Insurance Companies in Germany

Once a person receives a residence permit, they must join the health insurance system. Individuals residing in Germany, including all German citizens, are obliged to obtain health insurance.

Usually, the health insurance provider covers the costs of visiting doctors, hospital treatment, and medicines (often partial). In some cases, the health insurance system may take over the entire cost of medicines.

If the person is still at the stage of the asylum procedure or has received tolerant residence or other cases, information can be found in the "Healthcare for Refugees" section.

There, health options can also be found that can be used, in the absence of any papers.

Insurance Companies in Germany

Germany has more than 100 different health insurance companies. Some are public health insurance, others are private.

These two main types of insurance differ in terms of accessibility, the number of contributions, and benefits.

In principle, a health insurance company can be freely selected - knowing that there are some restrictions, but only in the case of private health insurance: private health insurance plans accept certain occupational groups (civil servants, self-employed people, students) and high-income people.

However, public health insurance plans are acceptable to all regardless of occupational group and income level.

Public and private Health Insurance

In the general health insurance system, health insurance contributions depend on the level of income, meaning that the higher the income, the higher the monthly insurance benefits.

Low-income people in public health insurance programs pay less. The idea behind the difference in contributions is that all members of society collectively bear the costs of health insurance.

A great advantage of public health insurance is that, under certain circumstances, a person can include his wife and children in his own health insurance system.

In the private health insurance system, the amount of health insurance subscription depends not on income level, but on insurance risk. Each individual's insurance risk is calculated on the basis of age, sex, pre-existing conditions, and lifestyle in part.

But it is safer to say that contributions to private health insurers are usually higher than general health insurance plans. This is why special patients are often treated preferentially.

for example, a doctor's appointment can be booked faster than others. Furthermore, specially insured individuals are entitled to more benefits than insured individuals in public insurance.

However, as a member of the private health insurance system, all costs of doctor visits and medicines must initially be paid in person - and the health insurance company will pay insurance later.

Whoever works in occupations associated with art or the media can apply for admission to the Social Security Fund for German Artists . If the application is accepted, fund is a market that covers half of the insurance contributions.

Most people in Germany are members of public health insurance programs. If the person is not sure which health insurance company is right for him, advice can be sought from the Consumer Protection Center.

Different insurance policies and their advantages or shortcomings can also be compared on www.krankenkassen.de.

website Each insurance company, whether private or public, offers various insurance programs. Some, cover the costs of glasses or alternative medicines, but others do not.

Note: Switching from private health insurance to general insurance is often very difficult, but almost impossible.

Before joining a private insurance system, you must carefully ascertain whether this is the right option.

Some doctors only recognize patients with special health insurance. These patients pay for their treatments directly to the doctor.

Members of the public health insurance system may have to look for a doctor who treats patients covered by the public health insurance .

Therefore, doctors can be found on the website of the German Medical Association . By entering the case and then clicking, you can also look for a doctor who speaks the language a person, masters.

If he cannot find a doctor who speaks his language, he can bring an interpreter.

Who pays for health insurance services?

People who are members of the public health insurance system, under certain circumstances, can also cover the costs of spouse and children at no additional fee.

This type of health insurance is called family health insurance. However, family insurance is available as an option only when the spouse/child has limited or no income.

It is better to ask the health insurance company how much we can earn to be able to benefit from family insurance. It is always better to communicate by writing all agreements are documented.

If any problem occurs later, it will be possible to provide proof of a potential claim and proof of rights.

In the case of children, age plays a crucial role: until the 18th birthday, children are always covered by the parents' general health insurance scheme.

Coverage will be extended until the 23rd birthday if children do not work.

Young individuals may also remain insured by family insurance until their 25th birthday when:

They go to school.
They participate in the vocational education program and have no income study.
Voluntary work of one year's duration (youth volunteering service abroad, voluntary social or environmental year).
Children with special needs are covered by their parents' general health insurance for life.

What costs are not covered by public health insurance?

Public health insurance companies do not pay for cosmetic surgeries, vaccines for private overseas trips, or medical treatments.

In principle, dentures are only partially covered, so it is useful to get the so-called (point book).

In this point book, the dentist confirms that the person underwent a regular examination (every six to twelve months).

If these assurances are collected in (the points book) over the years, the health insurance company will share the expenses when it comes to dentures.

The points book can be obtained from the dentist or from the health insurance company.
When staying in a hospital, 10 euros per day will be collected, and the health insurance system covers the rest of the medical expenses

Should I pay for the drug separately?

In principle, the patients must buy medications prescribed by the doctor from pharmacies. Paying for the drug separately or covered by health insurance depends on several factors:

People with private health insurance, initially have to pay for their medication themselves in the pharmacy.

After that, once the prescription is sent and the receipt to the health insurance company, they will receive the full amount.

For people who are members of a public health insurance system, the type of payment depends on whether the drug in question is a prescription drug.

Prescription medicines are medicines that can only be obtained if prescribed by a doctor.

For over-the-counter drugs, the doctor will give a green paper.

In principle, a person will have to pay for the full costs of any over-the-counter medicine he or she requests.

In the case of prescription drugs, a partial contribution should be made, meaning that a small portion of the price should be paid to the pharmacy. However, the cost ratio should not exceed 10 euros per drug.

Prescription drugs for children and adolescents are usually fully covered, meaning that a person does not have to pay anything in the pharmacy.

Note: There are limits to personal contributions when it comes to drug costs.

People who have spent more than 2% of their total annual income on indoor medicines and treatments will be exempt from additional fees for the remainder of the year.

Those who suffer from chronic illness and need multiple medications will be exempt from personal contributions once 1% of their total annual income is spent on medicines.

Once the cap is reached (1% or 2% of total annual income), an application can be submitted to the health insurance company to claim exemption from any additional payments for medicines for the rest of this year.

To do this, you must send, all relevant payment receipts and proof of income to the health insurance company. After reviewing the documents, the health insurance company will send an exemption certificate to the person concerned.

By showing this certificate to pharmacy employees, the holder will be exempted from the obligation to contribute personally. The exemption in question will be effective for the remainder of the year.

Do insurance companies cover the costs of psychotherapy?

In principle, health insurers also cover the costs of psychotherapy. However, members of the public health insurance system can only choose thera-pists-Accredited by health insurance companies.

When seeking appropriate treatment, attention can be paid to the keyword "health insurance approval".

To begin treatment, a doctor or psychotherapist must first make a so-called "suspected diagnosis".

This diagnosis will then be sent to the concerned health insurance company, which will then grant acceptance or refusal of treatment.

Can I move from one health insurance to another?

FBy 2023, it will be very easy to switch to another health insurance company. All you need to do is choose a new health insurance company and register there.

There is no need to even terminate the contract with the old health insurance company. However, this applies only if you switch from one legal health insurance to another.

However, if switch to private insurance or move abroad, you will have to cancel the old health insurance contract.

In principle, a health insurance company can be changed only after 12 months of membership. If you start a job with a new employer, you can also switch.

Regardless of whether the insurance contract is with the old health insurance company for 12 months or not.

If the health insurance company suddenly demands more money, the person concerned is entitled to the so-called (exceptionally termination right).

which means that the contract can be cancelled 12 months before membership and find appropriate new health insurance.

Note: Switching from a private health insurance company to a public health insurance company is often very difficult, but almost impossible.

So it is better to think about the potential outcomes well before applying for health insurance.

Where can I file a complaint if there is a problem with the insurance company?

When a health insurance company refuses to apply for membership or refuses to pay for a doctor's or medication visit, the independent patient counselling centers, can be contacted and complained about.

The call and consultation are free, knowing that the staff speak German, Arabic, Turkish and Russian. Members of a public insurance system can also contact and request assistance from the Federal Insurance Office or the Ministry of Social Affairs at their place of residence.

A complaint may also be filed with the health insurance supervisory authorities.

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