Statutory health insurance is part of the German one Social security system. It is compulsory insurance for the majority of employees in Germany. All employees whose gross income is less than EUR 4,162.50 per month or EUR 49,950 per year are compulsorily insured.
Spouses and children in training up to the age of 25 with an income of no more than 400 euros per month can be insured without additional contributions. Compulsory insurance Under certain conditions, voluntary membership is also possible for civil servants, freelancers and high-earning employees.
In the course of the health reform of 2007 it was determined that every person with residence or habitual residence in Germany must have health insurance. This compulsory insurance also applies retrospectively. According to § 175 SGB V, insured persons can choose their own health insurance company.
An allocation of the health insurance companies according to occupation, as was customary in the past, no longer takes place today. In principle, statutory health insurance must accept every customer. An exception are people who have passed the age of 55 and were previously not subject to compulsory insurance.
You can be refused admission. The insurance cover provided by statutory health insurers also applies in other EU countries and countries with which Germany has concluded a social security agreement. GKV: contribution Since January 1, 2009, health insurance companies can no longer set their own contributions. Instead, they must demand the contribution rate of the gross income of each insured person, which is uniformly prescribed by the federal government. Since July 1, 2005, this has no longer been financed equally.
Since January 1, 2011, employees have been paying 8.2 percentage points and employers 7.3 percentage points of the gross wage, so that the contribution rate is 14.915.5 percent of the income subject to contributions. If a fund operates successfully, contributions can be refunded. On the other hand, the health insurances can also demand additional monthly contributions – a social compensation should prevent excessive burdens for the individual.
Some health insurers also have special optional tariffs on offer, with which contributions are reimbursed if no services have been used. Billing is based on the benefit-in-kind principle. Doctors, clinics and other medical service providers settle the costs directly with the relevant health insurance company.
GKV: benefits A comparison of the many different health insurance companies has been very difficult since the introduction of the health insurance reform. Since 2009 the contribution rate ceased to be the main distinguishing criterion, the health insurance companies have tried to differentiate themselves from one another using other means. This is done through premium repayments, optional tariffs, bonus programs or additional services.
Around 95 percent of the health insurance benefits do not differ significantly because they offer uniform minimum benefits. This scope of benefits is stipulated in the Social Security Code and is covered by the health insurance company.
However, the health insurance companies have a certain amount of leeway when it comes to additional services. Some health insurance companies also offer preventive services such as preventive cures or health courses that are not included in the compulsory catalog.