If you are going to head to Germany for studying or working, one of the key matters to consider is the German health care system. One of the things you should know before getting to know more about the German health care system is that it is one of the world’s oldest social health care systems, with health insurance being introduced in 1883.
In fact, most of the analysts and think tanks recognize that the German health care system has been one of the most restrictive-free and “patient-friendly” health care systems in the world for a long time, placing it at the top of the lists. Actually, customers rarely face any obstacles when they want to get a medical service they wish.
How the German health care system works
Prior to going to Germany, you have to understand that having a health insurance in Germany is mandatory for all those who work and study there. Thankfully, the market is completely free and fairly competitive, which gives you more flexibility. During the last decades, however, the fees have risen sharply, so the government is trying to boost competition and, therefore, cause the fall of prices for medical services. But do not expect to find cheap health care services in Germany.
Basically, there are two types of insurances: compulsory insurance (public health insurance or, in German, Gesetzliche Krankenversicherungen) and private insurance (Private Krankenversicherungen). Based on your income, you will have to get one of those insurances. According to the German laws, you are obliged to enter the compulsory insurance if your gross annual salary is lower than 56,250 Euros (or 4,688 Euros per month). The state insurance is managed by Krankenkassen, where you make contributions that are typically charged at the 14.6% rate (from your salary) and at times with an additional median supplemental rate of 1.1%. More than 87% of Germans take part in the state health insurance.
Apply for a Krankenkassekarte and become eligible for various bonuses and discounts
Regarding the private insurance, you make contributions according to the conditions of the contract you have signed with a private insurance company or health care fund. Typically, those fees are noticeably higher than those ones that you have to pay for the compulsory insurance, yet patients get far more comfortable conditions and more medical services (see below). There are more than 40 health insurance companies in Germany, yet they usually don’t accept foreigners unless they had lived in Germany at least for two years.
All in all, there are three mandatory health benefits the costs of which are shared between employer and employee: long-term care insurance, accident insurance, and health insurance. The explanation above should be clear enough for having an understanding what a health insurance is. Accident insurance (known as Arbeitsunfallversicherung) is an insurance for covering the costs of treatments after the accidents in your workplace, which is typically completely covered by the employer. The long-term care insurance (Pflegepflichtversicherung) is shared between the employer and the employee half by half and covers the cases when a person is unable to do the daily routines (personal hygiene, apartment cleaning, provision of food, etc.). Typically, the long-term care insurance costs 2% of the annual income of a worker.
The German health care system: what is covered by the compulsory insurance?
Considering that this is the compulsory state insurance, the number of benefits you can get from the German health care system in such a case is quite lower than if you have joined a private insurance. In particular, the compulsory insurance does not cover a private room in a hospital (only shared), vision products for adults, dental implants, homeopathic (alternative) medical care, private surgeons or doctors, and any medical services received outside of the European Union. Also, your costs of staying in private hospital are not covered either.
Yet, your insurance in such a case covers basic dental care, out-patient care that you get from a registered doctor (Kassenarzt), and in-patient care (i.e. in hospital) at your nearest hospital with a doctor on duty. Also, if there is a dependant living together with you, at your home, they can apply for a compulsory insurance basically for free. All they have to do to get the same benefits that you get from the German health care system is to go to the nearest Krankenkasse and get registered.
The German health care system: joining the compulsory state insurance
If you have made up your mind (or just you are not eligible for joining any private health insurance) and want to join the compulsory state insurance, then you should go to a Krankenkasse and get registered there. Those Krankenkassen are non-profit unions that manage the government health scheme, and such Krankenkassen like DAK, BEK, TK or AOK have millions and millions of registered members. At the same time, there are Krankenkassen that are usually called BKKs and which basically have just a couple of thousand members.
In order to get the public health insurance, you should choose a Krankenkasse and get registered there
Some Krankenkassen also offer various bonuses, including discounts on health travels or free checkups. So it is better to check the websites of, at least, the major Krankenkassen and choose the best offers – and fees vary across Krankenkassen, too! So don’t spare your time and spend some of it on a proper research. Also, make sure that your Krankenkasse offers communication in English – basically, there are only a few Krankenkassen in Germany that offer such a service.
How to deal with pharmacies
First of all, you must be aware that medicines in Germany you can get only in Apotheke (typically they feature a large “A” letter colored in red), not Drogeries (drugstores). All the medicines are divided into two categories: the ones that are prescribed by doctors (and sold solely upon prescription, known as Rezept) and the ones that are freely available. In fact, you must be ready that some of the drugs (especially antibiotics) that you could buy freely, without any prescription in your country you will not be able to buy in Germany without a Rezept. The laws regarding prescription are, indeed, very strict in Germany.
In the German health care system, you pay only a small fee for each prescribed drug (Zuzahlungspflicht) you get in a pharmacy if you have joined the compulsory state insurance. The fee is calculated from the actual price of the drug. In the case if your income is lower than a certain level, you are able to get the drugs without paying Zuzahlungspflicht.
This way looks a typical pharmacy in Germany
If you have joined the private insurance, then you pay for drugs on your own and subsequently send receipts to your insurance company in order to get reimbursement.
However, the German health care system does not foresee the provision of non-prescribed drugs in the insurances. You pay a whole sum for the non-prescribed drugs. Considering that the medicines in Germany are among the most expensive in Europe, it would be wiser to bring some necessary drugs with you.
Typically, pharmacies have work hours similar to the ones of shops: from 9:00 to 18:30. However, there is always at least one pharmacy working at night in an area. You may need in case of emergency, so it is better to find out where is that pharmacy located in advance.
The following sources will help you to find out more about the German health care system: