Health care insurance

16 posts in this topic

Posted

Hi everyone, I just moved to Hamburg a few days ago and I need to choose a health care insurance. I am trying to do some research about different health insurances but it would be helpful if someone could recommend what would be best for my situation: I have 2 kids and one has many health issues, is delayed in his development and requires rehabilitation. Thank you.

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Posted

Oh Mania...why have you waited till now to do the research? You´re already here with two children and this issue is very complex.

What is your situation? Are you an employee, self-employed non-working , where have you been health insured till now? etc etc....

Please give much more detailed information if you want people to give you recommendations.

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Posted

I am employed, my kids are with my husband in US, he is working there and has insurance there and he will bring them here as soon as I have insurance. From what I found out I think I will sign for TKK but someone from different forum recommended to buy additional insurance because TKK might not cover everything.

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Posted

How will your husband get health insured in Germany? I ask this because you say he will bring the children as soon as YOU have insurance. What about him?

TKK is a very good public insurance but of course it doesn´t cover everything. You MAY decide later that you want extra things eg better dental cover, maybe semi-private/private hospital room etc but that can surely wait. You will not be able to get special extra private insurance for your child with many health issues, I´m afraid..but public insurance here is not the worst in the world.

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Posted

Hi mania, we moved here in August and have an 11 year old daughter with Down syndrome. We're insured with Barmer GEK and I have been very happy with them. My daughter receives speech therapy once or twice a week, she wears a special type of hearing aid and was supplied the radio accessory for it immediately and without any problems or additional payments being required.

Her orthodontic treatment was also approved.

My son has had weekly occupational therapy since we got here - basically for having rather bad handwriting. That keeps being provided without any problems, too.

My daughter's teacher at the special school she attends said that in his experience the public insurers are more generous than the private ones in terms of providing equipment.

I would recommend choosing an insurance company that has an office local to you, it's good to have a personal point of contact.

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Posted

Private health insurance will probably decline an application for a child who already has serious health issues as they can chose who to cover (unless for those contracts which don't provide better cover than the public providers). Public insurance providers cannot (and they all cost about 15% of your income, 7.5% of which paid for by your employer). So most probably you will want to chose from public insurance providers. You will have to take out insurance for yourself and then all your dependents will automatically be covered as well (including your husband, should he reside in Germany and have no income of his own). And in case you shouldn't be happy with your choice you can swap your provider at a later stage with 3 months notice (after 1 year I believe). Be aware that public German health insurance will not cover you in the US, so you might want to keep the right to opt for cover in the US in case you want to go back.

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Posted

What is the right to opt for cover in the US?

Travel insurance , if you go with TK, would be extraordinarily cheap through their Envivas branch . Under 50 euros a year, which would cover you out of the EU.

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Posted

Thank you for all your responses.

Someone asked how my husband will be insured in Germany - he will be insured under my insurance. The reason why I wanted to take additional insurance was to make sure that it will cover whatever my son needs like MRI, physical therapy, right now he has rehabilitation once a week, he has many follow up appointments with doctors.

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Posted

Hi Mania! I was the one who asked how your husband would be insured! :) So he won´t be working, is that correct? Or at least not earning over 385 euros a month if he will be working? Otherwise he will have to have his own.

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Posted

Thank you for all your responses.

Someone asked how my husband will be insured in Germany - he will be insured under my insurance. The reason why I wanted to take additional insurance was to make sure that it will cover whatever my son needs like MRI, physical therapy, right now he has rehabilitation once a week, he has many follow up appointments with doctors.

I really don't think you need to worry. As I said we get plenty of therapy in generous amounts. Another example of excellent medical care - when we got here we had a 'getting to know you' kind of appointment at the hospital audiology department. The doctor we saw was surprised that my daughter never had a ct scan of her ears etc in the UK, arranged for one to happen 2 weeks later, on the basis of that had a team meeting with several highly experienced specialists and decided that her hearing loss can possibly be fixed and booked her in for surgery another two weeks later. They said if that doesn't fix things they'll give her another implant (she currently only has one - they cost 9,000 euro including surgery etc and the British national health service reckons that hearing on one side is enough).

I've certainly never felt that she is getting inferior medical care in any way.

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Posted

The reason why I wanted to take additional insurance was to make sure that it will cover whatever my son needs like MRI, physical therapy, right now he has rehabilitation once a week, he has many follow up appointments with doctors.

Using a public insurance your children are also insured. If you want additional insurance for them you need extra private insurances for each of them. If your children have/had serious health issues now or in the past you have a problem. A private health insurance doesn't pay for known issues. If your children get ill later that's no problem, but the insurance checks the health status when you subscribe.

P.S.: Sorry for my English. I'm not a native speaker.

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Posted

My daughter's teacher at the special school she attends said that in his experience the public insurers are more generous than the private ones in terms of providing equipment.

This varies from company to company and also depends on the smallprint in your contract. Many private insurers basically cover only medically necessary treatment and restrict cover for whatever might be necessary beyond that to a minimum. The real advantage of private insurers over public ones is that the you are free to choose your doctor - whether or not he has a contract with your insurer - and that you are usually covered worldwide (not restricted to the EU). And usually you will be entitled to a room for yourself ( with your own private toilet) or maximum one person to share it with, whereas public insurance will usually pay for a shared room only (usually 3 - 4 persons sharing).

The advantage of public insurance are that

i) it covers all your dependents as well without additional cost ii) you will not even come to know the cost of treatment and prescriptions (as they will pay the doctor directly) and

ii) you don't have to worry about whether they will pay for what the doctor prescribed (as all their service providers will be paid directly by them)

iii) they go beyond covering what is medically necessary treatment (e. g. prevention (gym courses or spa stays, rehab programs, short-term caregiving, housekeeping if you are ill or in hospital so that your kids are looked after etc.)

Private insurance is usually cheaper if you are single as the cost only depends on how much of a risk you are to them (preexisting conditions?) and not on your salary, wheras public insurance premiums are always a certain percentage (usually 14.5% - 16%) of your salary, but independent of the risk they have to take on and independent of the number of dependents.

Be aware though that you can only opt for private insurance if your income is more than an certain amount (which is reset by government every year). Currently I think it is around EUR 45000 per year.

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Posted

Indeed, jeba, it DOES depend on the small print. That goes for the privates: you are not always free to choose your doctor or you are often limited to getting a referral to a specialist doctor ( Hausarztprinzip) and you MAY be covered worldwide..depends on the tariff and also for how long you are covered outside Germany.

Your point about being entitled to a room by yourself: that depends on the tariff! It may be semi-private or not at all private..depending on how much the client is willing/able to pay for the insurance..

Public insurance: SOMETIMES it covers dependents..depends!! If your dependent is working and earning over 385 euros a month..then not!

Private insurance for employees: it´s now an option with a salary of at least 52,200 euros - for freelancers/self-employed it ´s irrelevant. And for Beamte.

Your points are well made!

It´s complicated here, though!!!

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Posted

Your point about being entitled to a room by yourself: that depends on the tariff! It may be semi-private or not at all private..depending on how much the client is willing/able to pay for the insurance..

Public insurance: SOMETIMES it covers dependents..depends!! If your dependent is working and earning over 385 euros a month..then not!

All private insurance companies I am aware of offer sort of complementary cover for those who have public insurance but want to be treated as private insured patients when in hospital (e.g. private room, treatment by head of departement). Not sure whether that is also available any longer for outpatient treatment.

Wasn't the limit of EUR 385 actually EUR 400 and was raised to 450 as of January 2013?

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Posted

Ah, that´s a different point altogether, jeba: supplementary private insurance for the publicly insured. I read your post differently...

The EUR 400 you refer to is the mini job thing, which has gone up to 450. The 385 euro a month limit is generally for the spouse of a public insured person who wants to remain co-insured free of charge.

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Posted

Ah, that´s a different point altogether, jeba: supplementary private insurance for the publicly insured. I read your post differently...

Well, you read it correctly. In my first posting I wasn't talking about supplementary insurance. In my second posting I just wanted to make people aware of that this option is available as well. So you don't necessarily have to give up on all the benefits of private insurance when you opt for public insurance.

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