Health insurance: spoiled for choice

In Germany there is a dual health system. Under certain professional conditions, citizens are allowed to choose how to insure themselves.

Insured persons have the following options:

The health care system in Germany stipulates that, under certain conditions, citizens are allowed to choose how they want to insure themselves.

Insured persons have the following options:

In Germany there is a dual health system. Under certain professional conditions, citizens are allowed to choose how to insure themselves.

Insured persons have the following options:

Not everyone has the health insurance option

Topic Overview

Self-employment, civil service and some salary increases have one thing in common: they have to deal with the question of whether you continue to insure yourself by law or prefer to switch to private health insurance. Because in these moments you have the Choice between both systems. But is it worth a change? Or is it perhaps enough to supplement the statutory benefits with a supplementary health insurance? What to pay attention to when choosing.

Compulsory insurance and exemption

Most people in Germany are members of a health insurance fund of the statutory health insurance (GKV). About 10 percent of the population, however, are insured in the private health insurance (PKV). The possibility of private insurance does not exist for everyone. Rather, it depends on your professional situation, whether you may leave the GKV.

Conditions for exemption from compulsory insurance

Not every person has the choice between two health insurance policies. Because only if special requirements apply, the compulsory insurance expires in the statutory health insurance. In that case you will have the opportunity to insure yourself privately in the future or to remain a voluntary member of the GKV. This concerns the following groups of people:

Self-employed persons can become members of private health insurance, regardless of their income.

Even civil servants have the choice between private and statutory health insurance.

Good earner with one Salary above the annual earnings limit (2019 at 60,750 euros annual gross).

During their studies, students have the opportunity – at least until the beginning of their employment – to switch to private health insurance.

Do not make this decision lightly, because you may be after that for many years tied to the chosen type of insurance. An obligation to change to private health insurance does not exist. It remains your free choice.

What distinguishes the health insurance models?

If you have the choice between legal and private health insurance, you should now at the very latest deal with what insurance means in one or the other model. over powerful private health insurance Members can flexibly protect themselves against most risks. The GKV offers only one basic protection. However, health insurance members can also secure better benefits through private supplementary health insurance.

Also important: The choice of the insurance model ultimately depends not only on price-performance considerations. The statutory health insurance is one Solidarity Social Security. High earners and people who rarely get sick, with their membership fees, ensure that low paid and insured, who often get sick, nevertheless a affordable basic health care can afford. If such considerations matter to you, you should stay in the SHI. Because in private health insurance, there is no corresponding principle of solidarity.

Individual benefits and premiums in private health insurance

An advantage of private health insurance is the individual tariff design. Desired services can be included in the insurance contract, services not required can be excluded. Especially younger and healthy people benefit from this relatively low premiums. In old age or in chronic diseases, however, the contributions can rise sharply. Because the Premiums, however, are not income-dependent, but by age and state of health, it may then become relatively expensive at low incomes.

Income-related contributions and basic security in the GKV

Quite different is the situation in the statutory health insurance. Here are the health insurance contributions always coupled to your own income. An excessive financial burden is thus excluded. In addition, there is a cost-effective way to insure the entire family with the family insurance in the GKV, without – as in the private health insurance – additional premiums. A disadvantage of the GKV are the sometimes incomplete services. Certain pension benefits and treatment methods are not covered. However, these gaps can be closed with private supplementary health insurance.

Tip: Contributions to health and long-term care insurance can be taken together with other pension costs be deducted as special expenses from income tax. However, a cap in the amount of the so-called basic health insurance applies. Contributions that you spend on additional services are therefore not deductible.

Extend protection with supplementary health insurance

If you want to stay in the statutory health insurance, but want additional protection, you can achieve this through supplementary health insurance. Such insurance can for individual health areas be completed. So there are for example:

Alternative health insurance with homeopathic and other alternative treatments,

Additional hospital insurances with which health insurance patients can secure a two- or one-bed room in the hospital or a treatment by the desired doctor,

Supplementary dental insurance, with which even higher quality dentures is reimbursed.

Think through the decision well

Before you delve into the tariff conditions of private insurance providers, you should consider whether the price-performance ratio of your public health insurance company is sufficient for you. If that is not the case, the next question would be whether you want an insurance tariff for everything and then switch from the GKV to the private health insurance. If you do not consider this step to be necessary, but still not completely satisfied with the conditions of your health insurance, you can firstly change the health insurance and secondly with private supplementary health insurance selectively improve your services.

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