Health insurance in Germany Glossary

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The contribution assessment ceiling is the upper limit up to which the the income of the insured (e.g. the salary of employees) is used to calculate contributions.

In 2022 this ceiling (in German: Beitragsbemessungsgrenze = BBG) is 4.837,50 Euro monthly.

Daily cash allowance in the event of incapacity for work. When you are a member in the statutory health insurance scheme, this sick-pay is capped a the contribution assessment ceiling. When you are privately insured you can increase this allowance accorging to your actual income, so that there is no income gap in the event of incapability for work.

Private health insurers usually limit dental benefits in the first few years after taking out a policy. There are sometimes major differences here, so it is very worthwhile to take a close look.

This can look like this, for example:

Maximum amounts of reimbursement for dental treatment, dental prostheses and orthodontics:

• 1st calendar year 1.000 €
• 2nd calendar year 2.000 €
• 3rd calendar year 3.000 €
• unlimited from the 4th year onwards.

The deductible, also called excess amount (in German: Selbstbeteiligung) is the share that a policyholder has to pay himself/herself in the event of a claim. All costs beyond this are borne by the insurer.

The price of private health insurance depends on your age at the time of application. The younger you are when you take out the policy, the cheaper your premium will be for life, compared to someone who is, for example, 5 years older when they take out the policy.

Also called primary physician principle (in German: Hausarztprinzip). This principle is a requirement of health insurance, according to which the insured person must first consult his or her general practitioner if he or she is in need of treatment. Consequently, anyone who wants to go to a specialist doctor needs a referral. You can waive this requirement by opting for a slightly more expensive private heatlh insurance plan which grants free and direct accesss to specialist doctors.

This term comes from the world of statutory health insurance. In the statutory scheme, dependents who have no income or an income below 450 Euro per months, can be included cost-free. Private health insurance does not know such a thing. With private health insurance you pay per person. And children, for instance, cost an extra contribution of roughly 200 Euro/month.

in German: Gesetzlicher Zuschlag vor Vorsorgezuschlag: This legal surcharge, which is mandatory for private health insurance plans, amounts to 10 % of the main plan. This supplement is accumulated with interest during the runtime of the contract and ceases to apply when you reach the age of 60. The insurance cover therefore becomes around 10 % cheaper at 60.
From the age of 65, the accumulated capital is used to buffer the normally happening 3 - 5 % yearly increase in premiums and thus protects pensioners and older insured persons from rising premiums.

The actual health insurance and the compulsory long-term care insurance are inseparably linked. The long-term care insurance (in German: Pflegepflichtversicherung) is a part of Germany's social security system. The long-term care insurance covers the costs for an outpatient care service or inpatient care in a nursing home. If close relatives take care of the person in need of care, the insurance pays a care allowance. The severity of the need for care is measured in five care degrees. In Germany, you have to have long-term care insurance, it is mandatory and cannot be waived.

Some insurance providers return a part of your contribution if you didn't make a claim within the previous year. This so-calld "Beitragsrückerstattung" is a reward for cost-conscious life-still. Learn more...