Private vs Public Health Insurance

[Frantic]

I remember some interesting threads in the old forum that "scared" me and kept me far from the private health insurance.
Me and my wife are not satisfied about the health system here in Germany. We both are in TKK.
She want to switch to private in order to receive better service. I still think that going to private is a risk that can lock her/us in a situation that later on can be financially demanding....but i cant find any valid source for making my point.
Do you know any article or data that can give real examples of what it will mean financially to go private ?
Or, on the other way, am I totally wrong on this and maybe private is not that bad ?

[Fraufruit]

If you don't mind me asking, Frantic, which services is she disappointed with?

After being on public for over 30 years, I had my first "discrimination" this week when making an appointment at my regular Hautsarzt. I rang them up and the lady asked me if I was public or private. She had already asked my name and birthdate so had all of my info right in front of her. She even told me the last time I had a skin cancer checkup. They can't take me until Nov. and I'm sure it is because I'm public. I even told her I have an Überweisung from my Hausarzt because there are a couple of things that need to be checked. She also told me that I will have to pay €50 because I "just had a checkup" in Jan. 2023.

If I had asked for botox and filler, I would have gotten in immediately because that is all self-pay and expensive.

Other than that, I've never been disappointed with the service.

[snowingagain]

Finding info online is tricky in English as much of the information seems to be coming from providers of private health insurance. This German site translates nicely and seems more balanced.

https://www.finanztip.de/krankenversicherung/

[Eric7]

The only downsides to private health insurance that I can see are:

1. You have to pay all bills yourself and then claim them back from the insurance company. Sometimes items on the bills can be outside the scope of your insurance and are not refunded.
2. Rising costs as you get older. Although private insurance is (sometimes much) cheaper than public when you are young, as you get older it will definitely be more expensive. We pay over €1k a month for 2 people.
3. Unnecessary treatment being carried out, just because the doctor/hospital want to milk the insurance company.

I've been happy with my private insurance but the costs are rising so have been considering making the move to public before it's too late (55).
Ongoing health issues are causing me to rethink however!

Is your wife on your insurance/vice versa, or do you both work and pay full contributions?

[LeonG]

She want to switch to private in order to receive better service. I still think that going to private is a risk that can lock her/us in a situation that later on can be financially demanding....but i cant find any valid source for making my point.

Why does she think she will get better service? What is bad about the service you are getting now?

I have talked to someone who had private insurance and he said it was not all that. Said that billing is very confusing, you will get pages of itemized bills you don't understand and some items will be covered and some will not. Although I'm sure private insurances are not all equal.

If you want to see how it looks financially, get a quote. Keep in mind that as you get older, your premiums will go up and it may be hard to switch back.

https://www.verbraucherzentrale.de/wiss ... voll-13884

Edit: Also see this thread: viewtopic.php?t=288

[PandaMunich]

I still think that going to private is a risk that can lock her/us in a situation that later on can be financially demanding....but i cant find any valid source for making my point.

Stiftung Warentest is the consumer watchdog in Germany, and they say in their latest test of private health insurance from 2022 (complete text costs 4.90€): https://www.test.de/Private-Krankenvers ... 4692658-0/

• Nachteile einer privaten Kranken­versicherung
  Angestellte und Selbst­ständige sollten sich zweimal über­legen, ob sie sich die Beiträge für die private Versicherung auf Dauer leisten können. Denn wer mit Mitte 30 einsteigt, muss damit rechnen, dass er bei Renten­eintritt mindestens das Dreifache des Beitrags zahlt, der beim Abschluss der Versicherung fällig war. Wie viel jemand im Alter verdient, wird, anders als in der gesetzlichen Krankenkasse, beim Beitrag für die private Kranken­versicherung nicht berück­sichtigt.
• Disadvantages of private health insurance
  Employees and the self-employed should think twice about whether they can afford the premiums for private insurance in the long term. After all, if you start in your mid-30s, you can expect to pay at least three times the premium that was due when you took out the insurance when you retire. In contrast to statutory health insurance, how much someone earns in old age is not taken into account when calculating the premium for private health insurance.

Private health insurance:
Come pension time, you need to be able to afford to pay 3 times the private health insurance contribution amount that you pay today and only get a subsidy from German public pension insurance of 7.3%*public pension towards it (these 7.3% are half the 2024 public health insurance contribution rate. This percentage will be higher when you retire).
If you join private health insurance at a higher age than the age 35 that Stiftung Warentest used in their calculations, expect a factor that is eveb higher than 3, since you will have less time to save up the money that is supposed to be used to lower your contribution during your old age.

Public health insurance:
If you remain in public health insurance, your public health insurance insurance contribution will be half of the standard rate, so today, pensioners pay 7.3%*(public_pension + company pension) and that's it.

Stiftung Warentest also has a 2024 article with a table comparing public and private health insurance, that also links to a checklist for private health insurance (the article resists translation by GoogleTranslate, just copy the text into DeepL.com): https://www.test.de/Private-Krankenvers ... 5353750-0/

[bethannbitt]

No doubt about it. Public is cheaper. But here on the Swiss border we have a BIG problem! Doctors would much rather cater to Swiss folks who pay (and then get reimbursed in ) or Germans who are privately insured. Many practices, albeit not all, flatly refuse to see GKK patients like us. Our solution is to pay privately for extra svcs as warranted. Others have supplemental insurance to help. I have spent several years assembling my cadre of trusted doctors who I hope will not leave me in the lurch in a real emergency.

[kiplette]

My oldies are a mix of private and public. In all their conversations about health care, an enormous difference in outcome between the two is not a topic.

Essentially the ones who were Beamter are privately insured in some special category, and that's lovely thanks chaps, and the ones who are just privately insured have to pay loads and do headache-inducing amounts of paperwork. That's where that random sample of retired folk are at.

[Eric7]

No doubt about it. Public is cheaper. But here on the Swiss border we have a BIG problem! Doctors would much rather cater to Swiss folks who pay (and then get reimbursed in ) or Germans who are privately insured. Many practices, albeit not all, flatly refuse to see GKK patients like us. Our solution is to pay privately for extra svcs as warranted. Others have supplemental insurance to help. I have spent several years assembling my cadre of trusted doctors who I hope will not leave me in the lurch in a real emergency.

Public is definitely not cheaper if you are a single person in their 20's or 30's, earning decent money...

[kiplette]

Yeah - it depends on how long you are staying.

If you are going to be here for a couple of decades at those kinds of ages, without dependants, you may very well be better off.

If you are here for the foreseeable, then as you age, public is more predictable and less expensive, as Panda's post explains.

An example for when private is great - we have two kids in jobs where direct health care is part of the package. They have to get their own Pflegeversicherung because that's not included. For them to buy it through public KK, it will cost a percentage of their income (around 2-3% as I remember) whereas with a private company eg. Continentale it's a flat fee of about 30€ which is cheaper for anyone earning a living wage.

[Frantic]

If you don't mind me asking, Frantic, which services is she disappointed with?

I dont know if it is because we moved from Munich to an area of Erding and then the offer decreased in quality and quantity....but generally speaking we feel we are treated like second rank patients compared to what I hear from a pair of contact who are on private insurance.

Our medical visit are quick, some time "superficial".
I can compare a skin check (cancer prevention) I had here and the one I had years ago in Italy. THe one here in Germany was a joke, almost a formality. The one in Italy, compared to the one in Germany, lasted 6x time.
A phyisiotherapy cycle I did a pair of year ago was a joke, in term of duration. The same for my wife. Again, looked like a "pro forma" activity, nothing having really an impact.
When my wife was in hospital , her "room-mate" was getting visited by the main specialist doctor and having different better food because she was privately insured.

I dont know, maybe it is also about findind the right good doctor/specialist. But for sure being on public means longer waiting time...or sometime neither being able to access some doctor because they accept just privatly insured people.

[Fraufruit]

My medical visits last as long as it takes for the doctor to answer all of the questions I have written down.

[LukeSkywalker]

The waiting time for privately insured patients is definitely shorter than publicly insured. A girl-friend of mine has private insurance and is often seen within a couple of days. She visits several specialists on a regular basis. Basically, they squeeze her in it seems.

She also has her blood tested like me (public), but her list of values is twice as long. Sure, they often test everything possible since this is being reimbursed by her insurance anyway. Specialists get dollar signs in their eyes.

[Frantic]

Is your wife on your insurance/vice versa, or do you both work and pay full contributions?

we both works and we both pay the maximum possible (together with our employer). Each of us pays 9500 euro per year and each time there is always something not covered or you feel you are a rank B patient.

[LukeSkywalker]

A younger colleague of mine got private insurance, but later in life he became a father of two children. They are not automatically co-insured like with public insurance. He pays €180 per kid extra per month. The financial gain he got with private insurance was undone, so when you take private insurance, you need to think years ahead, even decades.