Health system in Germany | A summary

Of the many things we had to research and learn about this move to Germany, were the various types of insurance (Diego wrote a post about it included) and the health system was one of the most important things, since health insurance is mandatory in Germany.

In our many years in Canada, we learned how the system works there and of course, our comparison comes straight from there.

In Canada, health is public and you pay nothing on the spot (only in the your taxes, which are high). You have access to the family doctor and from referrals, to a large number of professionals, where almost 100% of the services are covered by the public provincial system. If you are a Canadian citizen, permanent resident and with some types of visas (work and study) you have access to health system.

In Germany, things aren’t quite like that. There is “government” health insurance that is mandatory and is discounted in part in the salary of an individual who works (or study) in Germany. This is considered the minimum and it is illegal not to have it. You can also voluntarily choose to invest more and sign up for a private insurance/health plan, which usually covers more things and gives some other advantages compared to the “public” version.

PUBLIC HEALTH INSURANCE (Gesetzliche Krankenversicherung – GKV)

This is insurance regulated by the German government (IF you receive a salary of UP to $62,550 Euro/year or $5,213 Euro/month – gross – it is mandatory).

The discount on your paycheck varies depending on several factors, but fluctuates between 14.3% and 15.7%, of which the employer contributes 50%. There is still another tax, compulsory assistance insurance (Pflegepflichtversicherung), which costs around 3.05% of the gross salary, of which the employer pays up to 71 euros (it is embedded in the total value of health insurance).

Germany has quite a large number of companies that provide the insurance service. According to my research, there are 108 different non-profit companies that run the German health scheme. You have the freedom to choose. We used the Check24 website to compare various types of “choices” we had to make in these first few months here, including our health insurer. We ended up choosing TK, one of the most popular in Germany and which has services and customer service in English, as an option.

PRIVATE HEALTH INSURANCE (private Krankenversicherung – PKV)

So if you earn more than $62,550 Euros per year (gross), you are self-employed and/or you are a student, you may opt for a private health plan, which usually has wider coverage. Of course, the premiums also go up (I don’t know how much more, but it’s worth researching).

If so, your employer will also contribute for a percentage of your plan.

Our experience so far…

We opted for the public health plan and so far everything is flowing well. They say that opting for private and trying to change to the public is basically impossible, so we preferred to start with the public and see how it would be. For now, all is alright.

I went after a family doctor (for me and Diego) and pediatrician for the kids in our city (near Frankfurt) and got it relatively easy. My tip is to actually start researching doctors in your region, or even neighborhood, and contact the offices, explaining that you are newcomer and would like to be patient. I did it by e-mail, and for us, it worked.

The consultations have all been free so far, we just hand over our health card. The children have already had check-ups and visits because of random sickness. Only a few extra vaccines were offered to us, which would have a cost to be paid on site and perhaps reimbursed by the plan.

For us adults, we also had check-ups and other consultations and everything was included.

We have already been referred to specialists and consultations have also been free of charge (family doctor or pediatrician issues a letter / referral prescription and only then you can schedule the consultation with specialists).

The consultations themselves so far (almost all) have been more detailed and better explained than compared to those in Canada. In the pediatrician, for example, the check-ups had more details, which I liked!

On a quick visit to the hospital (I went to the emergency room with Arthur, due to an allergic reaction to a virus), the service was very similar to Canada (it took us about 2 hours between arriving, waiting and leaving) and was all included in the plan, which means, I did not have to pay anything.

Medicine (based on our brief experience so far…)

Of all medicine prescribed to us so far, the children’s drugs were 100% free and for adults, we had to pay about 10% of the amount (which turned around $5 to $10 Euro).

The pharmacies here (Apotheken) have almost nothing to sell (over the counter), ie ‘on shelves where you choose yourself’. Everything is controlled, either with prescription or with explanation /conversation with the pharmacist / attendant.

I learned, for example, that for a medicine for infant fever/pain (like Ibuprofen), you can buy without a prescription, but you will have to ask and explain, in addition to paying the full amount (i don’t even know how much). In Canada, you can buy Advil (Ibuprofen) on supermarket shelves and pharmacies. Here, if you have a prescription from your doctor/pediatrician, the medicine is free of charge.

Well, I guess that’s it! There are still several things to talk about, such as dentists, other details of health plans, but you can already get a general idea of how it works (my knowledge of the subject is very superficial, read more in this link if you want). Any questions, leave in the comments!

Until the next post!