One of the branches of social security is administered by health insurance funds. Its structural feature, particularly in the case of statutory health insurance, is the acceptance in many respects of joint liability for funding equal cover for all.
Health care is mandatory in Germany. Almost everyone living in Germany has health insurance. Around nine percent of the German population are privately insured. However, the majority (about 88 percent) belong to the statutory health scheme – also known as national health plan or public health insurance (“gesetzliche Krankenversicherung”) institutionalised in so-called “gesetzliche Krankenkassen” (compulsory health insurance). The public programme as part of the social security system is mandatory for employees up to a certain level of income (in 2003, € 3,825 gross per month or € 45,900 per annum) and they are obliged to join one of the over 315 statutory health insurance schemes. Subject to certain conditions, the statutory system also covers pensioners, the unemployed, trainees and students.
If income is above this higher level, the individual can choose between public and private health insurers. Persons earning a higher gross amount than this are free to join a private scheme if they so desire.
As a citizen of another EU Member State you will benefit from the EU-wide agreement which guarantees free medical treatment free in Germany. To be eligible you must obtain the form E111 before you leave your home country. In the UK this form is available from any post office, Benefits Agency (BA) or Department for Work and Pensions (DWP) office. Remember, you must get the E111 stamped and signed by the post office or you will not be able to use it. Should you have forgotten to obtain your E111 before departing for Germany, you can contact the nearest British mission who can advise you on the procedure of obtaining an E111 retrospectively. The E 111 form gives EU and therefore British citizens medical cover in another EU country, for a short period usually whilst on holiday or business. The form is intended principally to guarantee urgent medical treatment which cannot be postponed before return to the UK. It also covers family members.
Please note however, that in order to be eligible for an E111 you must be an EU citizen and a resident of a European Union country, and you must obtain the form from the relevant authorities of that European Union country. You must also bear in mind that the E111 does not cover you for repatriation or any other costs incurred through illness, such as additional costs for changing travel tickets.
Additionally, you should obtain the form E104, issued by the UK Inland Revenue. It provides proof you have paid UK insurance contributions prior to your departure to Germany and will assist you with sickness and maternity benefits in Germany and help you to register with the German health insurance scheme.
Once you have taken up employment and long-term residence in Germany, you are subject to German social insurance regulations and should no longer use your E111. If you wish to take up permanent residence in Germany, you will become subject to German social insurance regulations and will no longer be covered by the E111; this means you must exchange your E111 for a local health insurance scheme.
Even if you have not yet taken up employment, you still have the option of taking up voluntary health insurance in Germany, and may apply for the form E104: this form is issued by the British Inland Revenue Service and provides proof that you have paid UK National Insurance for at least the 12 months prior to your departure from the UK. As part of your application the insurance provider in Germany may request additional details. If you have taken out health insurance in Germany, your insurance company will issue you with a health insurance card, which you have to take with you whenever you visit a GP, dentist or specialist (see 'Health').
For all citizens regardless of their nationality, we would suggest that, if you have health insurance in your native country, but have been accepted for a job in Germany, you should contact your health insurance company in order to find out what action you need to take to ensure that your insurance cover there is not interrupted. Especially, when you come to Germany only for a certain time, you may remain subject to your home insurance plan (you may be switched from a domestic to an international provider).
Furthermore, if for any reason you cannot obtain or are not covered by the E 111 (e.g. if you are not a EU citizen), and you are not paying German national insurance, you should consider taking out private medical insurance, or you may have to pay the full charge for any medical treatment you receive. Students may need to take out additional private health insurance.
British citizens seeking information on which forms to take, please contact the Centre for Non-Residents in Newcastle:
Centre for Non-Residents
Room BP 1302
Inland Revenue
Longbenton
Newcastle upon Tyne NE98 1ZZ
Tel: +44(0)191 – 225 4811
Or alternatively:
Dept. of Social Security
Overseas Contributions (EC)
Longbenton
Newcastle upon Tyne, NE98 1YX
Tel: +44(0)191 – 213 5000
For Britons who wish to come to Germany for medical treatment there is an agency, the Bonn-based Committee for Promotion of German Medicine Abroad who can provide information and advice:
Kuratorium zur Förderung deutscher Medizin im Ausland
7 Tulpenfeld
53113 Bonn
Fax: +49 (0)228 – 242 2991
E-mail: info-desk@committee-german-medizine.de
www.committee-german-medicine.de