10 important things to know

1. Statutory health insurance is part of a comprehensive social security system

Health insurance in Germany is part of a comprehensive social security system, which consists on sickness and nursing care funds (= statutory health insurance), a pension fund and unemployment benefit. Almost 90 % of the population, or 72 million citizens, are insured under the statutory health insurance scheme.

Instead of being a state-run public health service, our system is characterized by a close cooperation between the health insurance funds, the medical professions, hospitals and other related services. The state provides the necessary legal framework.

The statutory health insurance funds play a very significant role, since their mandate by law is to provide comprehensive coverage to their members should they fall ill.

Your employer automatically registers you and deducts your contributions from your wage to be paid into the state social security system. The choice of statutory health insurance fund is up to you - but you must inform your employer of your choice within two weeks of starting work, so that your contributions can be paid.

2. Tasks of the health insurance system

The statutory health insurance system has the following tasks:

  • Prevention, early diagnosis and treatment of illnesses
  • Medical rehabilitation
  • Payment of sickness benefit
  • Pregnancy and maternity benefits.
  • Payments to people in need of intensive nursing care are part of our long-term care insurance.

3. Self-governing, non-profit organisations

All forms, of statutory health insurance fund are self-governing, non-profit organisations by law, and are also legal entities under public law. Each of these forms (see below for an explanation) is responsible for balancing his own budget between income and services to members as expenditure.

The various forms of statutory health insurance fund are as follows:

  • The oldest form is the company health insurance fund ("BKK", such as the Bertelsmann BKK), some of which are over 100 years old, see also "What is the meaning of BKK?"
  • General local health insurance funds ("AOK"), formally for blue-collar workers,
  • Substitute health insurance funds ("Ersatzkassen"), formally for white collar employees not covered by a company fund,
  • Miscellaneous forms cover other sections of the working community, such as guilds, the merchant navy or agricultural sectors.

Since 1996 these restrictions governing the choice of fund no longer apply.

4. Contribution-based, shared by employee and employer

Statutory health insurance is contribution-based (i.e. not levied via risk-premiums or taxes). The contribution rate itself is calculated as a percentage of your income. This percentage is capped at a certain income level wich reflects the average national income in Germany. This income level is currently € 4.125 per month in 2015, and will be adjusted yearly. Age, sex and health risk of the insured are irrelevant to the level of contribution to be paid. 50 % of the entire social security contribution (including health insurance) is paid by your employer, and 50 % by you, employee. Our contribution rate is 15,3 %. Most of the other statutory health insurance funds take 15,5 %.

5. Obligatory nursing care insurance

In addition to your statutory health insurance you are also obliged to subscribe to a nursing care insurance. The nursing care insurance follows your health insurance like for BKK the BKK-Pflegekasse.

The obligatory nursing care insurance contribution rate in 2015 is 2.6 % for any fund (with children 2.35 %). 50 % is also paid by your employer. The services are rendered in kind or in cash including homecare or care in nursing homes.

6. Family insurance

Statutory health insurance also cover any dependent children or spouse (who is not earning) at no extra cost.

7. Access to benefits with your electronic health card

The service provided by the statutory health insurance funds are predominantly rendered in kind, such as outpatient services, hospital care, pharmaceuticals and remedies & rehabilitation services. Insured parties are entitled to any services and benefits within the legal parameters set by German law (Social Security Code, Book V).
There are no geographical limits to accessing these benefits within Germany, but there are differences between the service levels offered by individual health insurance funds.

8. Free choice of doctors

Under statutory health insurance you are basically free to choose your health care provider, unless you decide to join a specific scheme, such as a "quality network of doctors" (general practioneers and specialists) which are currently piloting new ways of organising health care in Germany.

9. Health care providers

All insured parties have access to all accredited health care providers. The main health providers are as follows:

  • Doctors/dentists: General Practitioners and specialists can be consulted, although usually the GP will be responsible for referring the patient to a specialist or hospital.
  • Hospitals: all levels of hospital care (primary to highly specialised care) are covered; hospital care is usually provided on referral by a GP or a specialist, or directly in case of emergency.
  • Pharmaceuticals and prescriptions medicine are available in pharmacies only, with co-payment according to package size.

Almost all health care providers and institutions are accredited by the statutory health insurance funds. Alternative health providers are not covered by statutory health insurance.

10. Private insurance companies

Private insurance coverage (i.e. non-statutory health insurance) is by law only available to those whose income is for more than 3 years above the national average (see above 4). This can take the form of supplementary or comprehensive insurance, which is provided by profit-based insurance companies, and is based on a cost reimbursement principle.

This does not cover any further family members, and once having signed up for private health insurance you are by law no longer allowed to become a member in a statutory health insurance fund.


What is the meaning of BKK?

The company health insurance funds (BKK)

The BKK system is one of the three largest providers in the German statutory health insurance system and originated in companies (some of them going as far back as the 19th century), which established their own health insurance funds for their employees.

Not only the 20 largest companies in Germany have their own BKK but also small and medium-sized enterprises. Company health insurance funds exist in all branches, in industry, trade, banks, insurances as well as public authorities.

BKK is not a central organisation with many branch offices but a flexible, decentralised system of currently more than 100 individual company health insurance funds. Each of these funds enjoys legal, economic and organisational independence.

There are over 8 million people insured in the company health insurance funds and the trend is on an upward climb! Just recently, BKK managed to win a large number of new members. Previously, only company employees and certain members of the family could be insured by the BKK. That situation has changed. Most of the statutory health insurance funds can be freely selected.

The BKK associations represent the interests of all BKKs and the people they insure. This includes adopting policies on all issues relating to health policy. As the slogan says: "Together we are strong" and the associations undertake common tasks, such as concluding contracts with dentists, hospitals and other providers in the health service.

Health at work: That's what we advocate

Knowing the workplace environment as well as it does, the BKK can do more for its members pursuing a more customer-oriented strategy. The wealth of knowledge we have gained with regards to the relationship between work and health provides an excellent basis for this work. We target this know-how to prevent work-related illnesses and to promote health at work. To this end we co-operate closely with those involved in the companies and in the statutory accident insurance system.

See the world from a different angle - The Bertelsmann BKK is definitely the right decision

A lot of advantages

  • Your partner concerning health and social insurance
  • Extensive service, farther more than the statutory
  • Faster service within 48 hours
  • You could see yourself what advantages you might achieve heading for a membership.

Customer orientated service

  • Uncomplicated service within 48 hours
  • If you have any questions, contact us for free on 0800 80-74000.

Principal of partnership

  • The BKK is a part of the partnership principle at Bertelsmann
  • Very confidentially we guarantee an absolute dataprotection
  • We are open for any proposal / suggestion as well as criticism 

Statutory service catalogue plus
an additional list of services

  • Healthprevention program "fit for life": courses, activ-weeks
  • Support in looking for treatment opportunities as well as the right specialist
  • Advice and training seminars concerning Nutrition, heart circulation, Asthma, diabetes an illness of the vertebra-Column
  • Through the social service of the company, we offer consultation related to psychological illness or problems of addiction

Support of health offers of the Company

  • We support regular vaxinations against flue, Tetanus, Diphteria, Hepatitis (all in cooperation with the company doctors)

More Information and Membership

For more detailed information we recommend the following PDF-Documents.

For your registration we offer the following PDF-Form and an online-form.

For your family we can offer the following PDF-form.

Seite zuletzt aktualisiert am: 08.02.2016

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