Health Insurance : Germany

Nearly everyone in the Federal Republic of Germany has health insurance, whether as compulsory or voluntary members of the statutory health insurance scheme (90 percent of the population) or through private insurance. Under the statutory scheme, insurance is compulsory for all employees and several other occupational categories up to a certain income level. Voluntary insurance is possible under certain circumstances. The statutory system also covers pensioners, the unemployed, trainees and students. Employees are insured through their respective local, company or guild health insurance fund or through one of the substitute health insurance funds.

They are free to choose their health insurance fund regardless of their occupation. In the case of company and guild funds, however, outsiders may only be insured if the respective fund’s by-laws provide for this. There are also special health insurance funds for certain occupational groups, such as the seamen’s, miners’ or farmers’ funds. All insured persons have a free choice of panel doctors and dentists. They pay half of the health insurance contributions, and their employers pay the other half. In 1996 the average contribution rate was 13.8 percent in the old states, and 14.5 percent in the new states, of the proportion of income on which contributions are based.

The health insurance fund pays the cost of medical and dental treatment, drugs and medicines, etc. as well as hospitalization and preventive health care. It pays all or part of the cost of necessary curative treatment at a spa. In the event of sickness, employees receive their full wages from their employer for up to six weeks. Some collective agreements provide for a longer period. After that the statutory health insurance fund provides sickness benefits, which amount to 70 percent of the normal wage, for up to 78 weeks.