Who can get statutory health insuranc

Statutory health insurance offers various options for insuring yourself. Common tariffs include compulsory insurance, voluntary statutory health insurance and family insurance. In addition, there are separate tariffs for students.

 Consumers can also equip their health insurance with optional tariffs and thus increase the insurance benefit. Self-employed people who voluntarily take out statutory health insurance can choose between health insurance with or without entitlement to sick pay. Depending on the selection, the contribution rate is 14.6% with an entitlement to sickness benefit or 14.0% without an entitlement. Before taking out health insurance, consumers should urgently find out about the different tariff options in order to save costs if necessary.

Health insurance has been compulsory for everyone in Germany since January 1st, 2009

Compulsory insurance includes all important medical treatments and preventive measures as well as the supply of medicines and aids

In addition to the compulsory insurance, additional services can often be selected

Further information on compulsory health insurance

The self-employed, civil servants or employees above the compulsory insurance limit can voluntarily take out statutory insurance, and students are also free to choose between statutory health insurance and private health insurance at the beginning of their studies

The current compulsory insurance limit is an income of €5,212.50 per month

The health insurance contribution is determined based on the gross income

More information about voluntary health insurance

Spouses who have no income, income from self-employment up to a maximum of €435 or who have a mini-job up to €450 can be insured free of charge

Children of insured members can also be insured free of charge up to the age of 23, as long as they are not gainfully employed

During an apprenticeship or study, the period can be extended up to the 25th birthday

More information on family insurance

For students who can no longer be insured through their parents due to their age

The minimum assessment limit of €1061.67 (2020) applies with a reduced contribution rate of 14.0 percent

So far, preferential conditions applied until the end of the 14th semester or up to the age of 30, but since January 1st, 2020 the limitation of the number of semesters has been eliminated

More information about student health insurance

Our readers ask - we answer: The most popular FAQ

There is no general answer to this question. Different aspects and services are important for every consumer. However, independent institutes and rating agencies carry out tests at regular intervals to check the quality of the insurance. For example, Stiftung Warentest chose hkk and BKK Firmus as the cheapest health insurance companies in 2019.

Further test results: Statutory health insurance test 

The costs covered by the health insurance company depend on the respective tariff of the policyholder. As a rule, the statutory health insurance covers all the services that are considered economical, sufficient, necessary and appropriate according to § 12 (SGB V). In addition, insured persons have the option of selecting further additional services before taking out the insurance.

Find out more about optional tariffs for statutory health insurance 

In order to be able to cancel the health insurance, policyholders must have been a member for 12 months or longer. Special regulations apply to a change of status or an increase in the additional contribution. The cancellation of the health insurance must be submitted in writing at the end of a month. The notice period is 2 months and is always executed at the end of the month.

More information on changing health insurance companies .

Resumption in the statutory health insurance is possible if privately insured persons with their gross annual income fall below the compulsory insurance limit again. If a policyholder meets the conditions for family insurance, it is also possible to switch back to statutory insurance. There are special regulations for individual professional groups, which are regulated in the Social Security Code (§5, 6 and 9 SGB V).

More about the return to statutory health insurance

Anyone wishing to submit an application for reimbursement to the health insurance company should do so in the form of a registered letter with return receipt. In this way, policyholders can be sure that the application will actually be received. In your letter, justify which treatment is to be covered at what cost and why. If necessary, attach attachments that confirm your information.

Learn more about reimbursement plans here .

The contribution assessment limit in statutory health insurance determines the maximum insurance contributions to be paid and was €4,537.50 per month in 2019. In 2020, the value is expected to increase to €4,687.50.

Find out more about the contribution assessment limit here

The entitlement to sick pay applies in principle from the day on which the doctor has determined that you are unable to work. In the case of employees, however, this entitlement is initially suspended, as they generally receive continued wage payments from the employer for up to six weeks. As a rule, policyholders receive sick pay for a maximum of 78 weeks or 72 weeks for employees. The payouts are regulated within a block period and are largely immobile.

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