Health insurance Germany
Public and private health insurance for young academics, doctoral students and professors in Germany
Health insurance has been universally mandatory in Germany since 1st of January 2009. According to the provisions of part 5 of the Social Security Code (5. Sozialgesetzbuch, SGB), every person living in Germany must be insured through statutory public (gesetzliche Krankenversicherung, GKV) or private (private Krankenversicherung) health insurance. The same usually applies to foreign guest researchers who are staying in Germany either in the long or short term for research purposes. Below we explain what the regulations are and what you, as an academic, need to take into account when taking out health insurance.
Which academics are subject to compulsory insurance?
The fact that you are an academic is not the only factor that defines your insurance status, what is decisive for doctoral students (Doktoranden), post-doctoral students (Postdocs), research assistants (wissenschaftliche Mitarbeiter) and professors (Professoren) is your current employment and income situation. It is here that the distinction is made between employees who are subject to compulsory insurance and those who are not obliged to sign up to compulsory insurance (GKV).
The following people are subject to compulsory insurance and must therefore sign up to public health insurance (GKV):
Employees with a monthly salary of between 400.01 euros and 4,237.50 euros (2012)/ 4,350.00 euros (2013)
Employees still in training or working on projects (§ 5 para.1 no.1 SGB V)
Conversely, the following people are not subject to compulsory insurance (cf. § 6 SGB V). They can decide whether to take out insurance within the public or private system:
Employees whose salaries exceed the relevant compulsory insurance threshold for a year (2012: 50,850.00 euros a year/ 4,237.50 euros a month; 2013: 52,200.00 euros a year; 4,350.00 euros)
Those without dependent employment: e.g. doctoral students, scholarship holders
Health insurance for doctoral students
Whether traditional doctoral students must get public insurance or can choose to receive private health insurance depends on what they earn. For example, those who are employed as research assistants at a university or other higher education institution are automatically covered by social security and consequently must obtain insurance from a public insurance provider. Doctoral candidates (Promovierende) who are receiving a scholarship or who are writing their dissertation "independently" are not subject to compulsory insurance. They fulfil the prerequisites for being allowed to become a voluntary member of a public health insurance scheme (cf. § 9 SGB V) or take out private insurance.
However, doctoral students are not entitled to the cheaper public health insurance rates for students. Doctoral candidates are not classed as normal students within the meaning of § 5 para.1 no. 9 SGB V; this was decided in 1993 by the Federal Social Court (Bundessozialgericht). Only a few health insurance providers allow "Health Insurance for Students" (Krankenversicherung der Studenten, KVdS) to continue as a gesture of goodwill until the doctoral student has reached their 30th birthday or their 14th semester (counting from the first semester of studies).
Health Insurance contributions for students with scholarships
The size of the contributions to voluntary public health insurance for doctoral students who are in receipt of a scholarship can vary significantly in practice (between a minimum contribution of around 130 euros and a maximum contribution of around 600 euros a month). The decisive factor is the financial sum of the scholarship. However, the income and financial means of a scholarship holder are estimated differently - to a certain extent, health insurance providers have no standard way of interpreting the regulations which determine the sum of the contributions students must pay. For example, some providers see separate, earmarked research allowances ("book money") as income that is subject to contributions, whilst others do not. In the past, this has created resentment among those affected (cf. judgement of the Social Court (Sozialgericht) of Hanover in October 2009, file ref.: M4 KR 164/09). According to the current jurisdiction, a scholarship is considered to be a tax-free allowance (§ 3 no.11, 44 Income Tax Law (Einkommenssteuergesetz)).
Private health insurance for doctoral candidates
Doctoral students who have prolonged their studies by taking on a traditional doctorate and do not pursue employment can take out private health insurance for the duration of the doctorate. In this case, insurance providers offer favourable conditions to those still in education. Research assistants who are doing a doctorate can also, by means of prospective entitlement, "reserve" entry conditions (e.g. earlier entry age) for private health insurance if they want to change over to it at a later date. This is because, unlike in the case of public health insurance, age of entry and state of health determine the size of the premiums. The latter is levied regardless of income.
Insurance options for professors
Professors are free to choose which type of insurance they want if they are university professors with civil servant status or have an income above the current income threshold for private health insurance (2012: 50,850.00 euros a year / 2013: 52,200.00 euros a year). The latter is often the case if the professor is allocated to remunerations system W2 or W3. Alternatively however, this group can voluntarily take out insurance within the public system. If the compulsory insurance threshold is not exceeded, the junior professor or professor must be insured under public health insurance (GKV). Within GKV, contributions are calculated in accordance with what the professor is able to pay. This is capped using the contribution assessment threshold. Income over and above this is, therefore, not taken into account. Currently the threshold is 45,900 euros a year (2012) or 47,250 euros a year (2013).
Special regulations for guest researchers in Germany
Health insurance is also obligatory for guest researchers in Germany and their accompanying family members. The authorities that register those moving into Germany normally request an appropriate proof of identity before arrival for the issue of the residence permit. For guest researchers from the European Union and states that have a social security agreement with Germany - incl. China, India, Australia, Canada and the USA - the health insurance from their home country also applies in Germany. If the researcher comes from a country outside of the EU or in the case of a long-term period of residence for research or a guest professorship, health insurance must be taken out with a German insurance provider. The same applies when someone's main residence is transferred to Germany. If the guest researcher has been hired at the university as an employee, they are insured with a public health insurance provider within the framework of social security. However, it must be noted that a stay with a scholarship can only be insured with private health insurance.
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INFO-BOX: 10 tips for finding suitable health insurance
Get all the necessary information about the legal provisions (what conditions there are for being or not being subject to compulsory insurance)
Find out about notice periods for terminating your old health insurance and criteria for being accepted to the new one
Consider what you want out of your health insurance
Weigh up the advantages and disadvantages of both systems (public vs. private)
Consider your professional activity and personal situation
The price should not be the only decisive factor
The quality and services of the insurance provider should also be taken into account
Compare the additional benefits and service of the public health insurance providers
Think carefully about private health insurance as a long-term alternative
Consult insurance experts as appropriate
INFO-BOX: A list of countries that have social security agreements with Germany
The Federal Republic of Germany has concluded bilateral social security agreements with 17 states outside of the EU. If you have health insurance in one of the following countries, in some cases it will still be recognised in Germany.
Bosnia and Herzegovina
Canada and province Quebec
Republic of Macedonia
Republic of Serbia
Content provided by: 1A Verbraucherportal - November 2012
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