I love Germany’s system, though it is far from perfect. I’ve had overwhelmingly good experiences. Just last week, I walked into a doctor’s office without my ID or credit card. I had injured my ankle. They asked me for my name and the insurance company, found me in the system, and treated me very efficiently. I got x-rays and an exam, then was sent down to have a brace fitted. I had to pay 5€ as co-pay for the brace, nothing else. And the whole thing took just an hour.
Things that have surprised my American husband:
- we never get a bill for our procedures
– no, really, never. Not for a walk-in x-ray. Not for an MRI, not for dental surgery.
– if you’re being treated, you don’t have to worry that anything would not be covered. Doctors are required to get your explicit consent and signature for anything that’s not covered, plus quoting the price up front
– all insurance companies have to cover roughly the same procedures and, more importantly: they all charge the same
– “deductibles” are rare and happen mostly for things like hospital stays, physical therapy, and certain meds. You’ll never be asked to pay more than 10€. For example, you can get a CPAP-machine for 10€. For a hospital stay, it’s 10€ per day, but only for the first ten days.
– insurance companies cannot operate for profit
– they also can’t turn anyone away for pre-existing conditions (they can’t ask about that)
– your monthly premium is on a sliding scale depending on earnings. It’s 15% of your income, and your employer (if you have one) is required to cover half.
– if you’re unemployed or a student, you pay about 80€ per months, or the state pays
– even if you stop paying your premiums, you will always be treated if you’re having an emergency or are in pain. You will never pay for an ambulance.
– insurance covers a lot of screenings
– kids can be on their parent’s plan for free until they’re 25
– dental is covered, even some cosmetic stuff
– therapy is covered
– if you’re savvy, your insurance may pay you small amounts of cash for taking classes on topics like meditation, aerobics, or quitting cigarettes
Things I don’t like, off the top of my head:
– lots of meds are covered, but those that are just for symptom relief often aren’t
– eyeglasses are covered only for children, as though you don’t need your eyesight as an adult
– wait times for therapy are very long unless you’re actively suicidal
– wait times for some specialists (such as dermatologists) are too long unless you’re currently in pain
– when you want them to cover unusual procedures, it can be time-consuming to talk to your health insurance company
– people who do not speak German need more patient advocates and information about their rights
– those who are severely mentally ill need prompt help so they don’t slip off the radar, and that’s not happening reliably