calamitysandra
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Answers for the German system
1. What if any are your out-of-pocket costs?
Well, first of all there is the cost of the mandatory insurance:
cost is shared between employee and employer
the employee pays 8,2% of his income, capped at a max. of 315 Euro/month
the employer pays 7,3% of the employees income
covered with this are:
the employee
his/her spouse if he/she has no income of their own/ income below 400 Euro per month
all children beneath the age of 18
children between the age of 18 and 25 if they have no significant income of their own and are still involved in some kind of schooling
There is a mandate to buy this form of insurance if your income is less than 46000 Euro per year. Above this threshold you can either choose to stay in this insurance or decide to buy private insurance.
Routine healthcare:
-10 Euro for the first office visit of each quarter (might be waived if the patient takes part in a preventive healthcare project),
-medication and things like filter for oxigen masks, incontinence pads, syringes, bandages, tape ... 0-10 Euro copay (10% of price, 5 Euro min. 10 Euro max. with a good deal of the less expensive medications free of copay),
-10 Euro per day of a hospital stay (28 days max.)
-Rehabilitation in a specialized facility 10 Euro per day (42 days max. prior hospital stays count against the max. copay needed)
-household help: 10% of cost min. 5, max. 10 Euro
-transportation cost: 10% of cost min. 5, max. 10 Euro
Copays are capped at 1% (if a family member is diagnosed with a chronic condition) or 2 percent of the annual income after deductions for family members (15% deduction for spouses, 7000 Euro per child).
If you recive social security, combined copays are capped at 90 Euro annually
There is no copay whatsoever for children
"Specials" like acupuncture, chiropractic, ... are often not covered, but relatively cheap additional coverage can be bought.
Dental health:
- preventive dental care is covered with two visits per year
-no copay for fillings, tooth extraction, root channels, cleaning once per year
- if you need tooth replacement your copay will vary between 35%-50%. If you choose some higher quality option like implants you pay the difference.
-additional insurance to cover the copays is available
Orthodontic care
-depending upon the diagnosis (cosmetic vs. medical necessity) children are completely covered. There is a 20% copay which the insurance pays back after the successful completion of the therapy.
-diagnostic criteria for adults are stricter
-additional insurance is available
Glasses
-adults pay completely (some exceptions for massive sight reductions)
-children only pay for the frames, the glasses are covered
-additional insurance is available
2. Are you or have you ever been denied service or coverage?
-Never!
3. How long are your wait times for service?
depends:
-acute illness that will be treated by a primary care physician (flu, gastrointestinal virus, ...) immediately
-chronic illness treated by a primary care practitioner (high blood pressure, diabetes ...) 0-5 days for check-ups, acute problems immediately
-specialists for not acutely dangerous conditions and check-ups: immediately-1 month (mostly within a week or two), there might be some outliers that take longer, mostly for "exotics" and never for acutely dangerous conditions
-acute conditions that require specialised care: immediately, normally in a hospital
4. On a scale of 1-10 how would you rank the quality of care?
As I believe that no 10 should be given, as improvement is always possible, I would rate the overall quality of care in Germany 8-9.
5. Would you prefer to have a health care system similar to the U.S.?
Are you kidding me?
While the German system is by no means perfect, I do feel that it does threat us well. Nobody has to choose between medication and eating, and an accident will not ruin a families finances.
< Message edited by calamitysandra -- 6/24/2012 3:54:42 PM >
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