Public health insurance, known in German as Gesetzliche Krankenversicherung (GKV), is Germany's statutory health-insurance system. It is the usual route for many employees and can also apply to other groups under particular rules. Members choose a statutory insurer, often called a Krankenkasse, and receive an electronic health card. The system is contribution-based, while access and benefits also reflect legislation and the insurer's approved services.
Private health insurance, or Private Krankenversicherung (PKV), is a contract-based alternative to statutory cover for certain people in Germany. Access depends on status and the applicable rules: employees, self-employed people, civil servants, and some students may face different routes. PKV is not simply a cheaper version of public cover. The tariff, health history, age, family plans, and ability to pay over many years all deserve careful review.
What is the annual compulsory insurance threshold in Germany?
The annual compulsory insurance threshold, called the Jahresarbeitsentgeltgrenze (JAEG) in German, is a legal gross-income test for employees. It helps determine whether an employee must remain in statutory health insurance or may become eligible for private health insurance (PKV) or voluntary statutory membership. The applicable amount is set by law and can change, so an old salary figure or online article may not be reliable.
Does an employer contribute to private health insurance in Germany?
An employer may contribute towards an eligible employee's private health insurance and private long-term-care insurance. In German, this is the Arbeitgeberzuschuss zur PKV, meaning the employer subsidy towards Private Krankenversicherung. The subsidy is not a general discount from the insurer and is not necessarily equal to half of every premium. It is subject to legal conditions and maximum limits, so the employee must budget for the balance.
What is the health assessment for private health insurance?
A health assessment, called Gesundheitsprüfung in German, is the insurer's review of your medical history before it decides whether to offer private health insurance and on what terms. The questions normally relate to diagnoses, symptoms, consultations, treatments, medication, hospital stays, psychotherapy, and other relevant care during specified look-back periods. Those periods and question wording are set by the insurer and tariff, so they must be read exactly rather than inferred from general advice.
What is an anonymous risk assessment before applying for PKV?
An anonymous risk assessment, known in German as anonyme Risikovoranfrage, is a preliminary inquiry used before a formal private health insurance application. It allows relevant medical history to be assessed by one or more insurers without initially identifying the applicant.
What is a risk surcharge in private health insurance?
A risk surcharge, or Risikozuschlag in German, is an additional premium an insurer may add after assessing a health risk in an application for private health insurance. It is part of the insurer's underwriting decision and is separate from the basic tariff premium. The amount, scope, and wording depend on the insurer, the tariff, and the medical information reviewed.
How does a deductible work in private health insurance?
A private health-insurance deductible is called Selbstbeteiligung in German. It is the part of eligible healthcare costs that the policyholder must pay personally under the selected tariff. The deductible may be expressed as an annual amount, a percentage, a per-treatment amount, or a combination of rules. Its exact structure is contractual, so the headline figure alone does not explain the full financial risk.
What is a premium refund in private health insurance?
A premium refund, called Beitragsrückerstattung or BRE in German, is a tariff feature that may return part of a private health-insurance premium when the policyholder meets defined claim conditions. It is not a general entitlement and should not be treated as guaranteed income. The amount, qualifying period, payment timing, and treatment of different services are set by the insurer and contract.
What are ageing provisions in private health insurance?
Ageing provisions, called Altersrückstellungen in German, are amounts built into certain private health-insurance premiums to help account for the fact that healthcare costs may increase as insured people grow older. They are not a personal savings account that you can freely withdraw, and they are not a promise that your premium will never rise. Instead, the tariff is designed to collect part of the expected cost earlier and use the arrangement to make the long-term premium structure less dependent on age alone. The exact calculation and treatment depend on the contract, insurer and applicable framework.
What is the portability value in private health insurance?
The portability value, known in German as Übertragungswert, is the part of certain ageing provisions that may be recognised when a privately insured person changes to another private insurer under the applicable rules. It is not automatically equal to every reserve associated with the old policy. The amount can depend on the contract, the benefits that can be compared and the legal framework applying to the policy and proposed change. Because the figure is specific to the individual contract, a general percentage or estimate can be misleading. A request for current, written information is more useful than relying on a sales illustration or an informal calculation.
Can I change my private health-insurance tariff under section 204 VVG?
Section 204 VVG, the German Insurance Contract Act provision on tariff changes, can provide a route for a privately insured person to request a different tariff with the same insurer. The German term is Tarifwechsel nach § 204 VVG. An internal change is different from cancelling one insurer and applying to another. It may allow the existing insurance relationship and certain accumulated arrangements to be considered, but the exact outcome depends on the available tariffs, benefits and applicable conditions. It is a request to examine options, not an automatic entitlement to any tariff with any benefit combination.
What is a premium relief tariff in private health insurance?
A premium relief tariff, called Beitragsentlastungstarif in German, is an optional arrangement attached to or associated with private health insurance. The policyholder pays an additional contribution during an earlier contribution phase in exchange for contractual premium relief during a defined later period, often connected with retirement. The relief is not a general promise that future PKV costs will be low, and it is not the same as ageing provisions included in the main health tariff. The contract determines how much is paid now, when relief begins and how the arrangement responds to changes in employment, insurer or residence.
Sick pay insurance, known as Krankentagegeld in German, is income protection that can pay an agreed daily benefit when illness prevents an insured person from working, subject to the policy conditions. It is separate from health-insurance reimbursement: health insurance helps address covered treatment costs, while Krankentagegeld is intended to replace part of lost earnings. The contract sets important details such as the waiting period before payment, the daily amount, evidence of incapacity and when payments stop. Employees and self-employed people may have different income risks and statutory arrangements, so the same benefit amount will not suit everyone.
Can my family be covered through family insurance in Germany?
Family insurance, called Familienversicherung in German, is a statutory health-insurance arrangement that may cover eligible spouses and children without a separate contribution. It is not the same as adding dependants to a private policy, and it is not an automatic benefit for every household. The responsible Krankenkasse, meaning statutory health-insurance fund, checks the circumstances of each family member.
GOÄ and GOZ are German medical fee schedules used for many private invoices. GOÄ means Gebührenordnung für Ärzte, the fee schedule for doctors and medical services. GOZ means Gebührenordnung für Zahnärzte, the schedule for dentists and dental services. They help structure an invoice, but they do not by themselves promise that a private health-insurance tariff will reimburse every amount shown.
Does private health insurance have a waiting period?
A waiting period, called Wartezeit in German, is a period after a private health-insurance contract starts during which selected benefits may not yet be available. It is not one universal rule for every PKV policy. The applicable contract, benefit category, start date and legal framework determine whether a waiting period exists and how it operates.
Does German private health insurance cover me abroad?
Coverage abroad, called Auslandsgeltung der PKV in German, depends on the private health-insurance tariff, destination, treatment, length of stay and purpose of travel. A short holiday, a temporary assignment and a permanent move are different situations. A policy that pays for some emergency treatment during travel may not provide comprehensive insurance for living in another country.
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