Krankenkasse | Health Insurance(s)

Germany loves its insurances. You can buy insurance for your insurance and for your insurance providers. This is probably common financial stuff everywhere but it feels much more “in your face” here. I am not the most well-versed in the various intricacies of personal finance and accounting but the literature I lean towards and the forums I read caution against being insurance heavy in one’s portfolio, except for health insurance, which in the US is a tricky subject. I am very pro “have all the insurance” and am on the German public health system now (I used to have private insurance) and it’s amazing. I am not here with any legal advices, just my background so you might understand a bit better my fascination with the insurance system, specifically health insurance.

Do you recognize that photo? It’s one of the many you’ll need when you first get passport photos done.

The US has a bit of a gentle conversation and sharing of ideas going on at the moment when it comes to the best way to insure people. I like to see the thoughtful and considerate statements passed between two opposing but engaged parties. So pleasant and peaceful.

I am overwhelmed

The idea of not having health insurance is scandalous here. I once said “I’m thinking of not having insurance” to a friend and their eyebrows disappeared under their hairline, there was a quick sucking in of air and “that is not possible” thrown in my direction. And they’re quite right. It’s really not possible, especially once one is working. Insurance is mandatory with freedom of choice being limited to choosing the private or public system. Once a system is chosen there are other options to consider but really, you either have private or public, or you don’t live legally in Germany. It should also be noted while there are something like 118 insurance companies, they all must legally provide the same services. There are three major ones, but other than a small extra premium charge (mentioned at the bottom) I’m not sure what all the different variables there might be when choosing.

I have had medical issues to deal with over the years as I’m sure many of you have. And I was nervous about moving and managing any medical issues that might occur. Would I be able to understand the doctor? The pharmacist? The instructions on the medication? Of course many people here speak English well, but that doesn’t mean the nuances would always come through.

German doctors often do this first during an exam.

Luckily, something that takes a huge burden off the mind is not having to wonder “how will I pay for care?” because it’s just not a question anyone here really thinks about. I had a sinus infection this spring, as I do each spring, as a sort of “welcome to warmth and light!” gift. This year though I was definitely not knocking it out myself and so hobbled into the doctor after a week and a half or so*

*which, I would like to point out right now, I only did because my bosses kept asking me to go home because I looked so awful. I protested, saying “tis only a flesh wound” but sick employees are taken seriously here, so much so that HR kindly emailed me and asked if I would please take my germs home and stay there.

I love my general practitioner in Wiesbaden and I’m linking to him because everyone should see him, but I will be pissed if I can’t get an appointment in the future. Within a few minutes of being seen, I had my prescriptions for antibiotics and was out the door to the Apotheke. He is a generally great guy and I can’t recommend him enough.

While Germany does not have liquigels, Ibuprofen in amounts bigger than 10 pills per box, and maintains a general distrust of medicines (despite being the home of Bayer and Vicks for example), the medicines one does get are a bit surprising in that it feels sort of “home remedy” and “old-timey”. For example, I’ve now had a few rounds of antibiotics while in Europe and each time I’ve been given a pack of powder or a bottle of liquid with the instructions “mix this into juice or water.” But never an amount of liquid. When asked about this the pharmacist said “Whatever feels right. Don’t drink a lot the day before you take this, but the day you take it you drink a lot and then drink a lot more the next day.” So, it feels a little witch-doctory but it’s always worked.

Any of those will work. It’s egal.

So how much did I pay? The medicine was free. I’m still not sure how but it was. I had expected to pay at most 10 € though, because that’s the legal cap for medication prices. The doctor visit I’m not sure of either because at checkout, I present my healthcard, they scan the chip, and then that’s it. No money is exchanged. But doctor’s fees are regulated; this document is from 1996 but it appears to not have changed much since then.

After this I became more curious about what else my insurance provides. In a nutshell, basically everything medical is available except vision care, which is covered only until age 18. But otherwise treatment is “free” for just about everything. And there is no sharing of health insurance when married, everyone has their own (children are on one of their parents’ plans). You can read more about what I picked here.

Krankenkassen I picked, I’m very happy with them and if needed they can do most administrative work in English.
How much does this all cost everyone?

14.6% of total monthly income. But the Krankenkassen are allowed to charge an additional percentage to meet administrative costs which in 2017 is up to 1.1%. This total amount of roughly 15.7% is supposed to be split evenly between employer and employee, however the employer share has been frozen at 7.3%. But once one earns more than 4,350 €/month there is no additional premium charged.

In addition, choosing public health insurance isn’t a choice if your gross salary is less than 57,600 Euro per year in 2017.

Overall, I’m happy with my experience and I’ll keep updating if I learn or experience anything new.


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