Versicherung2000

Only registered contract doctors with health insurance approval

No benefits for naturopaths

Statutory health insurance must make significant co-payments. Basically, there is an additional payment of 10% for almost all services of the statutory health insurance (GKV), which is at least EUR 5 but at most EUR 10 (e.g. for medicines, bandages and aids). In the case of medicinal products, the additional payment is a flat rate of EUR 10 per prescription and 10% of the costs.

co-payments:

• Doctor visits: EUR 10 per quarter
• Dental visits EUR 10 per quarter
• (other) specialist visits without referral: EUR 10

Exceptions to co-payments:

• The co-payment is limited to 2% (for the chronically ill to 1%) of the gross income
• No additional payment for children and young people under the age of 18.

Restrictions on services from 2004

An example: Adults only receive statutory benefits for visual aids in exceptional cases. Children and young people up to the age of 18 are still entitled to glasses or contact lenses.

Free choice among all registered doctors

Alternative practitioner services are usually also insured

Full reimbursement of all medically necessary medications and medical treatments.

Spectacle lenses are also paid for in high quality (e.g. with super anti-reflective coating, with tinting, plastic lenses). Spectacle frames up to EUR 150.00. Contact lenses are almost always reimbursed.

The doctor must take into account a hospital comparison list during admission. If another hospital is chosen, the additional costs could possibly be passed on to the patient in whole or in part. The deductible for hospitalization is:
EUR 10 additional payment per day for a maximum of 28 days per calendar year from the age of 18....

Free choice of hospital
Free choice of doctor, including senior consultant
Free choice of room size: single, double or multi-bed room

Statutory health insurance reimburses only 50% of the costs incurred for the usual health insurance plans. (Up to 65% for regular check-ups)

Dental implants, functional diagnostic measures in connection with diseases of the temporomandibular joint and additional costs for dentures, which are more expensive than necessary, must be borne by the person with statutory health insurance.

Dentures from 2005:
Dentures must be insured separately - either with the statutory health insurance company or with a private health insurer. The insured person must pay the contribution for this alone. So far, the employer has contributed 50% to the contribution for dentures.

Depending on the insurer and tariff, up to 100% of the denture costs are insured. High-quality materials, eg gold and ceramics, functional diagnostic measures and dental implants

Sickness benefit (also for voluntarily insured members) is only 70% of the gross salary and may not exceed 90% of the net salary. A sickness benefit payment that is above the contribution assessment limit of EUR 4,050.00 is not permitted. The benefit period is limited to 78 weeks. Serious loss of income can result.

Sick pay from 2006:
From 2006, the GKV-insured must pay for the sick pay alone. So far, the employer has shared 50% of the sickness benefit contribution. The special contribution for sickness benefit will be 0.5% of the contributory earnings.

The net income can be insured without a time limit.