual packages of what shall be insured and how much of it. The aim of this system is to find a way not to be over or under insured. Because otherwise it is possible that one is paying too much or not being safe enough. When using an internet calculator, which calculates the monthly payments it is important to give all relevant information like age and health status, otherwise the calculator gives wrong amounts. It can then be possible to pay much more later.
There are three types of persons that can get a private insurance under certain circumstances. Employees, crossing a given income limit, self-employed persons and clerks. Employees are normally insured with the compulsory health insurance. To change into the private insurance they have to cross and income limit. This limit is called “Jahresarbeitsentgeltgrenze” or “Versicherungspflichtgrenze” in German. In 2013 it was at 52.200 Euro per year or 4.350 Euro per Month. It is necessary to cross this limit for more than one year, to get a private insurance. The money is the pre-tax income and to get the amount per year there can also be included other things like:
- Monthly income from wages and salary
- Regular One-time payments (Christmas or Holiday)
- Benefits in kind
- Capital forming benefits
- Overtime money
- Income from second jobs
If interested in a private health insurance one should be aware of the family status. For families with many kids it can get too expensive but singles or households with two working persons can have advantages.
Even student can think of a private health insurance although they are ways from the income limit. While being student one can be freed from the compulsory health insurance and take a special private insurance for students. Advantage with this is that as a student one is quite young and the fee isn’t that high. Although the risk of pre-injuries is lower. Later when being in the job one has to pay less because he is already a member.
For self-employed persons the private insurance is interesting because the fee is not calculated on base of the income. As self-employed one normally has a higher income than average, which goes back to the business. The fee for the compulsory insurance is therefore very high. The private insurance is not calculated with the income and offers more flexible and individual options.
There is a special case with artists and journalists that want to be self-employed. They have special rules and rights and often are covered with the “Künstlersozialkasse”. To get a private insurance they have to get over the income limit as well.
Clerks have a right to help from their employer, who has to pay parts of the insurance and the treatment. There are special options for clerks, which are broad but with the help cheap. For clerks there is also the option to be insured by the compulsory insurance, depending on what is the better offer. The help from the employer can only be taken with the private insurance.
The following points show the advantages of the private insurance in short:
- Free doctor and hospital choice, often better treatment
- Depending on the insurance, safety abroad
- Broad and flexible benefits, individual offers
- Fees do not depend on income
- Private insurance offers advantages for young people, people with high income and special work categories such as clerks
When choosing the private health insurance one has to decide for a certain type of it. There are different ones and special names for them.
One can normally choose between basic, standard and comfort safety. The basic scale offers as the name says basic services and is similar to the compulsory insurance. Pros are the cheap fees and Cons the missing or too few benefits.
The standard scale has a solid all-around service and normally a good price-benefit relationship.
The highest one is the comfort scale. This type has no limits and no self-payments, but offers chief physician treatment in every case. But the fees are quite expensive for this one.
For older persons the private insurance can be a danger because the fees rise with the higher risk of getting sick. To antagonize this development there are so called “Beitragsentlastungstarife”, helping to keep the fees in a reasonable area.
Very controversial are also the first-time user scales also called cheap-scales. These shall attract young clients with cheap deals but the safety is often not enough.
There are some more interesting points when talking about the topic private health insurance in Germany. The basic scale is not always the cheapest one, because it is similar to the compulsory insurance and one does not always need all of these benefits.
One should always look if there is a self-payment in the insurance. Most scales do have a certain percentage of self-payment which shall decrease bureaucratic work because not all small amounts of money are paid back and not all receipts are send in.
For private insured clients there is a refund of costs meaning you have to pay the amount when being sick and the insurance gives the amount back later.
Those interested in the private health insurance first have to check if they can have a private insurance and second if it is not too expensive. To get a first overview the calculators on the internet are very good to calculate the monthly fees. Later one should compare the best types closely.