Germany's Health Insurance System

About 87 percent of the residents of Germany(2006: EUR 3,562.50 monthly / EUR 42,750.00
have statutory health insurance, i.e. GKV. As ofp.a.). Premiums are fixed according to earnings
May 2005, the GKV relied on 321 non-profitrather than risk and are unaffected by the
sickness funds to collect premiums from theirrespective member's marital status, family size, or
members and pay health care providers accordinghealth. Premiums are the same for all members
to negotiated agreements. Those who are notwithin a particular fund with the same earnings.
insured this way, mainly civil servants and theGermany's private health insurance
self-employed, receive health care through privateAbout eleven percent of Germany's residents pay
for-profit insurance.for private health insurance provided by some 40
An estimate of 0,3 percent of the Germanfor-profit insurance carriers. Many of those
population (around 250,000 people) has no healthchoosing private insurance are civil servants who
insurance at all. Some of them are so rich thatwant to secure percentage of their medical bills
they do not need it but most of them are poornot covered by the government. Some
and receive health care through social assistance.sickness-fund members buy additional private
Germany's statutory health insuranceinsurance to cover such extras as a private room
There are three different categories of sicknessor a choice of physicians while in a hospital.
funds: primary funds, substitute funds and "special"Otherwise, the medical care provided to the
funds. Some workers are required to bepublicly and privately insured is identical. In both
members of the primary funds, e.g. if they earncases the same medical facilities are used.
less than the than the income ceiling (2006: EURSelf-employed persons earning above the income
3,937.50 per month / EUR 47,250.00 per year).ceiling must have private insurance. Members of a
Those earning more than that ceiling may besickness fund who leave it for a private insurance
members on a voluntary basis, or they may havecarrier are not allowed to return to public
a choice of funds. Some of them automaticallyinsurance.
become members of a particular fund forAs opposed to the statutory heath insurance,
example because of their occupationcontributions to the private insurance depend on
(company-based funds) or place of residencethe member's age, gender, occupation and health
(local sickness funds). Some occupations havestatus, that is, the individual risk. Although private
their own "special" funds, e.g. farmers or sailors.insurance companies pay health care providers
Substitute funds are divided into two kinds: theyabout twice the amount paid by the primary
provide health insurance to both white collarsickness funds, private insurance is often cheaper
workers and blue collar workers earning morethan statutory health insurance, especially for
than the income ceiling. Membership is voluntary.younger policyholders without dependents. As is
Both, employers and employees pay half of athe case for members of sickness funds,
member's premiums, which in 2006 averagedemployees who have private insurance have half
between 13 and 14 percent of a worker's grosstheir premiums paid by their employers.
earnings up to the contribution assessment ceiling