Is it worth taking out private health insurance?

style="float: right; margin-bottom: 10px; font-weight: 600;"Thu 10th Oct, 2019

In Germany, health insurance is legally mandatory. For residents of the country, there are normally two main types of insurance you can purchase: public and private.  Whereas public health insurance is available to all, private health insurance is dependant on income (here you can read a brief list of private health insurance pros and cons). Private insurance offers the policyholder five main advantages:

o Better health care

o Income-independent contributions

o Free choice of doctor and hospital

o Contract security

o More flexibility

 

Better health care

The private health insurance companies reimburse doctors from 2 to 3.5 times the fee rate of the fee regulations. As a patient, you benefit from this in two ways. The first is thet you receive far better medical care than a publicly insured person. The second benefit is that you have to endure virtually no waiting times. As a private patient, you will always receive preferential treatment and will receive your appointment within a few days, especially an appointment with a specialist.

As a rule, the reimbursement treatments exceed the catalogue of benefits of the statutory health insurance funds. This applies to outpatient and inpatient treatment, but also to the reimbursement of medicines and medical aids. For example, you can expect higher co-payments for glasses, contact lenses, hearing aids, dentures or therapies of all kinds.

 

Income-independent contributions

For public health insurance, your insurance contribution is based on your income. In private health insurance your age of entry is decisive. The younger you are when you apply, the less you pay. As the risk of disease increases over time, your insurance will adjust the premiums for your tariff group from time to time.

In order to keep the adjustment within tolerable limits, the privately insured have been making old-age provisions for several years. You pay a little more to your usual contribution at a young age. The insurer invests the money at interest and thus improves the contribution stability in the long term. You also have the option to reduce your monthly charge with a deductible.

And those who live healthy lives and do not receive treatment are rewarded by the insurance companies. In return, you often receive generous contribution refunds.

 

Free choice of doctor and clinic

If you are insured with public health insurance, you must first obtain a referral from your GP in order to see a specialist. This is annoying and time consuming. In case of a hospital stay, your doctor or health insurance company determines which clinic you are admitted to. Most of the time, it is a hospital near where you live. It does not matter whether the clinic enjoys a good reputation in terms of treatment or is perhaps chronically overcrowded.

As a private patient, you can enjoy a free choice of doctor and hospital. You decide where and by whom you wish to be treated. In addition, many private rates include a chief medical officer clause. You are therefore entitled to treatment by the best specialists.

 

Contract security

The statutory (public) health insurance companies define a catalogue of benefits, which determines which treatments are reimbursed. However, this catalog can be changed at any time. Unfortunately, this happens often enough in practice. So you don't know what benefits your fund will do in five, ten or even thirty years. This is regulated in a completely different way with private health insurance where you sign a legally binding contract. What your insurer guarantees you in this contract, must comply as long as the contract is valid.

 

More flexibility

Private health insuance offers you basic and compact tariffs with a fixed range of services. But such ready-made packages are not the real strength of a PKV tariff. You will only fully exploit the potential if you compose your policy freely according to the modular principle. In this case, you only pay for services that you actually want and consider necessary. Therefore you can specifically cover special risks or include certain special benefits in your individual insurance cover

 

Editor's Note: For help in choosing a private health insurance company in Germany, see the bespoke special packages negotiated for foreigners/expatriates by this publication.


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