Private Health Insurance

In the private health insurance, the costs directly provided the policyholder at the doctor – he gets them refunded but in the Nachinein of the car. The German health insurance system consists of the statutory health insurance (GKV) and private health insurance (PKV). About 85% of Germans are members of statutory health insurance, while about 15% of the insured with a private health insurance signed on, because they meet the so-called shooting conditions. Both insurance companies differ, inter alia through its billing procedures, their achievements and their contributions. In a contract with a private health insurance the insured person pays an individual contribution plus 10% for retirement provisions, while in the statutory health insurance contributions from each insurance company are the same and also no age provisions are made.

Billing procedures of medical expenses in the statutory health insurance, as well as in the private Health insurance apply the treatment costs and the cost of diseases or accident of the insured from the insurance company. While the so-called principle of the kind applies to statutory health insurance, while the private health insurance companies prefer the cost reimbursement principle. Kind principle means that the costs incurred directly between the doctor and the health insurance fund are settled. The patient gets to see an invoice and also not know what services the doctor with the health insurance company has settled. Legally insured directly out of pocket to pay only the practice fee of 10,00 euro per quarter and the co-payments for drugs if they are not exempted from these payments. He completes a kind of contract the billing method of private hospital insurance if a private patient to the doctor’s and treated, with the doctor, which makes the patient the immediate contractual partner of the doctor. Therefore, the doctor sends its bills directly to the patient, and not to the insurance company. The Patient must forward the original invoice in the billing process of the PKV receipt to his insurance company, to obtain the money retroactively. The invoice amount is transferred to the account of the insured person, if the calculated benefits in accordance with the performance package, has agreed the insured person with his private health insurance and for which he pays a monthly contribution. The age provisions play no role in the settlement process of for private health insurance.