Public health insurance in Germany is based on the principle of solidarity, which means that everyone’s premiums are based on the same percentage of income. The current rate is 14.6%, and the lowest rate charged per month is € 145.37, the highest € 662,48. If your gross salary is higher than € 4,537.50 monthly (as of 2019), then you will pay the maximum monthly premium. If your salary is lower than the threshold, then your premium is proportionately less. Premiums are deducted directly from your wages and transferred to your insurance company of choice. The vast majority of medical bills are paid directly by the insurance company, so patients do not incur any expenses for treatment or have to submit paperwork for reimbursement.
There are currently over 100 different GKV companies in Germany. All GKV providers in Germany are non-profit associations which administer the government health insurance plan. Some are very large, for instance the TK, AOK, Barmer, and Debeka, with millions of members whereas others have just a few thousand insured. This does not mean that the basic benefits are different – all public health insurance providers must abide by the same government regulations.
As part of an effort to foster more competition, the GKV insurance companies are now permitted to offer bonus plans, reduced fees, special programs for dental work and other services. This means that, depending on your preferences, you can now select the most suitable insurance company for your needs.
When you first enroll in the GKVs, there will be no health questions about pre-existing medical conditions and there is no waiting period. The general minimum period of membership with any provider is 18 months, and after that you can change providers within the GKV and still pay approximately the same monthly premium.
In general, the quality of medical care is quite good for members of the public health insurance plan. There are co-payments between € 5-10 for each prescription medicine, although this is waived for children. Furthermore, you are required to pay € 10 per day for first 28 days of a hospital stay. Furthermore, you may be required to pay small additional fees for routine blood tests, etc.
Basic dental treatments are included in the GKV plan, but you will have to pay for any more complicated treatments such as bridge work or orthodontics. Some coverage is provided for optical lens for spectacles, but only as of a certain severity.
The most obvious advantage of the GKV system is that non-working dependents (i.e. spouse and children) have the same level of coverage as the insured individual at no additional cost. Many people choose to insure themselves and their families through the state-regulated system and then purchase supplemental private insurance in order to have access to superior coverage, such as a private hospital room, homeopathy, vision products and better dental coverage.