Health insurance in Germany. The health insurance system in Germany is unique, with both statutory and private health insurance coexisting, a distinction uncommon in other European countries. There are noteworthy bonus programs that everyone should be aware of. While the private health insurance option may seem appealing, offering shorter waiting times for doctor appointments, it’s important to note that not everyone is eligible to switch.
According to Finanztip.de, only civil servants, self-employed individuals, students, and employees earning above the annual salary limit, which was 66,600 euros gross per year in 2023, are allowed to opt for private insurance.
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Private health insurance
For over two decades, there has been ongoing discourse about eliminating current health insurance structures and implementing a unified health insurance system. However, as of February 26, 2024, a resolution is not yet evident. On a separate note, changes in tax classes might be on the horizon. What are the arguments in favour of private health insurance, and what are the counterarguments? Various pros and cons exist in this discussion.
Advantages of private health insurance
For civil servants, switching to private health insurance often makes financial sense, as their employer covers 50 percent of treatment costs. Opting for private health insurance is advantageous for the remaining costs. Stiftung Warentest explains that civil servants would have to bear the entire premium for statutory health insurance themselves. Only a few selected federal states offer a subsidy for statutory insurance for civil servants.
In contrast to statutory health insurance, those with private coverage typically experience shorter waiting times for doctor appointments. According to Finanztip.de, they usually receive treatment twice as quickly. A well-structured contract ensures that privately insured individuals have access to high-quality medical care and special treatments, even abroad. Moreover, private health insurance contracts can be tailored to include specific services that cannot be waived.
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Disadvantages of private health insurance
Unlike statutory health insurance, private health insurance companies have the discretion to reject individuals, even if they meet the fundamental requirements mentioned earlier. This can occur, for instance, if a person has a pre-existing illness. Private institutes often attract young people with low fees, but costs may increase significantly with age, a crucial consideration.
Moreover, unlike statutory health insurance, children cannot be insured for free under private plans. Dependents without income, such as children and non-working life partners, require separate contracts with contributions. It’s important to note that medical bills need to be paid out-of-pocket, with reimbursement taking up to four weeks, a potential financial challenge depending on the treatment.
The idea of taking advantage of potentially lower premiums with private insurance while young and then switching back to statutory health insurance as you age may seem appealing. However, this plan is not feasible due to specific conditions. Firstly, you must be under 55 years old, and your salary must not exceed the applicable limit, which was 69,300 euros gross per year in 2024. Those who were already privately insured as employees on December 31, 2002, have a lower limit of currently 62,100 euros, as explained by the consumer advice center.