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Living in Germany: How universal healthcare works

Healthcare in Germany is universal, and the system spends nearly half as much as the United States but still manages to cover 100% of its population through a mix of public and private insurance schemes

We were first thought of moving out of China in 2011, my wife and I knew we didn’t want to go back to Brazil. Our first son Caleb had just been born and we needed to consider when we would raise him (not knowing that Esther and Daniel one day would also come).

We know wherever we would go next needed to be closer to Brazil than China: it took us 3 days of traveling (flying time, layover, timezone difference included) between our family hometown and Shanghai, so we needed to cut the distance short.

We decided also that wherever we would go next needed to be home of a good education system to our kids and accessible health care for us (something we struggled with in China).

When the opportunity came to move to Germany, we knew that it had both good health care and education systems, but we didn’t realize how good they were: Germany’s healthcare system spends nearly half as much as the United States but still manages to cover 100% of its population through a mix of public and private insurance schemes.

How Healthcare in Germany works

There are two different systems that residents can turn to for insurance in Germany: SHI, which stands for Statutory Health Insurance and PHI or Private Health Insurance. Here’s how they work:

Healthcare in Germany: Statutory Health Insurance

Once your income is below the annual income limit of €59,400  you are automatically insured on the statutory health insurance scheme. If your income is above this limit you can choose to be insured on statutory health insurance, however it often works out more expensive than opting for a private option.

Statutory health insurance in Germany provides a range of services and benefits including:

  • Medical and dental treatment
  • Medicines
  • Hospital treatment
  • Sick pay

Health insurance payments in Germany are deducted at source and contributions are split between you and your employer. These deductions will cover the majority of your medical expenses.

However, to cover increasing costs of the state insurance scheme, public patients over the age of 18, are required to contribute to the cost of some services for example:

  • Prescription medicine: 10% of the pharmacy counter price minimum €5 and maximum €10
  • Hospital treatment: €10 per day for a maximum of 28 days in a calendar year
  • Outpatient rehabilitation treatment: €10 per day
  • Most costs are capped at a maximum of €10 a day or 2% of the income per year, in the case of medicines

For more detail on the state health insurance, search ‘Social Security at a Glance’ for a comprehensive overview provided by the German Federal Ministry of Labour and Social Affairs.

Healthcare in Germany: Private Insurance

If your salary is above €59,400 a year, you have the option to access private health insurance in Germany. In addition, civil servants or the self-employed in Germany can also choose private health insurance. About 11% of Germans opt for private health insurance.

The Benefits of Private Health Insurance in Germany

There are many benefits to being able to access private health insurance while working in Germany, including:

  • For higher paid professionals, private health insurance can be less expensive than the state scheme as contributions to the state scheme are based on your gross income
  • Access to private practice doctors
  • May offer more comprehensive cover for procedures
  • Access to semi-private and private rooms in hospitals

Source: How universal health-care works in Germany

By Itamar Medeiros

I'm a Strategist, Branding Specialist, Experience Designer, Speaker, and Workshop Facilitator based in Germany, where I work as Director of Design Strategy and Systems at SAP and visiting lecturer at Köln International School of Design of the Cologne University of Applied Sciences.

Working in the Information Technology industry since 1998, I've helped truly global companies in several countries (Brazil, China, Germany, The Netherlands, Poland, The United Arab Emirates, United States, Hong Kong) create great user experience through advocating Design and Innovation principles.

During my 7 years in China, I've promoted the User Experience Design discipline as User Experience Manager at Autodesk and Local Coordinator of the Interaction Design Association (IxDA) in Shanghai.

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