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Germany's Health Insurance System

About 87 percent of the residents of Germanybetween 13 and 14 percent of a worker's gross
have statutory health insurance, i.e. GKV. Asearnings up to the contribution assessment
of May 2005, the GKV relied on 321 non-profitceiling (2006: EUR 3,562.50 monthly / EUR
sickness funds to collect premiums from their42,750.00 p.a.). Premiums are fixed according
members and pay health care providersto earnings rather than risk and are
according to negotiated agreements. Those whounaffected by the respective member's marital
are not insured this way, mainly civilstatus, family size, or health. Premiums are
servants and the self-employed, receivethe same for all members within a particular
health care through private for-profitfund  with  the  same  earnings.
insurance.
Germany's  private  health  insurance
An estimate of 0,3 percent of the German
population (around 250,000 people) has noAbout eleven percent of Germany's residents
health insurance at all. Some of them are sopay for private health insurance provided by
rich that they do not need it but most ofsome 40 for-profit insurance carriers. Many
them are poor and receive health care throughof those choosing private insurance are civil
social  assistance.servants who want to secure percentage of
their medical bills not covered by the
Germany's  statutory  health  insurancegovernment. Some sickness-fund members buy
additional private insurance to cover such
There are three different categories ofextras as a private room or a choice of
sickness funds: primary funds, substitutephysicians while in a hospital. Otherwise,
funds and "special" funds. Some workers arethe medical care provided to the publicly and
required to be members of the primary funds,privately insured is identical. In both cases
e.g. if they earn less than the than thethe same medical facilities are used.
income ceiling (2006: EUR 3,937.50 per monthSelf-employed persons earning above the
EUR 47,250.00 per year). Those earning moreincome ceiling must have private insurance.
than that ceiling may be members on aMembers of a sickness fund who leave it for a
voluntary basis, or they may have a choice ofprivate insurance carrier are not allowed to
funds. Some of them automatically becomereturn  to  public  insurance.
members of a particular fund for example
because of their occupation (company-basedAs opposed to the statutory heath insurance,
funds) or place of residence (local sicknesscontributions to the private insurance depend
funds). Some occupations have their ownon the member's age, gender, occupation and
"special"  funds,  e.g.  farmers  or sailors.health status, that is, the individual risk.
Although private insurance companies pay
Substitute funds are divided into two kinds:health care providers about twice the amount
they provide health insurance to both whitepaid by the primary sickness funds, private
collar workers and blue collar workersinsurance is often cheaper than statutory
earning more than the income ceiling.health insurance, especially for younger
Membership  is  voluntary.policyholders without dependents. As is the
case for members of sickness funds, employees
Both, employers and employees pay half of awho have private insurance have half their
member's premiums, which in 2006 averagedpremiums paid by their employers.



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