SSAG

Health Insurance elaborated

Health Insurance is compulsory in Germany. Without a valid health insurance, you will not be issued a residence permit or enrolled into university. The premium for the health insurance for students costs approximately €80 monthly if you are insured by a state health insurance provider. You can arrange for health insurance after you arrive in Germany, by going personally to one of the health insurance companies (such as AOK or TK) and request for the package for students. There are also several private health insurance companies recognised by the state which offer additional perks such as no waiting time required at the doctor’s, but these often come at a premium. Do note that any form of insurance bought in Singapore is insufficient and do not fulfil the requirements for health insurance coverage in Germany.

The compulsory health insurance will cover the costs of basic medical treatment; it is not a savings or life insurance. That means that you will not get your premiums back, even if you have never seen a doctor for your entire stay in Germany.

Due to the strains that the aging population is placing on the national coffers, from 2004, having a health insurance will no longer exempt you from any payments at the doctor or hospital. You will have to pay a nominal sum for medical treatment. However, the total amount you pay out of your own pockets medical treatment in a year will not exceed 2% of your annual income after tax. Here are the core changes:

At the Doctors’
As of 1.1.2013, the €10 consultation fee per quarter has been abolished.

Prescriptions (Medication, Drugs etc.)
In Germany, doctors only prescribe medicines and drugs. You will have to go to the dispensary (Apotheke) yourself to buy the medicine. Previously, prescribtions are paid for by the insurance. Now, you will have to pay 10% of the price of the medicine, with a lower limit of 5€ and upper limit of 10€ per drug. Note that this is only valid for prescribed drugs. You will have to pay in full for non-prescribed drugs.

For example, if the medicine costs €30, you will have to pay 5€. If it costs €70, you will have to pay €7, and if it costs €150, you will have to pay €10. If the drug costs less than €5, you will pay for the full price of the drug.

Hospital Stays
Charges are generally pegged at €10per day of hospital stay, up to a maximum of 28 days per calendar year.

Visual Aid/Glasses
The insurance will no longer pay or give rebates for glasses.

Tooth Fillings and Replacements
From 2005, tooth fillings and replacements will no longer be covered. However, there will be an additional “opt-in” for the insurance against tooth replacements and fillings. The cost is estimated to be about €10.

Remember: If you ever spend more than 2% of your annual income on healthcare on top of your insurance premiums, you can claim the difference from your insurance company.

If you’re a employee and earn under the Versicherungspflichtgrenze (in 2014: 4.462.50€ a month) then you will be made a mandatory member of public health insurance, no matter whether you’re over or under 30. That age 30 limit is only for getting health insurance at cheap student rates, it doesn’t apply to employees (or anybody receiving an income in Germany).