I’ll start with the German system. Here you are either automatically insured in one of the public insurances (there are many), which marginally differ in their cost (think single digit euro differences) and have to cover basically the same procedures. If one reaches a certain income level, being privately insured is possible.
If you are publicly insured, you wont see most costs, as these are directly handled between your insurer and the doctor/hospital. For some medications and procedures there are co-pays that are flat fees (5 Eur for Medications, …).
Access to specialists mostly need a referral from your family doctor.
In private insurance, often you yourself will be billed and you will need to hand this to your insurance company.
The good side is that in most common situations I have never needed to worry about cost in public insurance, wait times for referrals can be very long and understanding what you need to get certain care can be very difficult.
Private insurance often has better payment schemes for providers and less artificial limits on number of patients or which doctor is able to provide services, so access to most care is faster and more widely available.
Access to specialists mostly need a referral from your family doctor.
That hasn’t been the case in many years now, you can just make an appointment without a referral.
In private insurance, often you yourself will be billed and you will need to hand this to your insurance company.
An experience that’s quite common, as public insurance only covers the absolute bare minimum for dental health (including only the visibly ugly fillings). So many (at least many compared to people having general private insurance) people tend to have additional private dental insurance, and there it works exactly like that, you pay, and then you send the bill to your insurance.
one of the public insurances (there are many)
For those wondering how you decide, it’s mainly about the extras. The one I’m at (TK) is well known for having an English-speaking hotline, which is great if your German isn’t that good, as they also can make appointments for you. One other feature I accidentally found once is that they support OAuth for netdoctor (digital dermatologist visit), while others have to send in forms.
It’s mainly small stuff like that, niche procedures that get covered, paid exercise, and obviously (because it’s Germany) what and how much esoteric bullshit they cover.
Access to specialists mostly need a referral from your family doctor.
That hasn’t been the case in many years now, you can just make an appointment without a referral.
Well, for most specialist. There are still a few cases were it is required, e.g. radiologist.
Also with public insurance you might have to wait longer for your appointment with a specialist - but if you have a referral from your family doctor, they can add a urgency note (Dringlichkeitsvermerk) on it and you will get an appointment faster. With that you can also call the health service hotline (116117) and they have to find an appointment for you.
That is not correct anymore - they are absolutely insured as long as they are entitled to Bürgergeld,even if they don’t actually get it or have the three month block in it.
The problem is more that the insurance works retroactively in that situation and they often are billed privately by health care providers (which is somewhat illegal) and some of these claims “stick”, especially if you don’t have the resources to fight it.
I’ll start with the German system. Here you are either automatically insured in one of the public insurances (there are many), which marginally differ in their cost (think single digit euro differences) and have to cover basically the same procedures. If one reaches a certain income level, being privately insured is possible.
If you are publicly insured, you wont see most costs, as these are directly handled between your insurer and the doctor/hospital. For some medications and procedures there are co-pays that are flat fees (5 Eur for Medications, …).
Access to specialists mostly need a referral from your family doctor.
In private insurance, often you yourself will be billed and you will need to hand this to your insurance company.
The good side is that in most common situations I have never needed to worry about cost in public insurance, wait times for referrals can be very long and understanding what you need to get certain care can be very difficult. Private insurance often has better payment schemes for providers and less artificial limits on number of patients or which doctor is able to provide services, so access to most care is faster and more widely available.
That hasn’t been the case in many years now, you can just make an appointment without a referral.
An experience that’s quite common, as public insurance only covers the absolute bare minimum for dental health (including only the visibly ugly fillings). So many (at least many compared to people having general private insurance) people tend to have additional private dental insurance, and there it works exactly like that, you pay, and then you send the bill to your insurance.
For those wondering how you decide, it’s mainly about the extras. The one I’m at (TK) is well known for having an English-speaking hotline, which is great if your German isn’t that good, as they also can make appointments for you. One other feature I accidentally found once is that they support OAuth for netdoctor (digital dermatologist visit), while others have to send in forms.
It’s mainly small stuff like that, niche procedures that get covered, paid exercise, and obviously (because it’s Germany) what and how much esoteric bullshit they cover.
Well, for most specialist. There are still a few cases were it is required, e.g. radiologist.
Also with public insurance you might have to wait longer for your appointment with a specialist - but if you have a referral from your family doctor, they can add a urgency note (Dringlichkeitsvermerk) on it and you will get an appointment faster. With that you can also call the health service hotline (116117) and they have to find an appointment for you.
Ah, probably true, they are extra special specialists though (as in there’s (afaik) not a radiologist practice you can go to.
Seems like one of the best types of systems in the world to me. Public insurance should have to compete with private insurance.
deleted by creator
That is not correct anymore - they are absolutely insured as long as they are entitled to Bürgergeld,even if they don’t actually get it or have the three month block in it. The problem is more that the insurance works retroactively in that situation and they often are billed privately by health care providers (which is somewhat illegal) and some of these claims “stick”, especially if you don’t have the resources to fight it.