Statutory health insurance: Benefits, contribution and family insurance

In short: Statutory health insurance (GKV) covers basic care; the contribution depends on income, and children or partners can be co-insured under conditions.

In more detail: In Germany there is compulsory insurance: everyone needs health insurance. Most people are in the GKV (health funds such as AOK, TK, Barmer, IKK), others privately (PKV). Amounts and rules change; check the current status with the responsible body.

In Depth

Benefits

Medical and dental treatment, hospital, medicines (with co-payment), prevention and vaccinations, sick pay, maternity, rehab, remedies and aids. An electronic health card proves the insurance and lets you see the doctor. Co-payments are limited (cap of 2 % of income, 1 % for chronically ill). Additional services (dentures, glasses) are partly covered only to a limited extent.

Contribution

The contribution consists of a general rate (about 14.6 % of gross income, half paid by the employer) plus an additional contribution of the respective fund (around 2 %, also split equally). Trainees pay too; with low pay (below the low-earner threshold) the company pays the entire contribution. Changing funds is possible with notice, especially by special termination on a contribution increase.

Family insurance

Spouses and children can be co-insured free of charge if their income stays below a limit. Children up to 18 years, in training or study up to 25 years (exceptions, for example with disability), without own compulsory insurance. With training (pay above the mini-job limit) you are usually compulsorily insured yourself through the company.

Practical

Take the card to the doctor, use preventive check-ups (free) and request cost reimbursement only after agreement. In case of trouble: complaint to the fund, then to the Federal Office for Social Security. Good information is offered by consumer advice centres and Stiftung Warentest.

See also: Social insurance