What are the costs of health insurance?
Since the 1. January 2009 the general health insurance obligation is valid in Germany. According to this, everyone must be a member of a statutory or private health insurance company. Legally insured persons can also choose between various providers, whose services vary. But how much does health insurance cost and are there alternatives to SHI for employees? We clarify these and many further questions in the interview with the cost check expert.
What do you mean by "statutory health insurance"??
Cost check: The main task of the GKV is, according to the Social Security Code, "to maintain or restore the health of the insured or to improve their state of health."It should ensure a full medical care, according to the needs of the insured. Everyone pays into the system, depending on their income. This provides financially weak members with the same benefits as those in the upper income group (solidarity community).
By law, all blue- and white-collar workers are compulsory members. Only those who earn above the compulsory insurance limit can leave the GKV at their own request and become a member of a private health insurance company. Civil servants and the self-employed are also not required to be members, but can take out statutory insurance voluntarily.
How high are the current contributions in the statutory health insurance?
Cost check: premiums are based on gross income. The contribution amount increases proportionally to the income, however, there is a contribution assessment ceiling. This was 4 in 2018.425 EUR per month and is in 2019 at 4.537.50 EUR. This sum, which determines the maximum insurance premiums to be paid, is adjusted annually. Above this the contributions remain the same. In this way, lawmakers want to create an incentive for higher earners to remain in the statutory health insurance system.
The general contribution rate for all statutory health insurances since 1. January 2015 uniform 14.6 percent of gross salary. Since the parity principle applies in Germany, employer and employee each pay half of this, i.e. 7.3 percent.
How much does voluntary health insurance cost?? What costs are incurred by private health insurance?
Example: Earn 2.500 EUR gross, corresponds to the total health insurance contribution 365 EUR. Of this the employer takes over 182,50 EUR.
In addition, there is an additional contribution for each individual health insurance fund. This is also measured on the basis of gross earnings and has been paid since 1. January 2019 again funded half by the employer and half by the employee.
Are the additional contributions of all statutory health insurance companies the same?
Cost check: No, these vary, as the general contribution rate for most health insurance companies does not cover costs. For this reason, insurance companies calculate an individual additional premium.
Below we have listed some health insurers and their contribution rates:
| hkk health insurance | 059 percent | 15.19 percent | 0.39 percent | 14.99 percent |
| Techniker health insurance | 0.9 percent | 15.5 percent | 0.7 percent | 15.3 percent |
| Debeka BKK | 0.9 percent | 15.5 percent | 0.8 percent | 15.4 percent |
| BARMER | 1.1 percent | 15.7 percent | 1.1 percent | 15.7 percent |
| Knappschaft | 1.1 percent | 15.7 percent | 1.1 percent | 15.7 percent |
Regionally open health insurance companies:
| AOK Saxony-Anhalt | 0.3 percent | 14.9 percent | 0.3 percent | 14.9 percent |
| AOK Baden-Wuerttemberg | 1.0 percent | 15.6 percent | 0.9 percent | 15.5 percent |
| IKK North | 1.3 percent | 15.9 percent | 1.3 percent | 15.9 percent |
| AOK Rhineland/Hamburg | 1.4 percent | 16.0 percent | 1.1 percent | 15.7 percent |
| IKK Southwest | 1.5 percent | 16.1 percent | 1.5 percent | 16.1 percent |
How much can you save on statutory health insurance?
Cost check: since the beginning of the year the employers take over half of the additional contributions, the possible savings potential decreases. If, for example, your health insurer demands an additional contribution of 0.9 percent, you can save by switching to the cheapest insurance company with a gross income of 2.000 EUR only save about 60 EUR per year.
What is the cost of voluntary statutory health insurance? What costs are incurred by private health insurance?
What benefits are provided by the statutory health insurance?
Cost check: Due to the standard benefits set by the state, the care in the GKV is almost identical, regardless of the insurance company. It covers all vital, medical areas.
Health insurers can act more freely with regard to the scope of the additional services offered. For example, some insurers also pay for homeopathic remedies or travel vaccinations. Some preventive screenings aren't paid for until you reach a certain age. However, there are insurance companies that focus on preventive care and reimburse such measures even for younger persons.
Some health insurers offer elective plans in which policyholders can receive special benefits or premium refunds. Other health insurance companies pay their members a bonus if they meet certain requirements. For example, it rewards you if you don't reach for a cigarette or regularly participate in sports programs. Partly the bonus is paid out in cash, partly you get bonuses in kind or subsidies for medical services.
When it comes to service, some insurers have a well-developed network of offices where you can get personalized advice. With other health insurance companies, you have to travel long distances or you can get the information you need by phone, e-mail or chat. Especially for seniors this can prove to be disadvantageous.
How a health insurer treats customers is also an important quality feature, as the quality of service varies greatly. Are cures and rehabilitation measures approved quickly or do you have to fight a long time for such benefits? Receive competent information and have your questions answered in a friendly and individual way? Ask around in your circle of friends and acquaintances and include their experiences in your considerations.
I am free to choose my health insurance fund?
Cost check: Since 1. January 1996, the insured can decide for themselves in which health insurance fund you want to be a member. However, the statutory health insurance companies have almost the same, predetermined catalog of benefits. Around 96 percent of benefits are clearly defined by the legislator.
Nevertheless, a comparison of the providers is worthwhile, especially if you attach importance to certain individual benefits.
May I as a legally insured person freely choose the doctor?
Cost check: Every insured person is free to decide which doctor to go to. The only prerequisite for the statutory health insurance to cover the costs is that the physician is licensed by the health insurance fund.
However, you can change your doctor in the current quarter only under certain conditions, for example, because the trust relationship is permanently destroyed. This right is also restricted if you participate in the general practitioner model or integrated care.
In the hospital, the right to free choice of doctor is also limited. As a rule, you only have the choice of which hospital you would like to be treated in. The therapy itself is usually carried out by the doctor on duty.
How reimbursement works?
Cost check: This is one of the great advantages of statutory health insurance. Unlike private patients, who must first pay for treatment out of their own pocket and wait for reimbursement from their health insurance company, the doctor settles directly with your health insurance company. You only have to show the so-called insurance card before the start of treatment.
I recently had to pay extra for medicines. Why?
Cost check: All people with statutory health insurance must pay co-payments for health care costs, for example, for prescription medications. The burden limit is two percent of gross income. If you suffer from a chronic disease, this is at one percent.
If you have exceeded this limit in the current year, you can be exempted from further co-payment costs for the rest of the calendar year. Collect all invoices and receipts for medicines, medical aids and treatments. Attach this to the application for co-payment exemption.
Tip: You can be exempted from co-payments retroactively for four years. The health insurance company will reimburse you for any overpayments.
I would like to change health insurance. What do I have to pay attention to when terminating the contract??
Cost check: In principle, you can change to another GKV after 18 months of membership. If the health insurance fund of which you are currently a member increases the additional contributions, you have a special right of termination.
Cancel in time two months to the end of the month. Look around in advance for a fund whose scope of benefits meets your expectations. Statutory health insurers are not allowed to refuse anyone and must accept you even if you are ill or over a certain age.
Attention: When changing health insurance companies, it can happen that the new health insurance company has contracts with another manufacturer of medical aids. Chronically ill patients should therefore find out in advance whether they can continue to receive the preparations they are used to.
Is it worth changing to private health insurance and who can become a member??
Cost check: Without further requirements can:
- Civil servants,
- Self-employed,
- Freelancer,
- Students
enter the PKV.
If you are a blue-collar or white-collar worker, your gross income must be above the contribution assessment ceiling of currently 60.750 EUR per year. This limit is set anew every year.
Especially in young years, the private health insurance scores with favorable rates. However, these contributions can rise sharply over the years, so that the financial burden is very high. Therefore, don't just let yourself be lured by low premiums, but check the quality of the insurance in detail and compare its benefits with those you have in the GKV.
If the nursing care insurance is obligatory?
Cost check: Yes, you must pay contributions to long-term care insurance regardless of how you are insured. Since these are almost identical, they play almost no role in the selection of health insurance.