The Things You Need to Know About German Health Insurance – If you’re moving to Germany, one of the very first things you need to do is purchase health insurance. As with many major bureaucratic institutions in the country, things like filing taxes, getting a visa, choosing the right bank, etc., it can be complicated and even frustrating for newly arrived expats to figure out just what the deal is with health insurance.
Lucky for you, me and the folks over at Siemens-Betriebskrankenkasse (SBK) are here to help, by not only providing a general overview of the German health care system, but also offering up insight on the five things you need to know about health insurance in Germany.
What You Need To Know About German Health Insurance
Germany has one of the very best healthcare systems in the entire world. Everyone contributes as much as they can individually and then benefits from coverage in the event of illness, accidents, and more. Although some gripe about what they feel is a high cost for health care, you’re protected when something happens and overall, this contributes to a high quality of life.
Before getting into the specifics, let’s first take a look at the German health system in general:
1) Health insurance covers things like illness, accident, unemployment, nursing care, and retirement.
2) Statutory health insurance providers in Germany are legally bound to insure everyone, regardless of their health, age, income, employment status, and more. You can also sign-up for any health insurance provider of your choice.
3) Most employees are covered by the social insurance system. You’re either a compulsory or a voluntary member – this depends on how much you earn. If you have a permanent position working for a company, they’ll take care of deducting health insurance fees from your salary every month. Your employer will pay for half of your total contribution, equalling 14.6% of your gross income. Providers usually charge another premium on top on this, equalling about 1.1% on average.
4) Freelancers and students also have to pay into health insurance, but can opt into different plans at an affordable price according to their income and other factors.
5) Family members without their own income can be co-insured at no extra cost.
6) You can choose from any medical provider of your choice – dentists, doctors, etc. that are authorized by statutory health insurance providers.
7) Once you’re insured, you’ll get an electronic health care card, which will cover things like doctor visits, prescriptions, and more. All you need to do is present it to your provider and they will automatically bill the health insurance company. No advance payments are needed, but in some cases, you may be required to make a co-payment. Examples include, prescriptions (€10 maximum) or hospital stays (€10 per day).
8) If you’re sick and need to miss work, your wages will continue to be paid by your employer for up to six weeks (provided the employment relationship has continued for four weeks without interruption). After this, your provider will take over and pay sick benefits until you’ve recovered, up to a maximum of 1.5 years.
9) Your health insurance is valid in Germany and the rest of the European Union.
What else you do you need to know about health insurance?
1) Compulsory vs Voluntary Insurance
- Compulsory Insurance – By law, German companies are mandated to offer their employees health care protection in order to help ensure their ability to work. For most, this comes through compulsory insurance which comes into effect as soon as you start work. Exceptions to this include marginal or short-term employment, which falls under a different kind of healthcare protection. Employers will calculate your social insurance contributions based on your income and then transfer mandatory payments for health, nursing care, pension, accident, and unemployment insurance to the relevant parties on your behalf. As a compulsory insured employee, you need to choose a healthcare provider within 14 days of starting your job, notifying your employer accordingly. Once you’ve registered, you’ll be sent a certificate of membership which you need to provide to your employer within this same time period.
- Voluntary Insurance – If your income exceeds €57, 600 per year, you can be accepted into a health insurance as a voluntary member with the exact same services provided under compulsory insurance. To activate this coverage, apply for the voluntary insurance with your health insurance provider within three months after you start employment. When you’ve received your certificate of membership, simply provide this to your employer.
2) The Power of Your Health Card
All services covered by your health insurance can be paid using an electronic healthcare card. You’ll receive this card by mail as soon as your membership begins. To begin using it, sign it, and present to as needed such as when you visit a doctor, buy prescriptions, visit the hospital, and more. This card will ensure that you’ll receive treatment on the spot. As mentioned above, service providers will bill the health insurance company directly without any cost to you. Exceptions occur, such as when you need to co-pay on a prescription for example. Deductibles range from €5-10.
3) Your Choice of Services Providers
One of the best parts of the German healthcare system is that you are free to choose which dentist, doctor, hospital etc you want to visit. You just need to ensure beforehand that they’re authorized by statutory healthcare provides to claim payment for covered treatments. If you happen to choose an unauthorized provider, you’ll be responsible for those costs yourself.
4) When You Get Sick
If you’re not feeling well and are down and out with a bad cold or flu, you may need to stay home in order to rest and not spread your sickness to your fellow colleagues. Usually if you miss only one day, you can call or email your employer without any further action. Definitely check into your employer’s policy on sick days for more information. However, if you’re going to miss three or more consecutive days from work, you’ll need a doctor’s note to present to your company, as well as the insurance company. Your insurance company will cover those days that you’re sick. If you cannot work as a result of a self-inflicted through grossly negligent behaviour, your employee will pay your salary for a maximum of six weeks so long as your contract has lasted for at least four weeks without any interruption and you’ve been unable to work during the previous six months as a result of the same condition. After this time has passed and you’re still unable to work, health insurance will cover you up to 1.5 years. The amount of sick benefits paid is based on your current salary.
Good to Know: When your doctor gives you a sick note, you’ll be provided with three copies. One is for you, another is for your your employer, and the last one is for your insurance company (which you can either send electronically or by mail). Your exact condition or diagnosis will not be specified on this paper, so your employer will only know that you’re unable to work.
5) Other Health Insurance Perks
Here’s some over various benefits that come from having health insurance in Germany:
1) Family members (spouse and children) without an income of their own can be covered by family insurance at no added cost.
2) Many other services may also be covered such as dental checkups (not cleanings), vaccinations, breast exams, skin cancer screenings, massages, walking aids like insoles, and more. Coverage of these services vary by provider, so check with them beforehand whether or not it’s covered by health insurance so you’re not stuck with a bill.
3) If you’re starting a family, some providers will even pay for additional pregnancy check-ups, midwife on-call services, and antenatal and involution classes. You can even choose where to give birth with support from your provider, be it a hospital, birthing center, or at home. In some cases, home care and household help can also be covered. As this varies by health insurance provider, get in contact with them for more details.
… and there’s even more benefits too numerous to mention.
Why We Recommend SBK
What makes SBK different from other health insurance providers in Germany?
1) SBK offers personal consultants to advise you on healthcare insurance offerings and other details, like family planning, locating a specialist, making appointments with them on your behalf, etc.
2) If it takes you a while to bring your German language up to speed, you can communicate with them in English.
3) SBK provides services that other healthcare providers do not like locating doctors close to home or work, enhanced pregnancy and childcare coverage, and more.
4) They’re the recipients of multiple industry awards and top ratings from their customers.
5) SBK has a Bonus Scheme where you’re rewarded for preventative services like dental and health checkups and gym memberships. These health conscious behaviours will be credited to you year after year. There’s also a Retention Tarid, which you can profit from financially if you rarely visit your doctor or dentist beyond regular checkups. The tariff usually runs three years and after one calendar year, you’ll receive an option for a reduced premium depending on how often you’ve used SBK services.
6) Visit the Siemens-Betriebskrankenkasse (SBK) website for more information.
If you like this guide to German health insurance, check out some of our other posts about living in Berlin – The Most Detailed (And Free!) Moving To Berlin Guide Out There and How To Make Friends In Berlin In 2021.