How are private health insurance payments different from public health insurance?
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How are private health insurance payments different from public health insurance?

Summary: Just signed up for private health insurance and are unsure how it works? Payments for private health insurance are actually structured differently than public health insurance, so it takes a bit of time to get used to the new system. In this article, we explain what these payments are, which bonus programs are included, and what you can expect when switching to private health insurance.

When people first consider signing up for or switching to private health insurance, they tend to be under the impression that it will work in the same way that public health insurance does: Your monthly health insurance payments are taken directly from your paycheck, you get a card, and you can show it at the doctor’s office to make claims directly to your health insurance provider.

This isn’t the case with private health insurance, which means it takes time to get used to the new system.

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Monthly premium payments


No-claims bonus

Old-age savings

Making claims

Signing up for private health insurance: deductibles

The application for private health insurance is also a bit different from public health insurance since certain people need to get a physical exam to determine their eligibility and monthly premium. If you’re incredibly healthy, you’ll increase the chance of paying the lowest monthly premium for your age group. Because premiums are based on your age at sign-up, it means if you’re 30 and healthy, you’ll still end up paying more for your health insurance than if you had signed up at 24. For people with chronic illnesses, this might mean that they’re also denied coverage or have to pay a higher premium. 

You’ll have the flexibility to decide if you want a deductible or not before receiving a final insurance offer. A deductible means you’ll need to pay a certain amount out of pocket each year before insurance will kick in. 

If your deductible is €1,200, then you’ll need to pay the entire amount before you are reimbursed for any claims. Still, your monthly health insurance costs are significantly lower than someone without a deductible. If you rarely go to the doctor’s office, this might be a good option; otherwise, if you want to make sure that health insurance covers everything right away, it’s a good idea to sign up for a plan without a deductible. 

Already know you want to sign up for private health insurance?

Monthly premium payments

Each month, you’ll need to pay for your entire health insurance payment at the beginning of the month. Unlike public health insurance, this won’t come out of your paycheck automatically. Instead, you’ll need to have enough money in your bank account for your insurance provider to pull out your entire premium. Your employer will still pay half of the cost for health insurance, but it will be sent to you in your paycheck and not directly to the insurance provider. 

Cash-back bonus

You’ll also get cash-back each month if you choose to have a €0 deductible on either basic or premium private health insurance. This means you’ll get €30 directly debited into your bank account for those on the basic plan or €60 for those on a premium plan. Annually, you can expect to get €360 for a €0 deductible basic private plan and €720 for a €0 deductible premium private plan. 

It can be a bit confusing since you’ll need to use your annual cash-back allowance before private health insurance will pay. 

For example: 

Ana has signed up for private health insurance, and she had a sinus infection in January. She goes to the doctor’s office several times for medication, a sick note, and another check-up. In total, she needs to pay about €400. Since she has basic private health insurance, she will need to use her annual cash-back allowance first before private health insurance will pay, which means that Ana will need to pay €360 out-of-pocket and get reimbursed the last €40. Since Ana has met her annual cash-back bonus, any future claims she submits will be reimbursed by her private health insurance plan. 

Even though Ana has only gotten €30 of the total €360 per year in cash-back, she’ll need to cover the entire bill since cash-back is calculated annually. But, it’s important that she also submit the claims to her private health insurer so that they can keep track of this. 

A lot of people enjoy the cash-back bonus since it means they’ll get to keep the extra amount if they don’t spend the entire €360 throughout the year. 

The no-claim bonus

If you don’t like going to the doctor, you’ll be pleased to know that there is an annual no-claims bonus, and it’s exactly what it sounds like. If you don’t make a claim during the entire year, you’ll receive some of your monthly premium back. 

There are some conditions for this before you’ll be able to receive your no-claims bonus. The first is that you’ll need to have had your health insurance for an entire calendar year (all of 2022 from January to December. If you sign up in June, you’ll need to wait a bit longer), and the payout happens around June or July of the next year. That means if you sign up in January, you’ll need to wait until June or July of the following year to receive your no-claims bonus. Depending on the premium you’ll pay, your no-claim bonus will also change respectively. 

If you’re only planning to stay for about a year in Germany, you won’t be able to receive your bonus. 

Old-age savings

Because the cost of private health insurance is often much lower than public health insurance, people often wonder if their monthly premium will go up when they’re older. Good news: it won’t. 

In order to keep costs consistent throughout your time on private health insurance, you’ll have something called “old-age savings” added to your monthly premium. These are included in your final quote, so you don’t need to worry about additional fees. 

Old-age savings require at least five years to build up before using them, so it’s important to sign up for private health insurance early. If you switch to another private health insurance provider, you’ll need to forfeit a portion of these savings. 

Making claims with private health insurance

Now that we’ve gone through all of the monthly payments and bonuses let’s talk about what it’s actually like to make a claim on private health insurance. 

After you’re accepted for private health insurance, you’ll get your health insurance card in the mail that looks like the public health insurance card. You won’t need this if you need to go to the doctor before the card arrives, but it’s nice to have it once you receive it in the mail. Claims are also not paid out by this insurance card, so you’ll need to take a picture and upload it to your account to keep track of each payment. This is especially important for tracking your deductible. Also, depending on what type of claim you’re making, you might need to submit additional paperwork. Still, you don’t need to worry about dealing with it yourself since we’ll let you know which additional documents you need, and we’ll help you find and submit them.

You’ll be able to book appointments like normal through Doctolib, but this time, you’ll have the ability to choose from all doctors who accept public insurance plus those who accept private health insurance. 

Just book an appointment, go to the doctor’s office, show them your health insurance card (since you need to have proof of health insurance to receive treatment), and you’ll get a bill printed for you. This is where private health insurance is different from public health insurance. You’ll need to take a picture of the bill and upload it to your Feather account. You can expect to receive reimbursement (we always recommend paying the bill immediately since German holidays and bank processing capacities can be unpredictable). 

Going to the hospital

If you’re staying at the hospital for a major accident, surgery, or even giving birth, you’ll be given a bill from the hospital with a list of all of the charges during your stay. You’ll need to upload this directly to your Feather account, so they can pay it directly to the hospital. Sometimes, if you have a deductible, or you’re not covered for specific treatments, these will be charged back to you from your insurance provider. 

Not sure which health insurance to get?

We’ve developed a health tool that doesn’t require any credit card information or contact information to see which health insurance is right for you. We believe in honest, simple recommendations, so you can use our tools an infinite amount of times and enter in whatever details you’re curious about to see how our recommendations change. 

Visas are complex, so it’s important to know what’s required for your application. In Germany, health insurance is a legal requirement to visit, live, and work here; Still, some people might not qualify for private or public health insurance. Because of that, one problem many people have is knowing which health insurance fulfills this requirement. 

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