A health insurance refunds the costs (full or partial) of treatment to the insured one after accidents, when illnesses and with maternity. It is part health and the social security system. In some countries also contributions of equipment are added apart from financial achievements. Whether the subsequent costs are taken over by accidents of the health insurance or a special accident insurance, is likewise country-specifically regulated.

Germany

In Germany there are two kinds of health insurances:

• Legal health insurance (GKV)
• Private health insurance (PKV)

During the legal health insurance the rate of contribution is income dependent, while it is individually computed in the private health insurance.

Legal health insurance

Legal bases:

• Article 20 Basic Law (welfare state)
• Fifth social legislation (SGB V)

The legal health insurance (GKV) is part of the Solidarsystems. Here liability to insure applies, in particular to:

• Person employed,
• Subscriber of an acquisition spare income (unemployment pay, pension, sickpay among other things),
• Student and their relative (see also family insurance).

Beyond that it gives the possibility to a freiwilligen insurance, in particular for:

• independently transacts,
• Subscriber of an income over the yearly pay border and
• Persons after ending liability to insure (divorced marriage partners, unemployed persons without requirement on unemployment pay among other things).

See also "§"§ 5, 9 and 10 of the fifth social legislation.

If no previous obligation insurance existed, cannot join the legal health insurance

• Independent one,
• An official
• Asylum-seeker and
• Person on social security.

Since 2005 the possibility exists that asylum-seekers and people on social security receive insurance cards to accounting purposes from a selected health insurance company. This is paid from tax and not from insurance means. (See also "§ 264 of the fifth social legislation.)

The incomes of the legal health insurance almost exclusively come from contributions. These are carried mostly in equal numbers between employees and employers. An exception is here to 1 July 2005 the introduced extra contribution for sickpay and artificial dentures (rate of contribution 2005:0,9 %), which are alone carried by the employees.

Except for few exceptions (sickpay) Versicherte receives achievements in the form of contributions of equipment. For this the Versicherte receives a health insurance map the 2006 by the health map to be replaced should. The introduction of this health map is pending however because of technical conversion problems until further notice. For the discharge of the contributions and thus the general ancillary wages, as well as for the motivation of a healthy life-style there are additional payments.

For the evaluation of medical specialized decisions an independent physician service stands for the health insurance companies for order: MDK.

According to report of the Federal Statistical Office from May 2003 were in the year at that time 188,000 Federal citizens without health insurance. Thus the number had doubled itself since 1995. For the year 2005 on an increase on 300.000 uninsured citizens one counts. By Hartz IV unemployed persons lose their requirement on a health insurance, which have no requirement on unemployment pay II or social welfare assistance, because they are not without means or live for example in a partnership without marriage certificate with a partner, which has a too high coming in or ability. These have to lock however the possibility a freiwillige legal insurance. Sebastian Jost: Main thing, not ill. In: South German newspaper. 28. /29. May 2005, P. 30

The FDP plans to abolish and introduce instead of its an obligation to the membership in a private health insurance company the legal health insurance companies.

Further details see the article to the GKV.

Private health insurance

During the private health insurance all cannot insure themselves legally persons subject to compulsory insurance. In addition belong:

• Employee and worker with a monthly gross income above the so-called liability to insure border ("€ 3937.50 in the year 2006, "€ 3900.00 in the year 2005; the border refers to the annual salary and with 13 monthly salaries with "€ 3,634, 62 in the month is already reached!),
• An official (with those only one part of the disease costs to be covered must) and
• Independent one without consideration of their income.

In the private health insurance each family member must insure itself and/or with (children) of and/or that/that concern-entitled, i.e. for each additional member the insuring contribution increases in the sum. The contribution classification takes place individually due to age, sex and state of health for the respective insurance level. Generally the principle applies: The younger (and healthier) the insurant is, the smaller is the contribution which can be paid. Because of the generally longer life expectancy of women and more frequent physician attendance women pay usually higher contributions than men.

Medical costs of a physician attendance are usually put forward with cases of trifle by the insurant and refunded then by the insurer. Higher calculations can be through-handed equivalent to the insurer, for his part then the physician paid. Similarly the Versicherte pays the actual price with medicines and submits afterwards the prescription for refunding.

Further details see the article to the PKV.

Did not patient-insure

In Germany there, despite liability to insure, are approximately 190,000 humans, who are not at all ill-insured, with strongly rising tendency according to micro censuses. When a reason for it economical pressure called for entering a e.g. by the Hartz concept ("i AG ", interim funds) and the decrease of the payment height of wage compensations, even if the concerning has only insufficiently money for a thus a renouncement of health insurance as economy measure.

Not insured of the GKV e.g. also such unemployed persons without requirement on achievements against the BA, those over parents in a PKV (usually with 20 per cent) singlecontractually insured were before - although it concerns only one here "derived "requirement "similarly" the family insurance in the GKV - and then from the aid authorization (consideration able i.d.R. with 80 per cent (see - >Beihilferecht the officials)) fall out. These are also not transferred by the KV to a "freiwillige" insurance.

Health insurance with handicaps

Depending upon personal situation it can come for handicapped ones to substantial difficulties to be able to insure itself. For handicapped ones it is important in each case to inform comprehensively. In particular if it concerns the decision "legally or privately", can be complicated the situations extremely. This applies strengthened, if third achievements (e.g. aid for officials) play an important role. Often only the way out remains to insure itself legally. Legal insurance is obligated to take up handicapped ones. A private insurance is directly possible after the birth and recently also through opening actions so mentioned of the private health insurers. Here however caution is required, since it can come to higher costs and even to worse achievements.

Articles in category "Health insurance"

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