Public v. Private

Germany has a universal multi-payer system with two main types of health insurance:
State health insurance - (Gesetzliche Krankenversicherung) Known as sickness funds, about 85 percent of the population is covered by the basic health insurance plan provided by the government.
Private - (Private Krankenversicherung) - some people, including many expats, are not eligible for state care and must purchase private insurance. This may offer lower payments, or expanded benefits.

Public Insurance

All salaried employees must have public health insurance. Only public officers, self-employed people and employees with a large income (above 50,000 euro), may join the private system.

The premium is set by the Federal Ministry of Health based on a fixed set of covered services. This is dictated by German Social Law (Sozialgesetzbuch - SGB), which limits those services to "economically viable, sufficient, necessary and meaningful services". Premiums are not dependent on an individual's health condition, but a percentage of salaried income (typically 10-15 percent, depending on the public health insurance company one is in, where half of that is paid by the employer). It may include family members (Familienversicherung) in which husband/wife and children are free.

Private Insurance

Within the private system, the premium is based on an individual agreement between the insurance company and the insured person defining the set of covered services and the percentage of coverage. The premiums depend on the amount of services chosen and the person's risk and age of entry into the plan. German insurance is required for foreigners applying for visas.

Self-employed individuals need to organize a private insurance scheme. A person who opts out of the public health insurance system and gets private health insurance cannot go back to the public system. Private health insurance is usually more expensive.

The European Health Insurance Card

The European Health Insurance Card allows access to medical assistance for EU citizens traveling to another Member State. It also expedites reimbursement of expenses.

The European Health Insurance Card is issued to:
• EU nationals
• Nationals of the European Economic Area (EEA)
• Swiss nationals
• Family members of the above, whatever their nationality
• Nationals of other countries, who are covered by a social security system in one of the Member States of the EU, the EEA or Switzerland

The pocket-sized plastic card contains basic information such as the card holder's name and surname and date of birth, but no medical details. It is easy to use as it has a gold chip that contains complete medical history and records.

The card can be used at any kind of health service, like a general practitioner, a hospital or a pharmacy. When the need for healthcare arises, treatment will be provided according to the rules of that particular country (for example if healthcare is free of charge in that Member State, the visiting patient will also be entitled to free medical care when presenting his/her European Health Insurance Card). It is not permissible to use it if the patient intentionally decides to obtain medical treatment abroad.

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