Most German residents are members of the state-regulated health insurance system (GKV). Membership in the GKV is mandatory for employees with a gross salary below 49,950 euros annually or 4,162 euros monthly (2010). Monthly premiums are presently set at 14.9 percent (increasing to 15.5 percent in 2011) of your gross salary and are currently capped at a monthly maximum of 560 euros. The employee pays 53% of this monthly premium while the employer pays the remaining 47%. Even if your salary is much higher than the annual threshold of 49,950 euros, your premiums remain the same ... one of the great advantages of the German system. Students are also required to have health insurance, but at a discounted rate of about 55 euros per month. In the past, there was little competition among the public insurance companies (Krankenkassen), so it wasn't really necessary to shop around for the best deal. But as part of an effort to foster more competition, insurance companies are now permitted to charge minor supplemental fees ... or not. This means that there is now an ever so slight price difference among insurers.

The GKV benefits include in-patient care at your nearest hospital, out-patient care with registered doctors (Kassenärzte), basic dental care and full pregnancy/maternity coverage. There is generally no coverage for a private hospital room, alternative/homeopathic medical care, dental implants, vision-related products for adults and medical treatment outside the EU (see the section on travel insurance). Your choice of doctors can also be somewhat limited, because some specialists refuse to treat GKV patients.

Patients are required to pay a 10 euro co-payment per quarter to both the first doctor and the first dentist consulted, as well as a 5-10 euro co-payment for prescription medicine and 10 euros a day for the first 28 days of a hospital stay.

The major advantage of the GKV system is that non-working dependents (i.e., spouse and children) living at your address in Germany are insured at the same level of coverage at no additional cost. Many people choose to insure themselves and their families through the state-regulated system and then purchase supplemental private insurance in order to have benefits such as reimbursement for a private room, homeopathy or alternative treatments and higher dental coverage. Please be aware, however, that these supplemental plans require a three-year commitment and cannot be canceled during that time, even if the premiums are increased.

All GKV providers in Germany are non-profit associations, administering the government health insurance plan. Some (for instance AOK, BEK, DAK) are very large, with millions of members, and others (such as the IKK or BKK) have just a few thousand. This does not mean that the basic benefits are different, because all health insurance providers must abide by government regulations. If your government health insurance provider increases your premiums, you can cancel the coverage and switch providers by giving a two-month notice. The general minimum period of membership with any provider is 18 months.

You and your dependents must also become members of the government long-term nursing care plan (Pflegeversicherung), regardless of whether you are insured in the public or private insurance system. This nursing care insurance covers some of the costs of personal nursing needs, such as feeding and bathing, for those people who become substantially disabled. The cost is 1.95 percent of your gross salary (with a maximum of approximately 84 euros per month), and your employer pays half.

(Foto: AOK-Mediendienst)