The statutory health insurance is part of the German social security system. For the majority of workers in Germany, it is a compulsory insurance. Compulsory insurance covers all employees whose gross income is below € 4, 162.50 per month or € 49, 950 per year. Spouses and children up to the age of 25 with an income of no more than € 400 per month can be co-insured without additional contributions.
Voluntary membership is also possible under certain conditions for civil servants, freelancers and well-paid workers. In the course of the health care reform of 2007, it was stipulated that every person resident or habitually resident in Germany must have health insurance. This compulsory insurance also applies retroactively. According to § 175 SGB V, insured persons can choose their health insurance themselves.
An allocation of health insurance by profession, as was customary in the past, no longer takes place today. The statutory health insurance must basically accommodate every customer. An exception are persons who have passed the age of 55 and who were previously not insured. You can be refused admission. The insurance coverage of statutory health insurance companies also applies in other EU states as well as countries with which Germany has concluded a social security agreement.
Since January 1, 2009, health insurance funds can no longer independently define their contributions. In the meantime, they must demand the contribution rate of the gross income of each insured, which is uniformly prescribed by the Federal Government. This will no longer be financed on an equal basis since 1 July 2005. Employees have paid 8.2% of the gross wage since January 1, 2011 and 7.3% of their gross salary, so that the contribution rate is 14.915.5% of the contributory income. If a cash register succeeds, contributions can be refunded.
The other way around, the health insurances can also demand monthly additional contributions - a social compensation should prevent excessive burdens on the individual. Some funds also offer special optional rates, which will be refunded if no benefits have been claimed. The billing takes place according to the principle of payment in kind. Doctors, clinics and other medical service providers calculate the costs directly with the respective health insurance company.
A comparison of the many different health insurance companies has been very difficult since the introduction of health insurance reform. Since 2009, the contribution rate has fallen away as the main distinguishing criterion, try the health insurance funds by other means to differentiate. This is done through premium repayments, optional fares, bonus programs or additional services.
About 95 percent of health insurance benefits are not significantly different because they offer uniform minimum benefits. This scope of services is defined in the Social Code and is taken over by the health insurance. However, the health insurance companies have a certain amount of room for additional services. Some health insurances also offer preventive services such as preventive cures or health courses, which are not included in the compulsory catalog.