HEALTH INSURANCE COMPANIES- READY MORE

HEALTH INSURANCE COMPANIES

 

MORE ABOUT HEALTH INSURANCE BELOW 

 

To find and rank the best private health providers, we conducted an analysis of more than 20 of the most popular Australian brands offering health insurance policies. We then analysed subsets of their data, in conjunction with the latest Private Health Insurance Ombudsman State of the Health Funds Report 2022, which is the most recent iteration.

“The Ombudsman Act requires the Private Health Insurance Ombudsman (PHIO) to publish the report after the end of each financial year to provide comparative information on the performance and service delivery of all health insurers during that financial year,” Acting Commonwealth Ombudsman Penny McKay explains in her foreword.

Ultimately, the State of the Health Funds Report provides consumers with the information they may require to make an informed decision on the right health insurance provider for them, which is established by comparing the following criteria:

Service performance and financial management;
Hospital benefits;
Medical gap schemes;
The number and nature of complaints investigated by the Ombudsman; and
General treatment (extras) benefits.
In addition to the comparisons and conclusions found within this report, Forbes Advisor also analysed the following criteria of each health insurer:

Market share;
Waiting periods;
Member retention percentages;
Discounts;
Customer service capabilities; and
Reviews from Australia’s leading and independent consumer review website.
While many Australians seeking private health insurance policies will be curious about cost comparisons, we did not include a price metric in our analysis. This is because the cost of health insurance varies widely among individuals, as it depends on numerous factors including age, pre-existing health conditions, desire for additional services and location.

To rank each private health insurer, a total of 13 variables were evaluated. From these variables, rankings were then made on a basis of 5 stars–with those included in our best-of list sitting at 2.5 stars and above.

About Star Rankings
You will note that we have included a star rating next to each product or provider. This rating was determined by the editorial team once all of the data points above were considered, and the pros and cons of each product attribute was reviewed. The star rating is solely the view of Forbes Advisor editorial staff. Commercial partners or advertisers have no bearing on the star rating or their inclusion on this list. Star ratings are only one factor to be considered, and Forbes Advisor encourages you to seek independent advice from an authorised financial adviser in relation to your own financial circumstances and investments before you decide to choose a particular financial product or service.

Medibank Data Fall-Out

As mentioned above, Forbes Advisor decided against including Medibank Private in our pick of insurers owing to the cyber security incident last year, in which the details, including the health records, of millions of Australians were stolen. The response prompted the federal government to increase penalties for companies that don’t properly store customer details, and the Private Health Insurance Ombudsman noted in its annual report that they had received 100 complaints against Medibank in relation to the data breach by the end of the year.

As it noted: “The privacy and data aspects of this matter fall outside the Office’s jurisdiction. However, it remains an issue of concern to consumers and Medibank policy holders can ask the Office for help about a broad range of issues and access our services if they are unsatisfied with a response to a problem raised with their insurer.”

The Ombudsman also addressed the issue of the data breach more broadly.

“One theme in the complaints made to the Office by both current and former members of Medibank was the extent of the historical data retained by Medibank and the length of time it was retained,” it said.

“Some consumers whose details were stolen had not been members of Medibank for several years. Some state and territory regulations determine the length of time that data must be retained before it can be destroyed, and Australian insurers are required to keep some basic information including length and type of membership indefinitely for purposes such as Lifetime Health Cover (LHC) records.

“However, some complainants felt data may have been retained by Medibank beyond the minimum requirements and suggested that, if data been appropriately destroyed or de-identified at an earlier stage, the impact of the data theft would have been mitigated.”

Private vs Public Health Insurance

In Australia, private health insurance is optional thanks to our public healthcare system.

However many individuals choose to take out private health insurance from one of the aforementioned providers due to their additional benefits, such as the ability to receive care in a private hospital, quicker treatment for non-life threatening procedures, and to avoid paying for treatments that are not covered by Medicare.

Those without private health insurance will be treated in public hospitals and, if additional services or treatments are required that are not covered by Medicare, they will be charged 100% of the bill.

Ultimately, deciding on whether to pay for private health insurance over Australia’s free-to-access public healthcare system comes down to personal health needs, income and age. For example, if you earn above $90,000 per year as a single, and do not take out basic hospital cover, you will be slugged the Medicare Levy surcharge of between 1-1.5% depending on your income.

Why? The Federal Government is trying to entice as many higher-income earners as possible to pay for some level of private health insurance so the public system is reserved for those who cannot afford private healthcare.

What Does Health Insurance Cover?

Depending on which type of private health insurance policy you choose will determine what your health insurance will cover. Your cover can include treatment in private hospitals with private rooms, ambulance services, or for treatments such as physiotherapy or dental care. The types of health insurance policies available on the Australian market are hospital-only cover, extras-only cover, and combined hospital and extras policies.

Types of health insurance policies

Hospital-only cover: helps to avoid public hospital waiting lists, and offers more options in terms of being able to choose your desired specialist and hospital. Your private health insurer pays benefits toward the cost of private treatment in a hospital.
Extras-only cover: helps pay for treatments that are not covered by Medicare and take place outside of the hospital. This includes services and treatments such as dental care, physiotherapy, and optical needs. Most policies pay back a percentage of the bill after it has been paid in full (rather than covering the service in its entirety), and annual limits for each service apply.
Combined hospital and extras: covers out-of-hospital treatments for the extras described above, as well as for hospital treatments in private hospitals. These policies are bundled together at varying levels of coverage for different procedures, and varying amounts of extras.

HERE ARE BEST HEALTH INSURANCE IN 2023

 

Best health insurance in 2023
Finding the best health insurance for both your health care needs – and your budget – takes time and research. Canstar has made it easier by road testing thousands of policy combinations from 27 different Australian health insurance providers. The result is our 2022 Health Insurance Star Ratings and Awards, designed to help you in your search to find the best health insurance for your needs.

You can use the table at the top of this page to compare health insurance policies to find the one that best fits your requirements. The table features Canstar’s expert Star Rating for each product, as well as premium and coverage details. Use the filters to adjust the table to show policies that match your requirements. The filters include options for both combined or separate hospital and extras policies, different ages and locations. There are also filters for:

Single female
Single male
Couples
Family
Single parent female
Single parent male.
You can also specify other requirements, such as the Star Rating, provider, and whether or not they are a Canstar online partner, which means there is a button to click that takes you to the provider’s website so you can obtain a quote (we may earn a referral fee in this instance).

When choosing the filters for ‘hospital & extras’ or just ‘hospital’ cover, other filters include:

The level of excess – $0 – $249; $250 – $499; $500 – $749; $750+
If you would like cover for pregnancy and birth services
A range of hospital inclusions, such as assisted reproduction, joint replacement, and palliative care.
When looking at ‘extras’ only cover, there are also a number of options for included cover, such as general dental, optical, physiotherapy and remedial massage, as well as excess and payment frequency options.

Best health insurance: Outstanding Value winners
If you’re looking for value for money in health insurance, Canstar’s Star Ratings and Awards could help. Four health funds topped the list nationally in Canstar’s 2022 Health Insurance Star Ratings and Awards:

ahm

ahm is a member of the Medibank group, and a second time winner of our Health Insurance Star Ratings Award. Canstar Research says ahm “continued to shine in 2022”, particularly for its extras offering. ahm also retained its national Health Insurance Award and won three state Awards for its extras policies.

Bupa

Bupa performed especially strongly with its hospital policies according to Canstar’s Star Ratings analysis. In addition to the national Health Insurance Award, Bupa picked up five state Awards for its hospital policies.

HCF

HCF offers a variety of health insurance policies designed to suit a range of life stages, including singles, couples, families and single parents. 2022 marks the seventh consecutive year that HCF has taken out Canstar’s national Health Insurance Award. It also retained multiple state Awards.

Medibank

Rounding out our best health insurance providers nationally, Medibank is no stranger to Canstar’s national Health Insurance Award, having taken out this Award for 15 consecutive years. Medibank was a strong performer when it came to hospital and package policies. Medibank picked up two state awards.

Focus on your state/territory
When you’re shopping for the best health insurance for your needs, it’s important to focus your search on health funds – as well as premiums – applicable to your state.

The Commonwealth Ombudsman says the premiums you pay and the benefits you’re entitled to can differ from state to state. This being the case, Canstar’s Health Insurance Star Ratings and Awards narrow down the best health insurance for different types of cover in each state or territory, too.

 

 

 

GET YOUR BEST HEALTH INSURANCE COMPANIES IN GERMANY 

With over 100 options for both private health insurance providers and public health insurance providers in Germany, it becomes difficult to pick your provider. This is why a breakdown of the best health insurance companies in Germany is necessary to help you narrow the search. The following companies were selected based on their excellent performance throughout the years providing insurance and due to the many awards and accolades they received, setting them apart from other companies.

Best Health Insurance Companies in Germany

Below you can find a list of some of the best health insurance companies in Germany, public and private:

Techniker Krankenkasse (TK)
AOK
Barmer
DAK Health
AXA
Allianz
Walter
HanseMerkur
Techniker Krankenkasse (TK)

Techniker Krankenkasse (TK) is a public health insurance provider in Germany and is one of the largest insurers in the country, with over 11 million members. It has also shown continuous high ratings in all aspects, making it one of the most reliable and popular choices among expats and residents alike

 

These ratings include customer satisfaction, service quality, healthcare provider networks, and innovative healthcare programs. With a total contribution rate of 15.8% (as of 2023), TK is also one of the cheapest providers among public insurance companies.

AOK

As another one of the largest public health insurance companies in Germany, AOK prioritizes the satisfaction of its policyholders. With a workforce of around 60,018, AOK delivers high-performance service through its extensive network of over 1,032 branches. There are currently 11 AOK health insurance funds spread out in various regions of Germany.

Each of the 11 AOK health insurance funds, serving specific regions, operates with distinct total contributions, ranging from the most affordable AOK Saxony-Anhalt at 15% to the highest contribution rate of 16.2% for AOK Bremen / Bremerhaven. This commitment to customer satisfaction, supported by a strong workforce and a wide branch presence, solidifies AOK’s position as a customer-centric and prominent health insurance provider in Germany.

Barmer

Barmer— serving around 8.7 million insured members as of June 21st, 2023— is another recognized public health insurance provider in Germany. With a dense branch network and well-established regional supply structures, Barmer ensures close proximity to policyholders and seamless access to doctors, hospitals, and cooperation partners in their area.

 

PUBLIC HEALTH INSURANCE /HOW MUCH IT COST?

All public health insurance providers in Germany charge the same basic premium of 14.6 per cent of gross income (2023), plus a supplemental charge that is an average of 1.6 per cent of gross income, with those premiums capped at a monthly income of €4,987.50.

Those who earn more than that will not pay a higher insurance premium. The basic premium is split equally between employee and employer: 7.3 per cent each. Since 2019, employers have been required to pay half of the supplemental charge as well.

Residents of Germany and their dependents must also become members of the country’s long-term nursing care scheme (Pflegepflichtversicherung). This covers some of the cost of meeting personal nursing needs, including the bathing and feeding of those who become substantially disabled.

The nursing care scheme cost varies based on the number of children a person has, although it generally runs from 3.4 per cent of a person’s gross salary with at least one child or 4.0 per cent (with a maximum of €199.50 per month) for a person with no children, of which the employer pays a maximum of €84.79. These figures vary slightly for the state of Saxony, where costs start at 2.2 per cent for a person with one child and 2.8 per cent for childless individuals. The employer contribution in Saxony is also lower, at 1.2 per cent.

Public health insurance – what does it cover?

The minimum threshold all health insurance coverage in Germany has to meet includes:

in-patient (hospital) care as a ward patient
out-patient care from a general practitioner or medical specialist (such as a cardiologist)
prescription drugs
pregnancy care
basic dental care
employee sick note
statutory sick pay when the employer’s duty to pay it is over (up to 90 per cent of a person’s net salary)

In addition, all non-working dependents – spouse, civil partner and children (up to a specified age) – living at the same address as the policyholder in Germany will be covered under the plan at no additional cost. They simply need to be registered with the same health insurance provider as the paying member.

Although the medical provision provided by public health insurance in Germany is fairly extensive, additional care may require additional payment – so it is essential to know what coverage is included. For example, while basic dental care is covered, aesthetic teeth cleaning may incur an additional fee.

PRIVATE HEALTH INSURANCE IN GERMANY WHO CAN GET IT ?

Germany does offer the opportunity to opt for private health insurance (private Krankenversicherung or PKV for short), but only for:

those who earn more than a predetermined amount (€66,600 per year in 2023),
those who are self-employed,
and university students, who can choose private health insurance for the duration of their our studies

However, even if one of these criteria is met, no one is obligated to choose private health insurance. Anyone can still opt for statutory health coverage.

 

 

PRIVATE INSURANCE / HOW MUCH IT COST 

There are a few important factors that should be reviewed before considering private insurance. Although not impossible, it can be extremely difficult to enter or return to the statutory healthcare system once a person has a private insurance policy. In addition, monthly insurance premiums for private policies are not pegged to a person’s salary. Germany’s leading consumer reports organization, Stiftung Warentest, writes that the average person who first signs up for private insurance in their mid-thirties can expect their premium to rise to at least three times the original price by the time they retire.

 

PRIVATE HEALTH INSURANCE WHERE TO GET IT 

A complete list of all private health insurance providers is available on this German-language website. However, given the differences in premiums and scope of coverage available, it is worth using a commercial price comparison website like Check24, Krankenkassen Deutschland and PKV-Gesundheit or a locally based health insurance broker, who can provide purchasing advice.

 

 

However, while the ActiMed tariff series is unsuitable for civil servants and doctors, Allianz offers separate tariffs tailored to their needs.

Hallesche Krankenversicherung

Hallesche Krankenversicherung is a mutual insurance company, setting it apart from conventional insurers. With this unique structure, any surpluses generated by the company are not retained for shareholders but instead flow back to the insured policyholders. Moreover, for employees and the self-employed, Hallesche offers three PKV full insurance tariffs, providing choices such as the budget-friendly “Primo” and options for enhanced coverage like the “Plus” level.

Additionally, specialized tariffs cater to doctors, civil servants, and students, ensuring tailored solutions for diverse needs. With a customer-centric approach and comprehensive supplementary insurance options, Hallesche Krankenversicherung is a reliable and customer-oriented choice for private health insurance in Germany.

HanseMerkur

HanseMerkur is a mutual insurance fund, following the same principle as Hallesche Krankenversicherung, ensuring that any surpluses generated are returned to its insured members. For employees, the BusinessFit and ProFit tariffs offer extensive coverage for medical, dental, and alternative practitioner treatments, along with additional benefits for those maintaining normal health.

The self-employed also benefit from the flexibility to choose between these tariffs, while both employees and self-employed individuals can further customize their coverage with optional add-ons. Beyond insurance, HanseMerkur embodies Hanseatic values and tradition while embracing innovation and modern service, aiming to provide holistic support to its members.

 

GERMAN HEALTH INSURANCE FOR FOREIGNERS

Health insurance in Germany is obligatory for all residents, including researchers and scientists coming from abroad to work here for the short or long term. To assist arriving professionals, we have compiled the following summary of how the German health insurance system works and how to obtain coverage.

 

THE GERMAN HEALTH INSURANCE SYSTEM

HEALTH INSURANCE IN GERMANY WHO NEEDS IT ?

PUBLIC HEALTH COVERAGE IN GERMANY HOW TO GET IT ?

PUBLIC HEALTH INSURANCE HOW DOES IT COST ?


PRIVATE HEALTH INSURANCE IN GERMANY WHO CAN GET IT ?


PRIVATE VS PUBLIC HEALTH INSURANCE IN GERMANY KEY DIFFERENCES ?


HEALTH INSURANCE IN GERMANY WHEN SHOULD I GET IT ?

HEALTH INSURANCE FOR RESEARCHERS AND SCIENTISTS?


EUROPEAN HEALTH INSURANCE CARD IN GERMANY

 

The German health insurance system

 

Since 2009, everyone who is a resident in Germany has been legally required to have health insurance, including, in most cases, foreign researchers and scientists. Under the law, all residents must have a policy with an insurance provider (called a Krankenkasse in German) that offers at least the minimum level of coverage permitted.

There are three options for expat health insurance coverage while living in Germany:

the government-regulated public health insurance system (Gesetzliche Krankenversicherung, GKV)
private health insurance from a German or international insurance company (Private Krankenversicherung, PKV)
a combination of the two that supplements coverage not included in the public health insurance policy.
Choosing healthcare insurance is one of the most important decisions a person can make when moving to Germany, and it can also have long-term ramifications for personal finances and for the care provided. It is thus important to research the options available as well as the advantages and disadvantages offered by public and private insurance respectively.

Health insurance in Germany – who needs it?

Public health insurance in Germany is known as Gesetzliche Krankenversicherung (GKV), which translates as “statutory health insurance”, and it covers the vast majority of the country’s residents – around 90 per cent. In 2023, those earning a gross salary of less than €66,600 per year, or €5,550 per month are required by law to be insured under a public, statutory health insurance scheme from a provider of their own choosing.

Public health coverage in Germany – how to get it

Once a job offer is in hand, employers can offer assistance in getting registered, although everyone has the right to choose their own insurer and does not have to necessarily go with suggestions provided by employers.

Four of the largest providers of health insurance in Germany are AOK, Barmer, DAK and TK. While there are over 100 (a complete list – in German – is available here), these four companies offer good English language websites.

Providers can offer slightly different rates and different incentives, such as cash back for quitting smoking or engaging in regular fitness activities, so it is worth researching and seeing what the options are. This German-language website has a comparison tool that allows for the comparison of different policies.

Once registered with an insurance provider, they will provide an insurance card, called a Gesundheitskarte in German. The insurance card has a chip to store personal data and must be presented the first time a doctor is visited each quarter.

Public health insurance – how much does it cost?

All public health insurance providers in Germany charge the same basic premium of 14.6 per cent of gross income (2023), plus a supplemental charge that is an average of 1.6 per cent of gross income, with those premiums capped at a monthly income of €4,987.50.

Those who earn more than that will not pay a higher insurance premium. The basic premium is split equally between employee and employer: 7.3 per cent each. Since 2019, employers have been required to pay half of the supplemental charge as well.

Residents of Germany and their dependents must also become members of the country’s long-term nursing care scheme (Pflegepflichtversicherung). This covers some of the cost of meeting personal nursing needs, including the bathing and feeding of those who become substantially disabled.

The nursing care scheme cost varies based on the number of children a person has, although it generally runs from 3.4 per cent of a person’s gross salary with at least one child or 4.0 per cent (with a maximum of €199.50 per month) for a person with no children, of which the employer pays a maximum of €84.79. These figures vary slightly for the state of Saxony, where costs start at 2.2 per cent for a person with one child and 2.8 per cent for childless individuals. The employer contribution in Saxony is also lower, at 1.2 per cent.

Public health insurance – what does it cover?

The minimum threshold all health insurance coverage in Germany has to meet includes:

in-patient (hospital) care as a ward patient
out-patient care from a general practitioner or medical specialist (such as a cardiologist)
prescription drugs
pregnancy care
basic dental care
employee sick note
statutory sick pay when the employer’s duty to pay it is over (up to 90 per cent of a person’s net salary)

In addition, all non-working dependents – spouse, civil partner and children (up to a specified age) – living at the same address as the policyholder in Germany will be covered under the plan at no additional cost. They simply need to be registered with the same health insurance provider as the paying member.

Although the medical provision provided by public health insurance in Germany is fairly extensive, additional care may require additional payment – so it is essential to know what coverage is included. For example, while basic dental care is covered, aesthetic teeth cleaning may incur an additional fee.

Private health insurance in Germany – who can get it?

Germany does offer the opportunity to opt for private health insurance (private Krankenversicherung or PKV for short), but only for:

those who earn more than a predetermined amount (€66,600 per year in 2023),
those who are self-employed,
and university students, who can choose private health insurance for the duration of their our studies

However, even if one of these criteria is met, no one is obligated to choose private health insurance. Anyone can still opt for statutory health coverage.

Private insurance – how much does it cost?

There are a few important factors that should be reviewed before considering private insurance. Although not impossible, it can be extremely difficult to enter or return to the statutory healthcare system once a person has a private insurance policy. In addition, monthly insurance premiums for private policies are not pegged to a person’s salary. Germany’s leading consumer reports organization, Stiftung Warentest, writes that the average person who first signs up for private insurance in their mid-thirties can expect their premium to rise to at least three times the original price by the time they retire.

Private health insurance – where to get it

A complete list of all private health insurance providers is available on this German-language website. However, given the differences in premiums and scope of coverage available, it is worth using a commercial price comparison website like Check24, Krankenkassen Deutschland and PKV-Gesundheit or a locally based health insurance broker, who can provide purchasing advice.

 

Private vs public health insurance in Germany – key differences

Although everyone has access to all healthcare institutions for doctor’s appointments and medical treatment with both types of policy, it is worth knowing the differences. For example, public health insurance does not cover needs such as dental implants, glasses or contact lenses or private rooms in hospitals, but a private insurance policy might cover several or all of these.

While basic premium rates for public health insurance are the same (14.6 per cent) for all residents of Germany, regardless of income, private health insurance charges higher premiums that vary according to income, health and potential future health problems, and the risks a policyholder is willing to accept when purchasing a policy.
Although pre-existing conditions are not an issue with public health insurance policies, that is not the case for private coverage. Still, because private health insurance providers in Germany are legally obliged to accept anyone, nobody can be denied coverage because of a pre-existing condition.
German private health insurance adopts the same style of system found in any general insurance policy. Each month, a monthly premium is paid and a level of excess (or deductible) is selected on top of that. For example, a €400 excess translates to the policyholder paying the first €400 of healthcare costs before the policy kicks in.
Under the public health insurance scheme, policyholders face a co-pay of 10 percent of the cost of any prescription medicine, up to a maximum of 10 euros and a minimum of 5 euros per prescription. Those with private insurance policies must pay the full amount for prescriptions up front but will then be full reimbursed after submitting the receipt.
It is important to note that while public health insurance policies also cover additional family members, this isn’t always the case with private health insurance. It is thus necessary to check the details of any private insurance policy, as it might be necessary to organise separate healthcare provisions for dependents.
Supplementary private insurance

Those who have public health insurance in Germany but want further coverage options can opt to enhance it with supplementary private insurance. While this will incur extra costs, it could come in useful for those seeking coverage for things not included in their public health insurance policy, such as additional dental care or treatment in a private hospital.

Health insurance in Germany – when should I get it?

Ideally, those coming to work in Germany from another country in the EU should get their health insurance as soon as they arrive and are registered as a resident of Germany. Still, there is no cause for panic: Germany offers a brief grace period from the date of registration, and employers will also provide guidance through the process.

Those coming from a country outside the EU, will need proof of valid German health insurance to obtain a residency permit. In such cases, new arrivals must have secured insurance coverage prior to arrival in Germany.

 

Health insurance for researchers and scientists

Even those coming to Germany to work as guest researchers or scientists must have a valid health insurance policy. Universities are able to accept proof of insurance policies held in guest scholars’ home countries if the coverage is equivalent to that provided by a German statutory health insurance policy. Don’t forget that if family members are also joining, they will also need have health insurance during their stay in Germany.

Germany has social insurance agreements with a number of countries, including the member states of the European Union and those in the European Economic Area. In such cases, policies held in home countries are valid in Germany as well.

Those from a non-EU country planning to stay in Germany for a longer period of time will need to obtain the compulsory health insurance from licensed insurance companies in Germany. It is possible to purchase a policy tailored for guest scientists and researchers, such as EDUCARE24, IHC-COMPANY’s International Science Healthcare Plan and MAWISTA Science.

European Health Insurance Card in Germany

Citizens of other EU countries, EEA countries and Switzerland who have a European Health Insurance Card are eligible for free access to some health treatments while visiting Germany on a temporary basis. This might be useful for jobseekers coming to the country to explore the possibility of living and working there. However, this isn’t a substitute for German health insurance, and as soon as residence or employment are established, all are required to have proper policy coverage.

 

 

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