Exclusive club with excellent service: private health insurance.
Statutory and private health insurance - advantages and disadvantages
In Germany there is a coexistence of statutory (GKV) and
private health insurance (PKV). Both systems have their advantages. While
private health insurance knows how to convince with higher quality services,
families benefit from the free co-insurance of children in the statutory
health insurance.
Anyone who can choose between PKV and GKV should therefore find
out in advance about various criteria such as contribution calculation,
scope of services and switching options.
You can find out below how statutory and private health
insurance differ from each other. You can also find out more about the
advantages and disadvantages of private health insurance.
Who can take out private insurance (PKV)?
Employees with a monthly gross income of 5,362.50 euros or 64,350
euros per year (compulsory insurance limit 2022) can join private health
insurance. The self-employed, freelancers, civil servants and students can
take out private insurance regardless of their income.
Who can take out statutory health insurance (GKV)?
Every citizen may or must join statutory health insurance. However,
employees with a monthly gross income of up to EUR 5,362.50 are
automatically insured by law. High-earning employees, freelancers, the
self-employed and civil servants can voluntarily
What are the advantages of private health insurance?
The advantages of private health insurance usually include better
services at the general practitioner or dentist and in the hospital.
Privately insured people also usually get an appointment with a specialist
more quickly and benefit from shorter waiting times. In addition, the
contributions to private health insurance are independent of income and
therefore do not increase as soon as the insured person's salary
increases.
What are the advantages of statutory health insurance?
Statutory health insurance also offers a number of advantages
compared to private health insurance. For example, family members with
little or no income can be insured free of charge. The contributions are
also based on income, so earners pay less, while high earners pay more
accordingly
Can family members be privately insured?
Spouses and children must have their own private health insurance.
However, family members of civil servants benefit from the support provided
by the employer. On our topic pages you will find more information on health
insurance for spouses and children of privately insured persons.
How can family members be insured in the GKV?
Spouses and children up to the age of 25 (possibly even older) with a
low income (up to max. 450 euros per month on a mini-job basis) can be
insured free of charge in the family insurance.
Which benefits are insured in private health insurance?
You determine the private health insurance benefits yourself - from
basic to top protection. The basic protection is comparable to the services
provided by the statutory health insurers. A top tariff offers you a free
choice of doctor and hospital, single or double rooms in the hospital,
treatment by the chief physician, reimbursement for dentures, visual aids
and more. More information about private health insurance benefits
How are the GKV contributions calculated and settled?
Employer and employee share the health insurance contribution. This
applies to both the basic contribution of 14.6 percent and the individual
additional contribution. In 2022, it will average 1.3 percent of gross
income. Civil servants and the self-employed, on the other hand, pay the
full contribution, with the self-employed, students and voluntarily insured
persons with low earnings paying a minimum contribution. In the GKV, billing
is based on the principle of benefits in kind. This means that the service
provider settles the treatment costs directly with the health insurance
company, the insured person does not have to pay in advance. To the current
health insurance contributions
How does private health insurance develop with age?
The private health insurance makes provisions for old age in order to
cushion age-related cost increases. However, increases in premiums cannot be
ruled out. However, cuts in performance are not to be feared. With the basic
tariff of private health insurance, it is possible to switch to an
inexpensive tariff with statutory standard benefits.
How does the GKV develop in old age?
Unlike private health insurance, statutory health insurance benefits
are not guaranteed. Due to the increasing age of the population and growing
expenditure in the health sector, rising contributions are also to be
expected.
Can private health insurance benefits be claimed abroad?
The private health insurance is automatically valid throughout Europe
and for at least one month outside of Europe, with a small additional
payment also worldwide.
Can statutory health insurance benefits be claimed abroad?
The protection of statutory health insurance is valid in the EU and
in countries with a social security agreement.
How does the termination or change in private health insurance work?
Insured persons must cancel at least three months before the end of
the insurance year. Before doing so, they should clarify to what extent
old-age provisions can be taken with them when changing providers, under
what conditions new insurance is possible and whether this is even possible
when switching to statutory health insurance. The insurance company is not
normally allowed to terminate a member (exception: in the event of a
pre-contractual violation of the advertisement or non-payment of the
premiums). More on the subject of termination and change in private health
insurance
How does the termination or the change in the GKV work?
Termination or a change to another statutory health insurance company
or to private health insurance is possible at the end of the month after
next, calculated from the month in which the member declares his or her
withdrawal. In order to be able to change health insurance, patients must be
insured there for at least 12 months. More about changing health
insurance
What are the disadvantages of private health insurance?
As a rule, privately insured persons have to reckon with increasing
contributions in old age. In addition, family members must be insured
separately (reduced price) in the private health insurance and cannot, as in
the statutory health insurance, be included in the family insurance free of
charge.
What are the disadvantages of the GKV?
The disadvantages of statutory health insurance compared to private
health insurance include, for example, being bound to statutory standard
benefits. As a result, those with statutory health insurance cannot
individually determine the scope of their benefits and are bound to the
prescribed benefits.
How decide?
That's why you should weigh up the advantages and disadvantages of PKV and GKV
Whether private or statutory health insurance is right for you
depends on many factors. The path to private health insurance is not open to
every insured person. Rather, as an employee, you must provide evidence of a
certain annual income or be a civil servant or predominantly self-employed.
Students can only take out private insurance at the beginning of their
studies or after they have turned 30. If you meet these requirements, it is
important to compare the advantages of private and statutory health
insurance. Private health insurance scores with its increased and more
individual scope of services. Statutory health insurance, on the other hand,
offers the advantage that children and spouses with low incomes are also
insured free of charge.
Both models of health insurance also have their pitfalls.
You should consider these disadvantages when deciding whether to take out
statutory or private insurance. In view of the fact that private health
insurance contributions increase with age, the choice of provider for your
private health insurance should not be taken lightly. You can find out which
insurer will provide you with stable premiums and comprehensive benefits
through a free, non-binding consultation with our insurance experts. Even
cash patients have to live with some disadvantages. The legislature
regulates the amount of the contributions and the scope of the benefits. The
health insurance companies hardly have the opportunity to make individual
offers. In addition, you must take out supplementary insurance for the full
reimbursement of many treatments, such as dentures.
