Public vs. Private Health Insurance for Parents in Germany

Discover the vital decisions in health insurance for parents in Germany. Navigate pregnancy, Elternzeit, and beyond, ensuring optimal coverage and financial balance for your family's well-being.

Key Takeaways

  • Navigating health insurance is critical for parents, impacting well-being and finances. This guide explores the implications.
  • Decide between public & private health insurance before pregnancy, considering a €69,300 income threshold for choice freedom.
  • Coverage differences emerge during pregnancy. Public insurance covers standard checks, while private insurance extends coverage.
  • Maternity leave sees consistent income in both insurances, but the premium payments and benefits are different.
  • Elternzeit yields consistent income but varying premium situations, public depending on insurance status, private on the provider.
  • Post-education, your child’s insurance independence unfolds, with their income playing a key role in how they are insured.

Introduction: Health insurance for parents in Germany

Entering parenthood comes with a variety of decisions, and perhaps none is as complicated as choosing between public and private health insurance. This guide aims to unravel the complexity of this important decision and focus on the different implications for individuals and families at different stages of parenthood.

Divided into three critical stages – before pregnancy, during pregnancy, and child is born- we address the nuances that affect your health, your child’s well-being, and the financial implications associated with choosing insurance. From pre-conception to post-natal care, this comprehensive review on health insurance for parents in Germany is designed to give you the knowledge you need to make an informed decision tailored to your family’s unique needs and circumstances.

Before pregnancy: deciding on your insurance

Becoming a parent requires strategic decisions, and one of the most important is the choice between public and private health insurance. This decision must be made either before or after pregnancy in order to avoid possible non-coverage during pregnancy.

In 2024, a minimum annual income of €69,300 will determine whether you can opt for one of the two insurances (as you need to be voluntarily publicly insured). With an average premium of €1,019 (with children) or €1,051 (without children), public health insurance offers 1-star basic coverage that meets the legal minimum requirements.

Private health insurance policies tailored to the chosen tariff have different premiums. For a 27-year-old, a 5-star private health insurance plan costs around €525 per month, not including any cashback benefits and without having a deductible included. One advantage is that from a 3-star tariff upwards, artificial insemination is also covered, so there are no extra costs if you do not become pregnant.

During Pregnancy: Navigating Health Insurance Variances

Throughout the course of pregnancy, the stability of health insurance premiums and salary provides a sense of consistency for expectant parents. However, the divergence in coverage between public and private health insurance becomes evident. Public health insurance encompasses standard laboratory checks for expectant mothers, ensuring essential prenatal care.

Conversely, the scenario shifts with private health insurance, which extends its coverage to more intricate laboratory examinations, including assessments for trisomy 21 or triple blood tests. The discrepancies continue as private health insurance offers unlimited coverage for prenatal courses designed for fathers. In contrast, public health insurance limits such provisions, with only select companies offering courses for fathers, often accompanied by a capped maximum contribution, typically around €80.

The variance in coverage during pregnancy underscores the nuanced aspects of health insurance choices, influencing the comprehensive care and support available to expectant parents during this pivotal period.

Are you considering switching to private health insurance and need help making a decision? We will help you find the best solution for you.

Maternity Leave: Income Stability Amidst Insurance Variances

Maternity leave, spanning eight weeks before and six weeks after childbirth, crucially maintains income stability for parents, regardless of their health insurance choice. In the public health insurance system, you receive €13 per day as maternity benefit, complemented by the remainder of your salary provided by the employer. This ensures that your income during maternity leave mirrors the exact compensation you received before, fostering financial consistency.

On the private health insurance front, the scenario remains parallel. The Bundesamt für Soziale Sicherung contributes €210 as maternity benefit, aligning with the employer’s share for public health insurance (salary – €13 per day). This combined support, while lower than your standard salary, prompts the private health insurance to cover the difference through sick leave benefits, maintaining uniform income levels.

While the income scenario aligns, the premium dynamics fluctuate between public and private health insurance. Public health insurance is cost-free during maternity leave, providing temporary relief. However, in the private health insurance realm, you continue to pay the standard premium of approximately €525 per month for yourself and an additional €150 per month for the child, without the 50% employer benefit.

As the income maintains consistency, the coverage nuances become apparent. Public health insurance guarantees a multi-bedroom setting in the hospital, complemented by access to the duty doctor. Conversely, private health insurance elevates the experience with the provision of a one- or two-bedroom accommodation in the hospital and specialized chief doctor treatment, highlighting the divergent dimensions of coverage during this critical period.

Transitioning to Elternzeit: Elterngeld and Insurance Dynamics

Post-maternity leave, parents seamlessly transition into Elternzeit, receiving Elterngeld for up to 14 months. This essential support, available in both public and private health insurance scenarios, ensures financial stability. Elterngeld equates to 65% of your previous salary, capped at €1,800 per month. This uniform income structure remains consistent across both health insurance options.

However, premium dynamics diverge once more. In public health insurance, voluntary members bear the full brunt of the premium without the 50% employer benefit, as they are not mandated participants. Exceptions arise for those married to a partner in public health insurance or those with zero income, qualifying for free coverage. If the spouse is privately insured, coverage extends to a 50% accreditation of the household income, aligning with a roughly 20% public health insurance premium. Privately insured individuals encounter varied options, with some plans allowing free coverage for up to six months or their child for up to one year. This underscores the pivotal role of selecting the right plan for comprehensive health coverage.

A notable advantage surfaces within private health insurance—the provision of rooming-in facilities. This allows parents to stay in the hospital when their child requires extended care. Family rooms become a common feature, enhancing the overall experience during this critical phase of parenting.

Returning to work: Financial realities and insurance benefits

At the end of parental leave, parents resume their professional obligations and return to their pre-pregnancy income level. At the same time, premiums for public health insurance return to their original structure, as the child is entitled to free coverage under family insurance (total costs of €1,019 on average in 2024).

Private health insurance, on the other hand, has a different financial framework. Parents incur monthly costs of around €150 for their child’s insurance cover, bringing the total amount before reimbursement to €675. An important aspect is that the employer provides a 50% subsidy for the child’s health insurance, thus alleviating a considerable part of the financial burden. This valuable contribution from the employer makes private health insurance more financially viable, which is crucial for parents who need to reorient themselves after parental leave.

Furthermore, private health insurance outperforms its public counterpart in terms of coverage, which is particularly evident when it comes to postnatal care and orthodontic procedures such as braces. While public health insurance only covers such expenses if the child’s teeth fulfill certain criteria, private health insurance offers more comprehensive benefits that cover a variety of medical needs and ensure the well-being of parents and children.

After Pregnancy: Balancing Family Health and Finances

As your child completes their education, they are poised to take charge of their health insurance, marking a crucial juncture in their financial independence. In the public health insurance system, they will transition to a premium structure based on their individual income, mirroring the arrangement for the general populace. Meanwhile, private health insurance offers an enticing alternative, particularly for those who have been insured under this system throughout their lives.

The conclusive chart, derived from precise data and historical growth rates of both public and private health insurance, delivers a staggering revelation. Even for families with three children spaced two years apart, the financial burden is notably lighter in private health insurance, even before factoring in potential cashback benefits. It’s crucial to note that this comparison primarily applies to individuals with an income exceeding €69,300, as those with lower earnings face a vastly different scenario, coupled with the inability to switch to private health insurance.

Health insurance for parents in Germany is inherently personal, and the provided information serves as a generic guide. For tailored advice suited to your family’s unique circumstances, consider scheduling a free meeting with our experts to explore the best health insurance options tailored to your needs.

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