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Health insurance is a must if you want to study
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Health Insurance
If you don't have a health insurance policy, you cannot register (matriculate) at your university in Germany. So please do not forget to take out health insurance as soon as you arrive.
Essentially, the following applies: Up to the age of 30 (or up to your 14th full study semester) you must be insured (compulsory insurance). This means that as you proceed through your studies you must continue to pay health insurance contributions. Otherwise you can be struck off the university register (exmatrikuliert). Proof of health insurance is also absolutely essential for extending your residence permit.
Medical emergencies? Call 112!Ouch! It had to happen on a Saturday just before the end of semester party. Mai got really bad toothache. "I had no idea who could help me at that time of night. It was already almost 8 pm," remembers Mai. Luckily, her friend Nina knew what to do.
Medical emergency service on call 24/7: Nina immediately checked the newspaper to find out which dentist was on emergency call at the weekend. Finally, she called an emergency ambulance to take Mai to the university hospital, since that was the quickest place to reach. All Mai had to do there was fill in a form with her personal details and present her health insurance card (Versichertenkarte). "I then got an injection to stop the pain. The doctor advised me strongly to get an appointment first thing Monday morning," recounts Mai.
Since experiencing this, Mai knows that Germany has a well-coordinated and efficient emergency medical service that works around the clock – at weekends and on public holidays. General practitioners (GPs) who alternate on call and the hospitals with the accident and emergency (A&E) units are all part of this system. If you want to know which doctor is on call, look in the local daily paper under "Ärztlicher Notdienst" (= medical emergency service). Often cities and municipalities have a local central emergency service (Notdienstzentrale) that you can contact by phone for advice or help.
Note down the emergency call number 112 just in case: The emergency call number 112 lets you order the emergency service ambulance direct to your home or to an accident. The emergency doctor and ambulance officers will then provide first aid on site. However, you should only use this service in extreme emergencies.
The general medical primary care services include the pharmacies/chemists (Apotheken). These also offer a 24/7 emergency service. The newspaper or the door of many pharmacies contain information on which pharmacy is on duty.
Health insurance at a glance
Any questions about health insurance? If so, then please contact the Social Advice Office (Sozialberatungsstelle) at the Student Services Organisation (Studentenwerk) or the International Office at your institution. The following provides some initial information to help you get your bearings.
Private or statutory (public) insurance?
You can chose between private and statutory (public) health insurance carriers and companies in Germany. Up until you turn 30 years of age (or up to the 14th full study semester) you must essentially be insured by a statutory health insurance carrier. Only in exceptions will you be allowed to take out private insurance. Please check this with your student services organisation. But before you transfer to a private insurance company, please also remember that you can then no longer move back to a statutory health insurance fund while you are studying.
Most students are insured with a statutory health insurance carrier in any case, since these generally offer more reasonable rates that the private health insurance companies. At present, the monthly statutory health insurance contributions for students amount to around 50 euros. Spouses and children of the insured person are also covered by this insurance, if they have no personal (or only little) income.
You can find useful information on the health insurance carriers and companies and on special student rates on the Internet at:
- www.g-k-v.com (statutory),
- www.pkv.de (private).
Who needs what kinds of insurance cover?
In principle, the following applies: To study in Germany, you must, up until you turn 30 years of age (or up to your 14th semester) be insured with a statutory health insurance carrier in Germany. Most of these insurance funds offer favourable student rates. In addition, many student services organisations (Studentenwerke) offer Service Sets for International Students that include appropriate health insurance cover.
Exception – Social Security Agreements: Social Security Agreements have been signed with some countries (including the member states of the EU and the EEA). In such cases, you may, under certain circumstances, remain insured via the health insurance in your country of origin. To do this, you have to present a number of documents in Germany. In most cases, EU nationals have to present a European Health Insurance Card or form E 128 /E 111. Before departing for Germany, please make sure that you find out which papers you have to present. Please also check in advance with your home insurer what benefits it will pay in Germany. Foreign insurance funds or companies do not always cover all the costs that occur here. If this is the case, you may end up having to pay any additional costs yourself.
The homepage of the German Liaison Office for Health Insurance Abroad (Deutsche Verbindungsstelle Krankenversicherung - Ausland (www.dvka.de) will tell you which countries Germany has concluded Social Security Agreements with.
Exception – if you are privately insured in your home country: In some cases, private health insurance policies from other countries will be recognised in Germany. If this is the case, you need a letter of conformation that you are exempted from compulsory insurance in the statutory health insurance fund – you must present this letter when you register (matriculate) at your university. Please note, however, that privately-insured people must first pay all the costs of medical services and medication themselves in Germany and then claim these costs back from the health insurance company in their country of origin.
Exception – exceeded the age limit of 30 years: If you are more than 30 years old (or have completed the 14th academic semester), you can no longer make use of the favourable student rates offered by the statutory health insurance carriers. You then have two options: firstly, to take out voluntary health insurance cover with a statutory health insurance carrier or, secondly, take out a private health insurance policy. In the latter case, the Deutsches Studentenwerk (the umbrella organisation of German students services organisations) has negotiated favourable conditions with a private health insurance company. For further information, see:www.internationale-studierende.de/.
All about patient rights
The following tells you what rights and obligations you have towards doctors and your health insurance carrier.
Best to find out about health insurance benefits and payments in advance
Even though you are a member of a health insurance fund, that does not mean that the fund is responsible for all the costs that arise in respect of your health or medical care. So please check in advance to find out from your health insurance carrier what benefits and payments you can claim for. The statutory and private insurance companies pay part of the costs for medical and dental treatment, for medication (drugs and medicines), for medical adjuvants and aids, for stays in hospital (in-patient treatment), for treatment by therapists (such as physiotherapy) or rehabilitation measures. Depending on the health insurance carrier you have, the benefits and payments that you are entitled to can vary considerably. Often, patients have to pay a personal excess (contribution). In addition, there are adjuvants, aids and forms of treatment that patients have to pay completely themselves. Depending on the financial situation, patients can be exempted from having to pay the personal excess. You have to apply to your health insurance carrier for such exemption.
More information is available on the Internet at: www.die-gesundheitsreform.de and www.deutsche-sozialversicherung.de.
Always carry your health insurance card with you
The health insurance card (Versichertenkarte) is your "entrance ticket" to all medical services and preventative measures covered by your health insurance. You get the card as soon as you become a member of a health insurance fund. Every time you go to the doctor, you have to present your health insurance card. The surgery will then settle the payments directly with the statutory health insurance carrier (does not apply to private health insurance companies). As a rule, you have nothing to do with this settlement of costs. However, you do have to pay a medical consultation fee per quarter if you consult a doctor.
Free choice of doctor and hospital
As a rule, you are free in Germany to choose which doctor and which hospital you go to. Exception: If you are a member of a statutory health insurance fund, your doctor must be registered with the panel of the German health insurance scheme. If he is not registered as a panel doctor, you will have to pay the costs of treatment yourself.
So when choosing your doctor, please also check the medical speciality and main treatment areas. There are general practitioners (Allgemeinmediziner) or (Hausärzte) in Germany. Normally, you go to these doctors with everyday illnesses (such as a cold or upset stomach) or if your illness is unclear. In such cases, the general practitioner will mostly refer the patient for further diagnosis and treatment to a specialist (such as an internist, an ophthalmologist, an orthopaedist or a gynaecologist). But you can also go direct to a specialist without such a referral. All panel doctors settle their payments directly with your health insurance fund.
Quarterly consultation fee
On your first visit to a doctor or dentist in any quarter, you currently have to pay a consultation fee of 10 euros. This consultation fee always covers just one quarter.
The doctor to whom you paid the consultation fee will, if necessary, issue you with referrals to other doctors. You do not then have to pay a consultation fee if you can present the referral.
Hospital treatment
There are state, charitable, denominational, and private hospitals in Germany as well as university hospitals. As a rule, you are admitted to hospital by a doctor. But, essentially, you have the right to choose your hospital yourself.
If necessary, all insured persons have the right to in-patient hospital treatment. Such a hospital stay may be required, for example, when other forms of treatment are not satisfactory.
The health insurance pays for items required for medical treatment in hospital, such as consultation by a doctor, nursing care, provision of medication, remedies, aids and adjuvants, accommodation and meals. However; during the first 28 days, you have to pay a small day-rate as a contribution to the costs.
Many medicines and drugs only available by prescription
You can obtain medication (medicines and drugs) from pharmacies (Apotheken) (www.apotheken.de) and, increasingly, online, too. However, a differentiation is made between non-prescription drugs and prescription drugs (i.e. where you need a prescription issued by a doctor). The statutory health insurance funds only pay for prescription drugs. However, patients have to pay a small excess (a set personal contribution).
Please note that the German Drugs Act is very strict. Some of the drugs that are prescription free in your country (for example, antibiotics) have to be prescribed by a doctor here.
From my personal experience
Khan from India, studying mechanical engineering for a Bachelor's degree
Always ask the health insurance company first
"There are dozens of health insurance companies and carriers in Germany. So it's not easy to decide which one to go with. I went and got advice at the beginning of my stay. Student services at my uni helped me a lot in this respect. For example, I didn't know that some health insurance companies offer reduced rates for students. If you take this into account when choosing a health insurance company, you can save a lot of money. I'm now paying around 50 euros per month. For that, I can choose my doctor myself. That's really great. I think it's very important that I can have confidence in my doctors and can feel that they give me good advice. What was a little difficult at first was understanding exactly what my insurance paid for me as a patient and where I had to make a personal contribution. You have to be really alert. Thankfully, my health insurance company gave me a brochure with lots of useful information. I read it very carefully. Now I'm relatively well informed. But if I am uncertain, for example about costs for a dentist, then I prefer to call my health insurance company first for advice. They know exactly what's what, and often know more than the doctors as well, since the rules and regulations are changing all the time."
© 2008 Deutscher Akademischer Austausch Dienst e.V. (DAAD), Kennedyallee 50, D-53175 Bonn
Source: http://www.daad.de/deutschland/deutschland/leben-in-deutschland/06266.en.html
Date: 2008-12-04