The majority of Germans are insured through statutory health insurance (GKV). Employees with a gross annual salary under €52,200, or €4350 per month, are obliged to enter the GKV scheme. The monthly rate is currently 15.5% of gross income. The maximum contribution is €610 per month. The employee pays 53% of the monthly contribution, and the employer the remaining 47%. Contributions remain the same even if your gross annual income lies significantly above the threshold of €50,850. This is one of the advantages of the German system. Students too, are required to take out health insurance, though they pay only €77 per month.
Once every quarter, a practice fee of €10 is required from the patient upon their first visit to a doctor or dentist. In addition, €5-10 are charged per prescription for medication, and €10 daily for the first 28 days of a hospital stay (if you were hospitalised due to an accident, this fee does not apply).
The most important advantage of the GKV is that non-working kin (e.g. spouse or children) living at the same residence, are likewise insured in Germany at no further cost. Many people have themselves and their families insured though the GKV and take out additional private insurance. This might, for instance, cover costs for homeopathic or alternative treatment, single rooms in hospitals, or more extensive dental care.
All GKV providers in Germany are self-governing statutory corporations; they represent the statutory health insurance. Some are large corporations with millions of members (e.g. AOK, BEK, DAK); others only have a few thousand (many guild and company health funds). But that does not mean that their basic services differ, as all GKV providers are obliged to follow the statutory provisions. Should your statutory health insurance provider increase your contributions, you can terminate your membership giving two months’ notice and move to another. The minimum term of membership is 18 months.
If your gross annual income is above €50,850, you can take out private health insurance. There are about 50 German insurance companies offering different services. Contributions depend on the services chosen, age and sex, and any previous illnesses.
In general, contributions charged by private funds to people over 40 are higher than those of statutory funds. (However, it is possible to lower contributions by opting for a higher excess.) Also note that separate contributions must be paid for all family members, unlike in the state system, which automatically insures non-working family members. Contributions are gradually increased depending on the current situation; the level of the initial payments is defined by your age at joining.
Private health insurance providers cover the costs of a variety of medical and dental treatments in Germany and abroad. With private insurance, you can usually count on preferential treatment when visiting a doctor or dentist, who will take more time and give you an earlier appointment. Private patients are welcomed by doctors and hospitals, who depend on them to a degree in order to raise their income.
Although most patients choose a doctor whose practice is near their home or workplace, it is a good idea to ask friends and acquaintances for recommendations – doctors’ personalities and working methods can vary widely. Keep in mind that the German system does not tie you to a specific doctor. If you are unsatisfied, you can change doctors at any time and even have the same condition treated by another doctor, should you think the first doctor’s treatment insufficient.
With most health problems it is advisable to visit a general practitioner first and only then to seek treatment from a specialist – should your general practitioner think this necessary. You will then be given a referral and, in many cases, recommendations for relevant specialists. Some doctors only treat private patients. This means that a patient with statutory insurance must look elsewhere or bear all costs for the treatment.
Almost all medication you may need is available through your pharmacy. Even non-prescription medications are usually available only in pharmacies. Vitamins and similar health products can also be found in supermarkets or at a chemist’s.
If you are insured through the GKV, the cost of medication is in the great majority of cases covered by the fund. Depending on how expensive the medication is you will, however, have to pay a €5-10 fee. Prescription medications are free for children.
If your pharmacy does not have the required medication in stock, you can usually order it for the next day; sometimes it can even be obtained on the same day. Pharmacies are generally open until 6.30pm.
You can also collect prescriptions outside business hours through the pharmacy emergency service. Pharmacies take turns to be on emergency standby; a schedule in the window will inform you which pharmacy will be on duty when
When you have found the duty pharmacy, ring the bell and a pharmacist or assistant will serve you over a narrow counter near the door (doors are usually kept locked outside opening hours). This service is useful for minor complaints such as headaches, hangovers or upset stomachs. However, you can also collect prescriptions if you have been busy during the day (assuming that the pharmacy has the medication in stock). Statutory health insurance funds will usually also cover the cost of prescription-only generic drugs, though the surcharge already mentioned applies.