在德国，相比法定医保，参保私人医保有什么优势（二）

Exiture
In Germany, both private and public health insurances are available, and both have their advantages and disadvantages. Here are some advantages of having private health insurance in Germany compared to public health insurance:
Access to a broader range of medical services: Private health insurance may offer a broader range of medical services and treatments compared to public health insurance. Private insurance plans may cover alternative therapies, elective treatments, and access to specialized medical facilities that may not be available under the public system.
Shorter wait times: Private health insurance plans may offer shorter wait times for medical appointments, procedures, and surgeries compared to the public system, as private insurers may have agreements with private medical providers.

在德国，私人和公共医疗保险都有，而且都有其优缺点。与公共医疗保险相比，在德国拥有私人医疗保险有一些优势：
获得更广泛的医疗服务：与公共医疗保险相比，私人医疗保险可能提供更广泛的医学服务和治疗。私人保险计划可能涵盖替代疗法、选择性治疗和使用公共系统可能无法提供的专业医疗设施。
更短的等待时间：与公共系统相比，私人医疗保险计划可能提供更短的医疗预约、流程和手术等待时间，因为私人保险公司可能与私人医疗提供商达成协议。
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处

More personalized service: Private health insurance plans may offer more personalized service, as policyholders can choose their doctors, hospitals, and treatment plans, which may not be possible under the public system.
Greater flexibility: Private health insurance plans may offer greater flexibility in terms of coverage options, deductibles, and copays, allowing policyholders to tailor their coverage to their specific needs.
However, there are also some disadvantages to having private health insurance in Germany. Private health insurance premiums can be more expensive than public health insurance premiums, and private insurers may deny coverage or charge higher premiums based on pre-existing medical conditions. In addition, private health insurance policies may require policyholders to pay for medical services upfront and then file claims for reimbursement, whereas public health insurance typically covers the costs directly. Ultimately, the choice between private and public health insurance in Germany will depend on individual circumstances, including income, health status, and personal preferences.

更个性化的服务：私人医疗保险计划可能会提供更个性化的医疗服务，因为投保人可以选择他们的医生、医院和治疗计划，这在公共医疗体系下可能是不可能的。
更大的灵活性：私人医疗保险计划可能在保险选项、免赔额和自付垫底费方面提供更大的弹性，使投保人能够根据自己的具体需求调整保险范围。
然而，在德国拥有私人医疗保险也有一些缺点。私人医疗保险费可能比公共健康保险费更贵，私人保险公司可能会基于预先存在的医疗状况拒绝承保或收取更高的保费。此外，私人医疗保险政策可能要求投保人提前支付医疗服务费用，然后提出报销申请，而公共医疗保险通常直接支付费用。最终，在德国的私人和公共医疗保险之间做何种选择将取决于个人情况，包括收入、健康状况和个人偏好。

Tomas Schild
Is it true, that in Germany, after you once try private health insurance, you cannot switch to the government insurance anymore?
Originally Answered: Is it true, that in Germany, after you once try private insurance, you cannot switch to the government insurance anymore?
The question refers to health insurance.
Yes, if you have opted into private health insurance (as an employee earning more than (as of 2017) 57,600 €/year or as a self-employed person), it is hard or even impossible to switch back.

在德国，在你尝试过私人保险后，你就不能再转向政府保险了，这是真的吗？
这个问题涉及医疗保险。
是的，如果你选择了私人医疗保险（作为年收入超过（截至2017年）57600欧元的员工或自营职业者），你很难甚至不可能重新投保。

The reason for this is to avoid cherry-picking by people opting into private health insurance (premium = fixed amount) when young and switching back to statutory insurance (premium = percentage of wage; children and nonworking spouse covered at no extra cost) when they are older and private insurance premiums are higher because older people need more medical tratment.
When younger than 55 years, you can only switch back when you are employed and your wage is lower than the point where you must enroll in statutory insurance (i.e. there are cases where you must ask your employer to lower your wage)
When 55 years or older, it is almost impossible - except when you are married to a person insured in the statutory insurance, then you can rejoin the statutory insurance by becoming unemployed and being covered as a dependent by your partner’s statutory insurance.

这样做的原因是为了避免人们在年轻时选择私人医疗保险（保费=固定金额），在年老时重新选择法定保险（保费＝工资的百分比；儿童和非工作配偶不需要额外费用），私人医疗保险的保费更高，因为老年人需要更多的医疗护理。
当你不到55岁时，只有当你有工作并且你的工资低于你必须参加法定保险的水平时，你才能换回来（即，在某些情况下，你必须要求雇主降低你的工资）
当你55岁或55岁以上时，这几乎是不可能的——除非你嫁给了一个参加法定保险的人，然后你可以通过失业和作为受抚养人参加伴侣的法定保险来重新参保法定保险。

Steffen H?user
A different way of calculating the Premium. For public it is based on a percentage of your income (not a tax though), for private it is a fixed amount. So for people with higher income private is cheaper, for people with lower/medium income public is cheaper. That is the biggest thing about what this is. Payment amount.
You get 1–2 bed room in hospital, chief doctor treatment and a higher percentage of coverage for dental care (dental care is one of the few regions where in Germany you have a Copay, public only pays 60% of Dental Care usually). People with public can take this sort of stuff as an optional addon insurance though (my wife - on public - for example raised her dental coverage from 60% to 90% by a price of 35 EUR per month, the 1–2 bed room and chief doctor treatment for her cost us 40 EUR per month - it is still cheaper than private for her - for me it is the other way round).
A few examinations are not covered by public. But they are rare .

保费方面是不同的计算方式。对于公共医疗保险的保费来说，这是基于你收入的一个百分比（但不是税），对于私人医疗保险的保费来说，它是一个固定的金额。因此，对于收入较高的人来说，私人医疗保险更便宜，对于收入较低/中等的人，公共医疗保险更便宜，这是最重要的一点：保费支出费用。
你可以在医院获得1-2张床位、主治医生治疗和支付更高比例的牙科护理费用（牙科护理是德国少数几个拥有自付额的地区之一，公共医疗保险通常只支付60%的牙科护理费用）。不过，有公共医疗保险的人可以把这类作为一种可选的附加保险（例如，我妻子的公共医疗保险，以每月35欧元的代价将她的牙科保险金支付比例从60%提高到90%，为她提供的1-2张床位和享有主治医生的治疗方面每月花费我们40欧元——对她来说，这仍然比私人医疗保险便宜——对我来说，情况正好相反）。
有几项服务是公开医疗保险没覆盖到的，但它们很罕见。

You might get an appointment 1–2 weeks faster (though if you are a recurring customer you usually get the same speed of getting an apopointment no matter if private or public)
You might have to wait less in the waiting room
Acupuncture, etc. is usually included by default for private. For public you have to request it (does not cost extra though - but some public insurances might not offer it)
Massages covered by insurance are a few minutes shorter if you are insured public
You need no referral to go to a specialist (public insured need this unless it is an emergency, also some fields are excepted from the referral even if no emergency, like male/female medicine, dental care, eye care)
Private also has disadvantages though:

你可能不用在候诊室等那么久了
针灸等通常默认为私人医疗保险使用。对于公共医疗保险，你必须提出要求（尽管不需要额外费用，但一些公共医疗保险可能不提供）
如果你是公众医疗保险，保险范围内的按摩会缩短几分钟
你不需要转诊就可以去看专家（公共医疗保险需要转诊，除非是紧急情况，而且一些领域即使没有紧急情况也不包括在转诊范围内，如男性/女性医学、牙科护理、眼科护理）
私人医疗保险也有缺点：

You have to pay upfront (though usually people do it like sending the bill to insurance, getting the money from them and THEN paying the doctor - the payment goals are typically big enough for this)
When you get older the price raises
Kids also cost, while for public insurance they are free (their insurance does not cost the same like for an adult though)
Once you have been in private for some time, you cannot switch back to public (to avoid people going for private when young and public when old)
Remember it is the SAME doctors to whom you go. There are no special “for private only” doctors
So yeah - mostly it is a decision based on what is cheaper for you.

你可能会提前1-2周预约（然而如果你是一个常客，无论参保私人医疗保险还是公共医疗保险，你通常都会以同样的速度预约上）
你必须提前付款（尽管通常人们会这样做，比如把账单交给保险公司，从他们那里拿到钱，然后付钱给医生——付款金额通常足够多）
随着年龄的增长，保费会上涨
儿童也要付费，而公共医疗保险方面儿童是免费的（他们的保险费用与成年人的保费不同）
一旦你参保私人保险一段时间，你就不能再转回参保公共医疗保险（以避免人们年轻时参保私人医疗保险，年老时参保公共医疗保险）
记住，你去找的是同一个医生。没有专门的“只针对私人医疗保险”的医生
所以这主要是基于对你来说哪种更划算而已。

Tomas Schild
What is the difference in quality between private and state health insurance in Germany?
We refer not to ‘state’ but to ‘statutory’ health insurance in Germany because the carriers of statutory insurance are not agencies of the state but highly regulated non-profit institutions.
The main incentive to choose private insurance is that with statutory insurance your premium is a percentage of your wage, while with private insurance it is a fixed amount, depending on your age/health. So, a young, healthy person who earns a very high wage pays less in premiums in private than in statutory insurance. The catch is that once you are in private you cannot change back when your age, or having children (covered under statutory insurance at no extra cost) or income would make statutory insurance a better deal.
Quality pros of private health insurance

德国私人医疗保险和国家医疗保险在特征上有什么区别？
在德国，我们指的不是“国家”，而是“法定”医疗保险，因为法定保险的承运人不是国家机构，而是高度受监管的非营利机构。
选择私人医疗保险的主要动机是，在法定保险中，你的保费是工资的一个百分比，而在私人医疗保险中，保费是固定金额，这取决于你的年龄/健康状况。因此，一个年轻、健康、工资很高的人在私人医疗保险中支付的保费比法定保险少。问题是，一旦你参保私人医疗保险，当你的年龄因素，或者有孩子了（参保法定医疗保险范围，不收取额外费用）或收入方面参保法定保险变得更好的时候是不能转变为参保公共医疗保险的。
私人医疗保险的优势
原创翻译：龙腾网 http://www.ltaaa.cn 转载请注明出处

You can get earlier appointments in non-emergency cases with physicians in private practice. The delay is in the order of days to weeks, sometimes months for checkup-type appointments in certain specialties. When time is of the essence, in a medical sense, your general practicioner (where you get appointments in short order - for many GP you walk in and wait a bit) will have his office call a specialist
Some but not all private health insurance schemes pay for a better ‘hotel’ component of a hospital stay, e.g. a single room where someone in statutory insurance would share a larger room with another patient.
Quality cons of private health insurance
Hospitals are a bit more likely to subject you to unneccessary procedures (as they can bill a higher rate with private insurance).
You pay out of pocket for your doctor visits and must file with the insurance for reimbursement - more paperwork compared with statutory insurance where the doctor directly bills the statutory insurance.

在非紧急情况下，你可以提前预约私人诊所的医生。对于某些专业的体检类预约，延迟时间约为几天到几周，有时甚至几个月。从医学意义上讲，当时间至关重要时，你的全科医生（你是可以在短时间内预约上的，对许多全科医生来说，你走进去然后等一会儿就行）会让他的办公室打电话给专家。
一些但不是所有的私人医疗保险计划都会为住院期间更好的“酒店”类病房费用买单，例如，单人病房，而参保法定保险的人将与另一名患者共享一个更大的病房。
私人医疗保险的劣势
医院更有可能让你接受不必要的手术（因为反正有私人医疗保险可以报销）。
你必须先自费看医生，再向保险公司申请报销——与医生直接开具法定保险账单的法定保险相比，这需要更多的文书工作。

Anna Schleicher
Germany has a mixture of private and public health insurance, how does that system work?
All residents of Germany must have health insurance. There are two systems – the public and the private health insurance. These are the main differences:
Public health insurance:
Your contribution depends on your salary: the more you earn, the more you have to pay.
Premiums can reach up to € 977.55 a month which you share with your employer. As a self-employed person, you must cover the full costs yourself.
Coverage is quite limited and benefits can be cancelled at any time.

德国既有私人医疗保险，也有公共医疗保险，这个体系是如何运作的？
所有德国居民都必须参保医疗保险。有两种体系——公共医疗保险和私人医疗保险。这些是主要区别：
公共医疗保险：
你的贡献取决于你的薪水：你赚的越多，你必须支付的就越多。
保费最高可达每月977.55欧元，由你与雇主共同支付。作为一个个体经营者，你必须自己承担全部费用。
保险范围非常有限，而且随时都可以取消。

Private health insurance:
Your monthly premium does not depend on your salary.
Premiums depend on your health status, the desired scope of benefits and your age of entry: the earlier you decide to switch to private health insurance, the lower your monthly premiums will be.
Coverage is much more extensive and benefits are guaranteed for the entire duration of your contract.
Eligible for private health insurance are these persons: employees with a salary above the annual income threshold of €66,600, self-employed persons and civil servants

私人医疗保险：
你每月的保费并不取决于你的工资。
保费取决于你的健康状况、所需的保障范围和你的入职年龄：你越早决定转为私人医疗保险，月保费就越低。
保险范围要广泛得多，在你的整个合同期限内都有保障。
这些人有资格享受私人医疗保险：年收入超过66600欧元门槛的雇员、自营职业者和公务员

Jan Krusat
What is the most affordable private health insurance in Germany?
What for? Unless you are really in the upper levels of the income range, as an employee you will be automatically insured through the public system (though you can pick among about 200 insurance providers. The premiums are similar, a percentage of your gross income, with your boss paying half). Even as self employed or student you can join them.
Compared to private insurance (where the premiums are calculated based on age, sex and previous diseases and might be cheaper for a young, healthy male, but become very expensive once you get older) the public system is quite hassle free.
With the private insurance you will usually have to forward the payment of the medical bills, but will get re-imbursed later.
I’m an employee with an income well above average and I decided that I will stay in the public system.

德国最实惠的私人医疗保险是什么？
为何？除非你收入范围真的处于较高水平，否则作为一名员工，你将自动通过公共医疗保险系统投保（尽管你可以在大约200家保险公司中选择。保费是相似的，占你总收入的一个百分比，你的老板支付其中的一半）。即使是作为个体经营者或学生，你也可以参保公共医疗保险。
与私人医疗保险相比（保费是根据年龄、性别和既往疾病计算的，对于年轻健康的男性来说可能更便宜，但一旦你长大，保费就会变得非常昂贵），公共医疗保险系统会相当轻松。
参保私人医疗保险，你通常必须提前支付医疗费用，但稍后再报销。
我是一名收入远高于平均水平的员工，我决定参保公共医疗保险系统。

Claus-Jürgen Heigl
The main difference is that the cost of insurance is dependant on income when you are insured publicy and is dependant on age when you are insured privately. The catch is, once you are insured privately it is very hard to switch back. You might want to if are getting old.
The consequence is, when you are young and you have a high income private insurance is very competetive compared to public insurance for the moment. This is why private healthcare insurance is sold almost exclusively to young people. For elder people private insurance is much more expensive than public insurance. No one tries to sell private health insurance to someone who is over 50. It’s not even a contest.
Because there is no switching back you should think very thoroughly if you will be able to afford private insurance when you get old. If you are 80, for example, you can expect costs of 20k Euros or more per year just for private health insurance. Which is somewhere around the cheapest rate as per now, but expect much more in 50 years. With public health insurance the cost for the 80 year old person would be a percentage of your income.
Let’s say you have the average income for a 80 year old (you plan to become old, do you?). This means your income would be around 30k Euros per year. 30k - 20k = 10k which is what you would have left if you are privately insured. This puts you well below the official poverty threshold. Yuck! With public health insurance you would have left roughly 25k Euros which is more than twice you would have left if privately insured.
Of course you will have better and more healthcare if you are insured privately. Still you better plan to get rich and have a good chance at it otherwise you won’t be able to afford your healthcare if you are getting old. Better, switch to private healthcare after you have got rich, because just in case. However you may find that when you finally are rich private healthcare has become unattractive because you are getting old.

主要的区别是，参保公共保险的保费取决于收入，而参保私人医疗保费取决于年龄。问题是，一旦你参保私人医疗保险，就很难再转回公共医疗保险了。其实如果你变老了，你可能会想转的。
结果是，当你年轻，收入高的时候，私人医疗保险比公共保险更有竞争力。这就是为什么私人医疗保险几乎只卖给年轻人。对老年人来说，私人保险比公共保险贵得多。没有人会把私人医疗保险卖给50岁以上的人。这甚至不具竞争性。
因为私人医疗保险不可转公共医疗保险，所以你应该仔细考虑当你老了之后是否能够负担得起私人医疗保险的保费。例如，如果你80岁了，仅私人医疗保险每年的费用就可能达到2万欧元或更多。这大约是目前最便宜的价格，但预计50年后会更多。参保公共医疗保险，80岁老人的费用将仅占你收入的一定比例。
假设80岁时达到80岁老人的平均收入（你做变老的打算，是吗？）。这意味着你每年的收入将在3万欧元左右。30000-20000=10000，如果你参保私人保险，这就是你剩下的钱。这使你远远低于官方规定的贫困线，哎！参保公共医疗保险，你会留下大约25000欧元，这是私人医疗保险的两倍多。
当然，如果你参保私人医疗保险，你会得到更好、更多的医疗保健。尽管如此，你还是要计划致富，并有很好的机会，否则如果你老了，你将无法负担医疗保险的保费。更好的做法是，在你变得富有后，转向私人医疗保险，这样可以以防万一。然而，你可能会发现，当你终于富裕起来时，私人医疗变得没有吸引力，因为你越来越老了（费用越来越多）。

Which is not a problem if you have public healthcare. If you want and can afford it you can always have additional healthcare privately. As much as you want to afford. In the end, if you plan to get old you are more flexible with public healthcare and are cheaper .
Another thing I know personally because my brother has private healthcare: if you are privately insured there is a tendency for doctors to get you over treatment. Doesn’t sound bad? Well, expect to get unnecessary treatment because you are the one that get’s the doctor his next Porsche. You will stay longer than necessary at the hospital because you are the gold mine.
There are definitely differences in waiting times to get to see a doctor. This is the huge drawback when insured publicly. Two episodes that happened:
To me (public healthcare): I was in need to see a specialist to exclude a certain cause for high blood pressure. This is nothing life threatening and there is only one specialist in the particular field in my city of 350.000 inhabitants. My waiting time to get an appointment was 13 months. More than a year! That’s an extreme case but when you need to see a specialist expect to have waiting times for more than a month on average.
To my brother (privately insured): “I have a certain health condition and I would like to see a specialist. When can I have an appointment?” - “How about right now?” - “No, it’s short before noon and I’m hungry. I have to eat something.” - “Well, then come after you are finished, no problem.”
This is the difference between having a platin class private health insurance and public healthcare. But when he goes to the hospital because of a fever at a Friday evening he is invited to stay at the hospital for the weekend because the head physician would want to have a look at his new Porsche patient but is back only Monday while the public healthcare patient would get two Paracetamol and being sent home (also happened).
So if you are rich, get what fits you best. If you are not, think twice.

如果你参保公共医疗保险，这不是问题。如果你想要并且负担得起，你可以随时私下获得额外的医疗保健。你想买多少就买多少。最后，如果你做变老的打算，你参保公共医疗保险方面会更灵活，而且会更便宜。
我个人知道的另一件事是，因为我哥哥有私人医疗：如果你参保私人保险，医生会倾向于让你接受过度治疗。听起来不错吧？好吧，那就等着接受不必要的治疗吧，因为是你让医生开上了保时捷。你在医院待的时间会比必要的时间长，因为对医生而言，你是“金矿”。
去看医生的等待时间肯定是有差异。参保公共医疗保险时，这是一个巨大的劣势。发生了两件事：
对我来说（公共医疗保险）：我需要去看专家，以排除高血压的某些原因。这并没有威胁生命，在我这个拥有35万居民的城市里，只有一位特定领域的专家。我等待预约的时间是13个月，一年多！这是一个极端的情况，但当你需要看专家时，平均等待时间会超过一个月。
对我的兄弟（私人医疗保险）：“我有一定的健康状况，我想看专科医生。我什么时候可以预约？”，“现在怎么样？”，“不，中午前时间太短，我饿了。我得吃点东西。”，“好吧，等你吃完了再来，没问题。”
这就是白金级私人医疗保险和公共医疗保险之间的区别。但当他在周五晚上因为发烧去医院时，他被邀请在医院度过周末，因为主治医生想看一看让他换上新保时捷的病人，他周一才出院，而参保公共医疗保险的病人只服用两粒扑热息痛就被送回家（也发生过这种情况）。
所以，如果你很富有，就买最适合你的。如果不富有，请三思。