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The Simplest Way to Understand German Health Insurance ✅

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Life in Germany

Life in Germany

Күн бұрын

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@ThamiorSilberdrache
@ThamiorSilberdrache Жыл бұрын
Ok, as a former employee of a german private health insurance company I have to add some things here. First: You are right that you are gonna be backcharged, but "only" to a maximum of two years (which of course still is nearly 24K €). At least it was that way back than. That might have changed. Second: Private Health Insurance companies don't have to take you unless you are an official or public servant. And they will only take you if you are perfectly healthy. If you have the slightest health problem, they will charge you a lot more or even refuse to insure you at all. Same goes if you have a job or a hobby that might be dangerous to your health. Third: The biggest difference between public and statutory health insurance was partly mentoined by you, but you didn't point out that very clearly. You said that public health insurance charge you a percentage of your income, but you might have stressed the point that private health insurance does not work that way. They have a fixed price. And in many cases that price is notably smaller than what you might pay in public health insurance if you earn above average. So it is very tempting for many to switch to private health insurance. BUT: You might want to think that through before you do that as you cannot simply switch back to public later on. In fact it is not impossible, but it takes a lot of effort and might even cost you a lot, depending which of the few loopholes in the system you use. So, what is the big "but" with private insurance? Well, once you stop to be happy about the very cheap offer the private health insurance gave you, think about it. You will have to pay that price under any circumstances. If you lose your job and are unemployed you'll only have to pay the minimum amount for public health insurance or the employment office might even pay for you, but the proce for private health insurance won't drop and the employment office will only pay if you switch into a special tariff that every private company has to offer for that cases but that is worse than public health insurance while being more expansive and from which you maybe won't be able to switch back once you get a job again. You'll also have to pay full price for private health insurance once you get retirement pensions unless you pay for a special additional insurance ("Altersrückstellungen") that makes your health insurance a little cheaper later on. And, of course, if you intend to start a family: In public health insurance there is the so-called "Familienversicherung": You don't have to pay for your children, they run on your insurance. If your partner doesn't work or only earns a certain amount of money under a certain threshold, he or she will be covered too by your insurance. That is totally not the case in private health insurance. They may cover babies up to a certain age, but you'll have to pay extra for every children above that age and for your partner. As a conclusion: After working for a private health insurance company I can assure you that I'll NEVER switch to any of them and stay in the statutory/public health insurance! There is only a hand full of cases in which the private insurance system is realy cheaper or better. But you might consider some supplementary insurances adding to your public health insurance, such as dental insurances that cover cases where the public insurance doesn't pay (full).
@LaureninGermany
@LaureninGermany Жыл бұрын
Wow, thank you for all this information. I was wondering if I was missing out, but I definitely am not!
@njordholm
@njordholm Жыл бұрын
Well costs are only one aspect. Try to get an appointment with specialized doctors with public health insurance. Some simply don't accept new patients at all as they are already crowded with non-critical standard check-ups etc., some give you an appointment in months (even if it is categorized urgent), some almost even a year if you go there directly. Some have 2 hotlines. The hotline for public health insurance is never picking up calls. The one for private insurance is picked up immediately and you get an appointment within the next day. My mon recently needed an appointment with a dermatologist for urgent needs (got an referral from family doctor), who had not the special equipment needed to investigate and treat the issue. She ended up making an appointment with a private doctor (not covered by public health insurance), paying the bill herself, as she was in pain and wasn't able to do her job anymore and to keep up care of family/household. Right before, we tried the physicians association hotline to make an appointment for us. The next available dermatologist accepting an appointment was 200+km away. If this 2 class system wouldn't be that sad, I would say it's a joke.
@jennyh4025
@jennyh4025 Жыл бұрын
Thank you for this information! I assumed/remembered the gist of it, but I couldn’t quite remember why I never wanted to switch and suggested to friends and colleagues to look into things carefully (and think about a time in a few decades) before switching to private health insurance.
@ThamiorSilberdrache
@ThamiorSilberdrache Жыл бұрын
@@njordholm Well, there are also doctors who don't accept private patients like my father-in-law. He says although he could charge up to three times the money, it isn't worth the trouble for him. As with public insurance patients he only makes his quarterly accounting run with the "Kassenärztliche Vereinigung" and simply gets his money while he has to write a bill for every single private patient and if they don't pay immediately he has to write reminders and sometimes even doesn't get the money at all unless he goes to court... But yes, most times it is easier to get an appointment if you have private insurance. Notable: Sometimes in cases like the one you describe, the public health insurance might even cover the costs (up to the normal price for public health insurance patients) for private only doctors if you describe your case, but that is goodwill and nothing you can rely on. It still might be worth asking.
@njordholm
@njordholm Жыл бұрын
@@ThamiorSilberdrache Yeah, that's why I choose 'some' to describe. There are 'always' good examples to a certain matter.
@omadduxo
@omadduxo Жыл бұрын
What people often don't understand is that the public health insurance in Germany isn't like universal healthcare in other countries. All health insurances in Germany is private but we differ between for-profite private (the classic private HI) and non-profite private (public HI). The non-profite HIs just operate under a more strict rulebook than the for-profite HIs are but in return get other benefits.
@gerohubner5101
@gerohubner5101 Жыл бұрын
You're completely mistaken. Public health insurance in Germany is by law (SGB V) handled by public corporations governed by public law, never by private companies. Please avoid commenting on issues that you don't understand yourself.
@njordholm
@njordholm Жыл бұрын
​@@gerohubner5101 Well said, just wanted to correct the initial commentary as well, but I have found yours and have nothing other to say.
@T0MT0Mmmmy
@T0MT0Mmmmy Жыл бұрын
Important points of privat healthcare PKV in Germany: It is cheaper than the solitary GKV when you are young, but will be much more expensive than the GKV when you are old. Because the fees of the PKV are adapted to your actual health and when you are getting older you will be not so much healthy any more. Whereas the fees in the GKV will be all life through an affordable percentage of your income. And you can't change back to the GKV once you have been in the PKV, Because it would be a scam for the solitary GKV, no cherry picking.
@Dueruemtarget
@Dueruemtarget Жыл бұрын
That is not completely correct. You can change back to GKV, but this only possible if you are not 55 years old.
@Dahrenhorst
@Dahrenhorst Жыл бұрын
@@Dueruemtarget Exactly, because at that time you'll realize, that private health insurance will become very, very expensive when you get older, and then it's to late to change (evil laughter ...). Additionally, you probably need to change your job, since you need a job where you are subjected to public health insurance by law to be able to switch from private to public health care - but this workaround to go back to public health insurance is closed at your 55th birthday for good.
@wernerruf7761
@wernerruf7761 Жыл бұрын
@@Dueruemtarget And only idiots wait that long, because they missed an important point in time. In order to be a member of the GKV for pensioners, you have to have been a member of the GKV for at least 9/10 of the last half of your working life, and that is extremely important. When you are in there, you pay the contributions for health insurance and long-term care insurance, based on what you receive in the form of a pension and any supplementary benefits from your employer. If you missed that, you pay up to the assessment limit for all types of income you have, interest, dividends, rental income, etc., small subtle difference. People with brains would rather just pay taxes on it. Preferably only 25% capital gains tax, because people with brains don't pay church taxes.
@gerohubner5101
@gerohubner5101 Жыл бұрын
​@@Dueruemtarget Also not correct. The prerequesites are more complex, but your general statement is wrong.
@thorstenbrandenburg4338
@thorstenbrandenburg4338 Жыл бұрын
@@Dueruemtarget and your status changes. If your status, being eligible for the private insurance, does not change, you cannot opt out and go back to the public insurance.
@JustAnotherMe
@JustAnotherMe Жыл бұрын
Just a FYI, in the sponsored ad you mentioned "They also speak English, German, Italian, Spanish and Hindu". The language is called Hindi. Hindu, is a religion.
@lifeingermany_
@lifeingermany_ Жыл бұрын
Wow! I didn't even catch myself saying that after the 5-8 times I rewatched it after post-production! Please accept my apology! 💛
@winterlinde5395
@winterlinde5395 Жыл бұрын
But children are usually included without paying more in the public health insurance (Familienversicherung). Only if one of the parents goes private to save money and the other public the public will have questions.
@manub.3847
@manub.3847 Жыл бұрын
In the past, the children had to be insured with the person in the private health insurance, today they can also be insured with the parent in the statutory health insurance. . And if you default in payment and ignore the reminders for a mandatory health insurance company, it can also happen that an account is garnished.
@winterlinde5395
@winterlinde5395 Жыл бұрын
@@manub.3847 ach! That’s how old I am!😒😃
@tasminoben686
@tasminoben686 Жыл бұрын
🤗
@winterlinde5395
@winterlinde5395 Жыл бұрын
@@tasminoben686 Ben!!! Moin!!!😃👋
@mwexpatsolutionservicesgmb1213
@mwexpatsolutionservicesgmb1213 Жыл бұрын
Thank you for starting that topic. We just would like to add some additional information which might be interesting :) Statutory health insurance is good coverage in Germany. Especially for families with 2 children statutory health insurance is like an all-round carefree insurance cover for the time you live in Germany. That’s why the price of over 970 euros/month is justified (income over 59,850 euros). Particularly for small children, who might need to go to the doctor more often, it is a good insurance cover with a manageable deductible. However, this means, that for singles or couples it can be worth comparing private insurance options. If you are planning on staying in Germany for a longer time, this can be a great solution - especially, when you already know that you won’t live in Germany as a pensioner. In that case, the private premium offers better benefits at a fair price. Expats in Germany therefore have a big advantage over German policyholders. A comparison is particularly worthwhile for expats.
@erikweber8514
@erikweber8514 Жыл бұрын
PKV just still exists because for Beamte it is the states choosen insurance. If the the state of Germany (or one of its Länder) decides to send all new Beamte into GKV, PKV will be dead, probably. Dont worry, this will not happen. Because its much cheaper to insure Beamte by PKV, instead of GKV.
@TheyCalledMeT
@TheyCalledMeT Жыл бұрын
very short answer .. you can't not pay. even self employed you're mandated to have it and when you get behind with payments .. you have to pay it later edit: as pointed out in the video, just with bette english words ^^
@bearenkindercool
@bearenkindercool Жыл бұрын
sorry to put my comment on another video below this great post. i put it in backets, so you can skip, as you like. (​ @Life in Germany you as a family do not have to justify why you stay in nrw. it might be an option when kids are out and live their lives, any other year. it comes to you both then, you/husband to think about. i myself can only say that i would help for your umzug, as well as anything else. you do a terrific job here, and i do not know anybody who doesn`t love you. go and get your candy.) i couldn`t get it done on your other statement, pls. don't be mad i put it on here... bavaria is calling 🙂
@Anson_AKB
@Anson_AKB Жыл бұрын
switching from one insurance to another is possible in general, but as soon as you once are in ANY private insurance, there are quite some conditions to "go public" afterwards. thus think twice before you choose a private insurance. private may have some additional options, but you have to pay most things first yourself and then have to get it back later from the insurance. on public insurance i only show my card and pay at most a very little copay (mostly around 5€ to 10€, eg for any prescription drugs), private may be somewhat cheaper for young people, but becomes increasingly more costly with higher age, and approaching or even reaching the age of pensioners it is much more costly and may virtually be impossible to "go public" any longer. worth a consideration if you intend to really stay in germany for a long time or forever. i am in a public insurance and have no problems with those conditions, still getting appointments for important things in time, or having a room with 2-4 beds in hospital (and if available, i could even have paid a bit extra, under 100€ per day, to get a 1-2 bed room, which i didn't want anyway)
@hellkitty1442
@hellkitty1442 Жыл бұрын
You could actually get an additional insurance for little money to cover some differences between private and public insurance. For example teeth, hospitalization (1-bed-room or chief doctor treatment etc.), ... You can just add that or leave it out, depending on what is important to you. So just to have some benefits, you don't have to go private.
@mwexpatsolutionservicesgmb1213
@mwexpatsolutionservicesgmb1213 Жыл бұрын
Thank you for commenting, we appreciate lively discussions and we would like to add something: After the insurance cover has been taken over by the private health insurance, there are not allowed to increase the premium because of a deterioration in health. Every customer of a PKV thus has a guaranteed benefit during his/her insurance period in Germany; a reduction of included benefits is not possible. Good to know: Premium increases also take place in private health insurance. Medical progress and inflation have to be factored in. However, this also applies to statutory health insurance, which not only adjusts premiums, but can also reduce or cancel benefits at any time. This cannot happen with private health insurance. Also: With private health insurance, benefits and premiums can be determined flexibly. The tariffs allow the expat to choose the price up to a certain level. The more benefits, the more expensive.
@filipegrieb-dunlap5625
@filipegrieb-dunlap5625 Жыл бұрын
You forgot to mention the pitfall of private insurance that the premiums arn't tied to your income and will significantly increase the older and/or sicker you get. The doctoes who don't take GKV patients are only in for it for the money and are no better than the other doctors.
@jennyh4025
@jennyh4025 Жыл бұрын
Or because they don’t get approved by the board of the Kassenärztliche Vereinigung or no „place“ is free for them where they want to practice.
@mwexpatsolutionservicesgmb1213
@mwexpatsolutionservicesgmb1213 Жыл бұрын
Thank you Filipe, there seems to be a misunderstanding: After the insurance cover has been taken over by the private health insurance, there are not allowed to increase the premium because of a deterioration in health. Every customer of a PKV thus has a guaranteed benefit during his/her insurance period in Germany; a reduction of included benefits is not possible. Good to know: Premium increases also take place in private health insurance. Medical progress and inflation have to be factored in. However, this also applies to statutory health insurance, which not only adjusts premiums, but can also reduce or cancel benefits at any time. This cannot happen with private health insurance.
@javednoor832
@javednoor832 Жыл бұрын
That's great
@MrMojo271
@MrMojo271 Жыл бұрын
1000€ per month? I pay less than half in the US.
@reinhard8053
@reinhard8053 Жыл бұрын
That is the maximum if you earn well and the employer pays half of it. Otherwise it's less. I find €728 max. for the employe. And how much do you need to pay for visits, treatments, operations in the US ?
@arsfwb
@arsfwb Жыл бұрын
First excuse my bad english, pls I think it is true, but.... - is your wife (if she has no job) included in your insurance? - are your children included in your insurance? - can you choose the doctor you want, or must you visit the doctor your insurance tell you? - how much you pay for a day in hospital? in germany you pay 10 Euro/day for food and so on.... I think you can't just compare the monthly costs
@SirHaviland
@SirHaviland Жыл бұрын
That's the maximum rate for people who don't fall into any category. Usually you pay maybe 200 up to 400 Euro. And you don't have to fear that you get a bill over 20.000 Euro nevertheless because one of the doctors who touched you didn't have a contract with your insurance company... that's clearly regulated.
@wernerruf7761
@wernerruf7761 Жыл бұрын
Another smart guy comparing apples to oranges! Let's ask, your health insurance in the USA also covers every visit to the doctor, every ambulance, every hospital stay, every due date, prenatal care and aftercare, all aids without co-payment/personal contribution or without co-payment/personal contribution that exceeds 10 euros? Or do you not pay anything in the USA, the costs add up very quickly. OK, I want to be honest, we also have to pay in the hospital or for rehabilitation measures. In the hospital 10 euros a day for a maximum of 28 days a year, that used to be better when it was only 18 days. For rehabilitation measures, 10 euros for a maximum of 42 days per year, with a maximum of 14 days for rehabilitation measures following a stay in the clinic. If I look at the posts of some expats, a single visit to the doctor is more expensive in the USA. It should be noted that the 10 euros are usury, a professional or temporary soldier only has to pay 9.60 euros when they are obliged to take part in communal catering and a person doing military service is paid the same amount if he is not in the barracks over the weekend. The fact that that's 0.40 cents more is a bottomless cheek, especially since I can get by with less money at home. Only idiots have an ornamental garden where you can also grow lettuce, vegetables and fruit. "Branded products" for milk, yogurt, butter, etc. only buy idiots, 3.5 percent milk is still 3.5 percent milk. It doesn't matter whether it's in the overpriced box of a "brand manufacturer" or in the house brand of a discounter like Aldi or Lidl. The same applies to butter, what can be called butter is defined throughout the EU and if it says (German) table butter in Germany or tea butter in Austria, it is always the highest quality level, why should you be so stupid and buy an overpriced branded product? Can you continue with medium-hot mustard, when I was a student I worked for a manufacturer who also produced for Aldi, exactly the same goo was bottled for Aldi and their own brand, only the glass was thinner and shaped differently. Not to forget there was a small difference, at Aldi the glass with the same filling cost either 0.59 or 0.69 German marks, the branded product had a mark more at the front, a little brazen to exploit the stupidity of others and just like that asking more than twice what it's actually worth. Back to the health care system and health insurance, because the system in the US is so great, that's why the infant mortality rate is on par with developing countries, or even worse than in some of them. Whether that has something to do with the "minor" co-payments for every doctor's visit or hospital stay in the USA? Apart from those who don't have any health insurance because they can't afford it. Incidentally, you do not pay 1000 euros health insurance in Germany, you only pay if you earn 66,600 euros (monthly 5,550 euros) gross or more. And only if you are self-employed, in the case of employees, the employer pays half of the contributions for health insurance, nursing care insurance, pension fund, if necessary for a supplementary pension. In addition, the employer continues to pay wages for six weeks (for the same illness), followed by 72 weeks of sick pay amounting to 90% of the net income from the GKV. In addition, there is four weeks of statutory minimum vacation, usually six weeks with a collective agreement, and if a severe disability of at least 50% is present, there is one more week of vacation, which is even more difficult to cancel. Then there are per parent and child under the age of 12, if they fall ill and have to be cared for, either 30 days of continued wages or sickness benefit from the GKV, for single parents this increases to 60 days. Not to forget, if children are still in training, then they are also insured in the family insurance from the age of 18 to their 25th birthday. The same applies to a partner who is stupid enough to stay at home because of the children and therefore has no income of his own and is therefore not entitled to his own old-age pension. If the pensioner dies, that can get pretty tight. The survivor's pension accounts for only 55 percent. In addition, employees can claim 1900 euros and self-employed persons 2800 euros in the tax return. Which obviously does not compensate for the additional costs for the self-employed. It makes sense to found a UG (limited liability company) or a limited liability company as a self-employed person, also to protect your own assets. The former can later be converted into the latter. You get hired there, so you're an employee and the company pays half of the social security contributions, which reduces the pre-tax income. If you marry your wife/partner, you ensure that you are not the controlling shareholder, otherwise you will not receive unemployment benefits in the event of insolvency or the liquidation of the company. Whereby the trust should not go too far, you keep trademark rights and patents yourself and only make them available to the company, make sure contractually that this also applies to patents and utility models that are acquired during business activities. From that point of view, let's recalculate your American savings. We're not assuming soldiers and graduates of a master's degree with a subsequent top position and a top contract in some large company. Which, by the way, first has to put a whopping five or six-figure sum on the table for the university, in Germany you study without these costs. Rather, we assume the normal low or average earner in small businesses who are a little less generous, which is the majority of the population. Where do you think the average family does better overall. You Americans are always lying to your pockets, everything that you pay less in taxes and duties, you pay twice or three times more elsewhere. What is paid elsewhere by the state or the local authorities, you have to pay privately, whereby families with low and middle incomes are disproportionately affected and there is no social compensation. Just when I look at the lousy education system, outside the private schools and universities that are unaffordable for mere mortals, I get sick, the result can be seen on the streets and in the privately run prisons. When I say stupid things like "why should I use my taxes to pay for other people's children's studies" I get sick. Ask who should pay for the manufacture or manufacture of a company's means of production, but the company. The state's means of production are the tax and duty payers, so it has to pay for the creation of these from it's budget and not pass the costs on to third parties (parents/grandparents/...). Good education at all levels also ensures that people disappear from the streets into employment. Much cheaper in the long run than providing lifelong housing or care at government expense. And what the gentlemen, who always don't want to pay for the education of third parties, overlook are these children who will later help ensure that their pension funds yield reasonable returns and that the state can provide a reasonable infrastructure with their taxes and duties. The better the education, the higher the income, the higher the returns for the general public. You can't just pick any individual points and pick the advantages without considering the disadvantages that result elsewhere. The fact is, if you leave out the top 10 percent in terms of income and assets, for which it doesn't matter anyway, the living conditions for the remaining 90 percent in the EU, Switzerland or Norway are much better secured than in the USA. POINT!
@annamc3947
@annamc3947 Жыл бұрын
Probably subsidized by your employer. I pay over $60,000/year for a family of three unsubsidized. This is for a regular PPO plan.
@falcotol9299
@falcotol9299 Жыл бұрын
Ein überflüssiges Video. Wer ohne Krankenversicherung unterwegs ist, nimmt ein unverantwortliches Risiko. Das weiß doch jeder Mensch.
@wernerruf7761
@wernerruf7761 Жыл бұрын
Das Video ist ja auch nicht für Deutsche oder in Deutschland lebende gedacht, dient dazu denen westlich über dem großen Teich das Prinzip zu erklären.
@marybella4350
@marybella4350 Жыл бұрын
I found your tone in the video really condescending, because there are some people in Germany, who don’t have health insurance because because they can’t afford it or because they’re in the country illegally, and if they try to get health insurance or register in the city, then perhaps to get deported back to their country which might be war-torn or where they might be prosecuted if they return. I was in Germany for two years without any health insurance because I had no job, although I search for one and no health insurance company would insure me voluntarily. I couldn’t afford €800 a month, not all of us have husbands who can put it under their health insurance like you so you’re really showing your privilege in this video. Instead of shaming people or trying to scare them, you could have put a link in the description box for resources where people can access healthcare, even if they don’t have health insurance because there are doctors who work voluntarily to treat people who are here without health insurance. You really don’t understand how undignifying it is to live in a country where you can’t access health insurance.. we are really not staying here without health insurance for the fun of it. It’s because we have no other option.
@lifeingermany_
@lifeingermany_ Жыл бұрын
Legally, Mary, everyone is required to have health insurance. Even refugees here in Germany are covered by health insurance (and do not have to pay for it if they are being supported by the government.) 800€ is a maximum for those who earn in the highest income bracket, not for the homeless or lower income families. And it is absolutely absurd for you to make such a bold assumption that I am covered under my husbands health insurance plan and over-privileged. You have no idea who I am or my financial situation. But I can tell you this. I work full-time, pay my own health insurance, and my own bills. You have no idea who I am so please don’t be so rude as to make assumptions of me.
@marybella4350
@marybella4350 Жыл бұрын
@@lifeingermany_ say you’re a privileged pompous woman and move on honey. I myself was 2 years here without health insurance and had no way to paying for it out of pocket. You’re so condescending it’s unreal.
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