The price of private health insurance, and what’s included

Private health insurance has a reputation for being pricey, but that’s not always the case. Privately insured patients get the best healthcare available. Find out what you’re paying for when you go private.

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Germany has a reputation for its excellent healthcare system. With state-of-the-art treatments, great access to knowledgeable physicians, and a structure that allows you to choose your ideal coverage plan, expats in Germany are very fortunate.

It’s essential that you do your research when you’re determining the most effective plan. Health insurance is an important choice that can have serious effects on your health and happiness abroad. There are many deciding factors to consider when it comes time to selecting the right insurance plan for you and your lifestyle: coverage, cost, which company to pick?

Public or private health insurance?

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Private or public insurance?

All facts summarized for you!

When you’re sick, most people go the modern route and ask Dr. Google what’s wrong. Or you can visit a doctor and get an official diagnosis so you can take care of the problem efficiently and effectively. Patients with public insurance will receive the most basic treatments. Common cold? Drink tea and rest. Fever? Rest and drink tea. But patients with private insurance are eligible for coverage that includes a full battery of tests and treatments that public insurance won’t cover, so you’ll receive a thorough examination.

Insurance providers in the public system calculate their coverage based on laws passed down from the German government. Some conditions must be covered. But for many other conditions, treatments are considered optional and are not paid for by public insurance.

For those insured in the public system, important aspects of physical health like vision and dental aren’t covered. But in the private system, most companies offer generous compensation for both. Visual aids, like glasses or contact lenses are often covered, while the public system offers no financial compensation for these necessary aids.

Dental cleanings are a hugely important component of overall health. The health of your gums is directly correlated with a healthy circulatory system and a functional heart. Many private insurance companies offer semi-annual cleanings, as well as coverage for gum treatments, cavities, root canals and more. Public insurance, however, only covers the bare minimum for these dental treatments. As a result, many publicly insured patients seek out “top-up insurances” to complement these gaps in their statutory coverage. While these are viable options for those who are ineligible for private insurance, those who do opt for private can save a great deal with comprehensive plans that already include dental coverage.

All German doctors accept privately insured patients. But not all doctors accept publicly insured patients. Simply by choosing to be privately insured, you’ve increased your options dramatically.

For most patients, it can take weeks to get an appointment with a physician, especially when you need to see a specialist. But doctors prioritize privately insured patients, which means that when you need to a see a doctor, your insurance coverage matters. For context, consider this: for public patients, doctors are paid a fixed amount for each appointment, regardless of their condition. Additionally, they’re only able to accept a fixed number of patients per quarter before the German government caps the amount they’re willing to pay. This means that doctors are financially incentivized against taking too many public patients. But with private patients, doctors are given more freedom when it comes to their billing structures, allowing them to earn more money with the various tests and treatments they can offer.

While the cost of public insurance is based on the idea that everyone pays into a shared pot, private insurance is calculated differently. Germans believe strongly in planning for the future. And to ensure that your healthcare costs for the future are covered, your premium each month goes towards securing your treatments, for now and for whatever comes next.

In the private system, the base cost for your monthly premium is calculated based on your age at the time you sign up. This base cost is the same for any 26-year-old, or any 34-year-old, and so on. This sum already factors in important variables like possible inflation, rising costs of health treatments, and more. But more importantly, this price is also calculated at double the price required for your current calculated health status. Why? To ensure your financial security in the future. Half of the premium you pay now will go towards paying for your anticipated health costs. The other half is set aside and conservatively reinvested by the insurance company to ensure that your costs will stay stable in the future.

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In contrast, the public system’s rates may increase every year, and they will. The current demographic situation guarantees it. With the current system, in which every young healthy insured person pays towards a shared pot that goes towards financing the rest of the insured bodies, the shift towards an older population with fewer young people to contribute toward the costs means that costs will continue to increase, year after year. The private system makes sure that your individual healthcare costs are taken care of.

ottonova Magazin Autor
HIER SCHREIBT Espen Markus Mjos

Espen Markus - originally from Norway - is sales agent in ottonova's English sales team. He's in contact with potential customers every day and answers Expats' questions about German health insurance.

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