What is the dual-payer healthcare system in Germany?

If you’ve recently moved to Germany then you might be surprised to find out that health insurance isn’t free for everyone. Unlike the UK, and other European countries, Germany has a dual payer system which includes both a private and public option. Instead of health contributions being taken directly from their taxes, residents are required to choose a health insurer and forward the details to their employers who process the payment. Here’s how it works:

What is the dual payer system?

A dual payer, or two-tier system, is one in which a basic government healthcare is offered but a secondary, often privatized healthcare offering also exists. In Germany, there are two health insurance options: private or public health insurance.

The first tier: Public health insurance

Public, or gesetzliche krankenversicherung, is state insurance that is provided by over 110 individual krankenkasse, or health funds. TK (Technicker Krankenkasse) for example is just one of the many individual state funded health insurance companies. Each one of these health funds is operated by contributions from both it’s members and the German government.

The second tier: Private health insurance

Private insurance, or krankenversicherung, operates entirely outside of the world of public health insurance. These institutions don’t receive any money from the German state, but do however abide by certain regulations mandated by German law.

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