Das Gesundheitssystem in Deutschland

http://www.justlanded.com/english/Germany/Germany-Guide/Health/Health-insurance

http://www.youtube.com/watch?v=jvHFeGZwFoQ

Wer (who) muss sich versichern?

• Since 2007 mandatory for everybody living in Germany

Wer (who) bezahlt? •Health insurance contributions are split 50-50 between employers and employees

• Students are offered special student insurance schemes with favorable rates.Under 25 years of age usally insured for free throug the parents insurance. At 25 years of age or older has to be insured individually, cost are 53,40 Euros per month

Staatliche vs Private Krankenversicherung

State health insurance • run by the German government (but not a monopoly)• provided by a network of non-profit companies working with

the state to administer the national health program ( Gesetzliche Krankenkassen). Some of the most popular ones include the TK, AOK and BEK.

Private health insurance • can be chosen in some specific cases• offers more extensive coverage, but is not automatically an

advantage for all cases.

Contributions State and private insurance work on completely different contribution

models

• State health insurance contributions are based on your gross income (14,9% with an income cap). If you have a high income, it might therefore be cheaper to opt for a private insurance policy. Students can use a special insurance scheme that offers favorable rates.

• Private health insurance contributions are based on your risk profile, not on your income. For example, women and older people generally pay higher contributions than young men. This is due to a calculation of the average cost for medical treatment for different groups. The older you are, the less attractive it thus becomes to opt for a private insurance.

Sample paycheck Praxisgebuehr

The “doctors fee” has to be paid for a 3 month period. So if you go to the doctor in January then you don’t have to pay again if you go to the doctor in February or March. But you have to pay again if you go in April. Jan - March = € 10April - June = € 10July - Sept = € 10Oct - Dec = € 10

State health insurance systemYou only pay a nominal fee for treatments and medicines as these are directly paid for by your insurance company

• Medical and dental treatment, with free choice of doctors and dentists • Hospital treatment • Drugs, complementary treatment, and aids such as hearing aids and wheelchairs • Sickness benefit (Krankengeld)

Normally, your employer will continue to pay your wage or salary for six weeks if you are unable to work. After that your health insurance would pay 70 per cent of your regular wage or salary before deductions for a maximum of 78 weeks

• Measures for the prevention and early detection of certain diseases • Preventive dentistry• Orthodontic treatment, normally only up to the age of 18.

In the following cases, you will have to an additional contribution to treatments and medicines :• The cost of dentures (50% of medically required treatment). • A share in the cost of in-patient preventive treatment and rehabilitation, out-patient

rehabilitation, and in-patient hospital care (€10/day for a maximum of 28 days) • 10% of the cost of prescription drugs, minimum €5 and maximum €10. • If your income is below a certain level, you can be exempted from these additional payments.

State health insurance also insures your family at no extra charge! Your spouse or civil partner and, up to a certain age, your children are covered by your insurance, provided among other things that their collective income does not exceed € 345 a month and they do not have their own insurance (figures for 2005).

Private insurance system You pay doctor's fees and medicine costs and send receipts to your insurance company for reimbursement.

• Option of private/semi-private hospitals• Alternative therapies such as acupuncture and herbal treatments• Glasses and contact lenses and other treatment that may not be

available under the state scheme. • At the doctor, you will often be treated preferentially compared to

state insured patients.• Private insurances don't expect you to pay any additional co-

payments (Zusatzzahlungen) for medicines and treatment as in the state scheme

• However, some private insurance policies offer you the option of a (Selbstbehalt), which means that for each case of illness part of the cost is paid by you up to a certain amount per year. On the upside, the insurance company will lower your contributions if you go for this option.

Versicherungskarte Your insurance company will issue you a health insurance card, which you have to take with you whenever

you visit a doctor, dentist or specialist

Helpful to know• Dial 110 to reach the Police• Dial 112 to reach Fire Brigade & Ambulance• For medication go to the Apotheke• If you urgently need medication, the pharmacy

emergency section (Apotheken-Notdienst) in local newspapers gives the addresses of the pharmacies

open outside normal hours. You can also visit any local pharmacy, which will list the address of the closest open Notdienst in the window or on the door.

http://www.youtube.com/watch?v=AR0d1BrhIMk

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