Health Insurance coverage in Germany
About 87 % in the citizens of Germany have statutory health insurance coverage, i.e. GKV. As of May perhaps 2005, the GKV relied on 321 non-profit illness funds to collect rates from their members and spend well being treatment providers based on negotiated agreements. Individuals who are not insured in this way, mainly civil servants along with the self-employed, get wellness care by way of personal for-profit insurance.
An estimate of 0,3 % of the German populace (around 250,000 people today) has no health insurance at all. Some of them are so wealthy they usually do not need to have it but most of them are poor and get wellness care through social assistance.
Statutory health insurance
There are three different categories of sickness money: primary cash, substitute cash and “special” money. Some workers are required to be members of the primary funds, e.g. if they earn less than the than the income ceiling (2006: EUR 3,937.50 per month / EUR 47,250.00 per year). These earning more than that ceiling may be members on a voluntary basis, or they may have a choice of money. A few of them automatically become members of a particular fund for example because of their occupation (company-based cash) or place of residence (local sickness cash). Some occupations have their own “special” cash, e.g. farmers or sailors.
Substitute funds are divided into two kinds: they provide wellness insurance coverage to both white collar workers and blue collar workers earning more than the income ceiling. Membership is voluntary.
Both, employers and employees pay half of a member’s rates, which in 2006 averaged between 13 and 14 percent of a worker’s gross earnings up to the contribution assessment ceiling (2006: EUR 3,562.50 monthly / EUR 42,750.00 p.a.). Rates are fixed in accordance with earnings rather than risk and are unaffected by the respective member’s marital status, family size, or well being. Rates are the same for all members within a particular fund with the same earnings.
Private health insurance
About eleven percent of Germany’s residents spend for private wellness insurance coverage provided by some 40 for-profit insurance carriers. Many of individuals choosing private insurance are civil servants who want to secure percentage of their medical bills not covered by the government. Some sickness-fund members buy additional personal insurance to cover such extras as a personal room or a choice of physicians while in a hospital. Otherwise, the medical care provided to the publicly and privately insured is identical. In both cases the same medical facilities are used. Self-employed persons earning above the income ceiling must have personal insurance coverage. Members of a sickness fund who leave it for a personal insurance coverage carrier will not be allowed to return to public insurance coverage.
As opposed to the statutory heath insurance, contributions to the private insurance depend on the member’s age, gender, occupation and well being status, that is, the individual risk. Although private insurance businesses spend health care providers about twice the amount paid by the primary sickness money, private insurance coverage is often cheaper than statutory health insurance, especially for younger policyholders without dependents. As is the case for members of illness money, employees who have private insurance coverage have half their premiums paid by their employers.
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