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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:
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 member contributions as income and services to members as expenditure.
As of 1996 with the Risk Structure Compensation Act, statutory health insurance funds with a low-risk member structure (e.g. members with a low average age working in low-risk, high-paid office jobs) are required to donate financial support to funds with a high-risk member structure (e.g. members who are older, unemployed or who work in physically demanding environments).
The various forms of statutory health insurance fund are as follows:
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 € 3.825 per month in 2012, 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. The statutory health insurance contribution rate in Germany is 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 is 2.2 % for any fund (with children 1.95 %). 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 insurance 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:
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.
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.
A lot of advantages
The Bertelsmann BKK
Customer orientated service
Principal of partnership
feedback[at]bertelsmann-bkk.deStatutory service catalogue plus
an additional list of services
Support of health offers of the Company
Our successfulresults
Who?
How?
via internet (available only in german)When?
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We recommend the following website:
www.deutsche-sozialversicherung.de/en/index.html
Or send us an email.
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