Social security in Germany
Social security in Germany is divided into five areas: health insurance, long-term care insurance, accident insurance, pension insurance, and unemployment insurance. The legal basis for this is the German Social Security Code (SGB).
Employees are automatically compulsorily insured in Germany. Social security is organized by the employer, who calculates the contributions to the pension insurance, health insurance, unemployment insurance, and long-term care insurance contributions on a monthly basis from the gross salary based on the statutory rates, deducts half from the salary as the employee’s share, and pays this to the health insurance company of the insured together with the employer’s share. The health insurance company forwards the respective shares to Deutsche Rentenversicherung and the Federal Employment Agency (unemployment insurance).
From a certain income level (currently 4,950 euros gross/month), employees may switch to a private health insurance provider. Private insurers calculate the monthly contributions based on individual risk.
Self-employed persons usually have to take out their own insurance. Health insurance coverage is compulsory in Germany, i.e. self-employed persons must take out private health insurance or – if they meet certain conditions – insure themselves voluntarily through a statutory health insurance provider. Voluntary insurance through a statutory health insurance provider is possible if, for example, the automatic compulsory insurance coverage ends due to termination of an employment relationship and the employee was insured through the statutory health insurance scheme for a certain duration. Information about this can be found here (additional details) – in German language only.
Long-term care insurance also must be taken out through the health insurance provider. Retirement arrangements can be made privately but it is also possible to join the statutory pension insurance scheme (coverage through the statutory pension insurance scheme is compulsory for certain occupational groups, e.g. for self-employed teachers).
Statutory health insurance (SHI): Employers and employees share the basic monthly contributions. In addition, the insured party pays an additional contribution, which in 2018 amounts to an average of 1.0 percent of the gross income. Civil servants and self-employed persons pay the full monthly contribution themselves.
The SHI settles any medical services based on the principle of benefits in kind. Medical practices, hospitals, etc. charge the treatment costs directly to the health insurance provider. The insured party does not have to make any advance payments.
Private health insurance (PHI): The monthly contribution is calculated independently of income and based on age, occupation, and health. Employers pay employees a subsidy. Civil servants benefit from low, subsidized rates.
Medical services are initially billed to the insured party. He/she receives an invoice which he/she checks, pays, and submits to the PHI for reimbursement. Hospitals usually settle inpatient treatments directly with the PHI.
Note on family insurance
It is possible to co-insure family members free of charge under the statutory health insurance scheme. This applies to spouses and registered life partners as well as to children (i.e. children, stepchildren, grandchildren, foster children, adopted children, as well as children of children insured under the family insurance option) – initially until the age of 18.
Some prerequisites must be considered regarding the insurance: The co-insured person
Detailed information from the Federal Ministry of Health can be found here on the Familien-Wegweiser website (in German only) of the Federal Ministry for Family Affairs, Senior Citizens, Women, and Youth.
The German-Turkish Social Security Agreement includes a number of special provisions. For example, family members of Turkish citizens who are statutorily insured in Germany may be included in the family insurance policy, even if they reside in Turkey. The statutory health insurance providers can provide information in this regard.
One interesting read on the topic is the report of the Wissenschaftlicher Dienst (Scientific Service) of the German Bundestag entitled ‘Fragen zum Deutsch-türkischen Sozialversicherungsabkommen’ (‘Questions regarding the German-Turkish Social Security Agreement’), January 2018 (in German only).
Artists’ social security fund (Künstlersozialversicherung) – insurance through the artists’ social security fund for self-employed artists and publicists
A special social security system, the artists’ social security fund, has been established for artists and publicists in Germany. Since January 1, 1983, this system has enabled freelance artists and publicists to access social security benefits by allowing them to pay only approximately half of their social security contributions, just like employees. The legal basis for this is the Artists’ Social Security Act (Künstlersozialversicherungsgesetz (KSVG)).
Artists and publicists from Turkey who live in Germany permanently, as well as German artists and publicists, can be insured through the Artists’ social security fund. This includes pension and health insurance but not unemployment or accident insurance. The latter two must be taken out privately if desired.
For the purposes of the KSVG, an artist is anyone who creates, performs, or teaches music, or the performing or visual arts. This also includes designers and instructors in the field of design, for example. For the purposes of the KSVG, a publicist is anyone who works as a writer or journalist or who engages in a similar publicist activity or teaches journalism. The catalog of artists provided by the KSK (German language) gives an overview of the activities covered by the KSVG – such as solo entertainers, photojournalists, game designers, editors, music teachers, make-up artists, voice-over artists, etc. Decisions concerning many activities are made individually on the basis of the job description.
The prerequisite for acceptance into the KSK is that an artistic or publicistic activity is carried out commercially and not just temporarily. The income is estimated for the respective following year and used as the basis for calculating health insurance, pension insurance, and long-term care insurance contributions. The minimum annual income threshold is 3,900 euros.
There are special regulations for new applicants, which are explained here.
A questionnaire is available on the website that can be used to apply for acceptance into the KSK. In order to apply, you will need to complete the form and send it to the KSK. The average processing time is two to three months or longer in some cases; the earliest possible start of insurance coverage is the date of first contact with the KSK.