I have been reading a lot into the financial comparison between taking Public vs Private health insurance, but I haven't been able to clarify a detail:
– Does the employer contribution also cover the benefits that go beyond what the Public Insurance would cover?
It is often explained (including in the wiki) that when you're in Private, the employer will pay 50% of your total insurance premium up to what they would cover were you Publicly Insured; but this point is rarely mentioned. In fact, I have found conflicting information on this:
https://www.tk.de/firmenkunden/versicherung/beitraege-faq/arbeitsentgelt/hoehe-arbeitgeberzuschuss-zur-privaten-krankenversicherung-2034496?utm_source=chatgpt.com
In this page TK clearly states that the employer only has to cover the benefits that are comparable to Statutory Insurance.
However, I also found the following from Allianz:
https://www.allianz.de/gesundheit/private-krankenversicherung/arbeitgeberzuschuss/
They give two examples on Rechenbeispiel Arbeitnehmer of someone who has extra benefits (extra dental and Krankentagegeld) while keeping their total premium under the Statutory Premium, and conclude that the Employer would still cover 50% of the total premium.
Can anyone who is privately insured shine a light on this?
by Cold-Scientist4450
2 comments
Both can be true
The general rule is 50% of your actual PKV contribution, but only up to the statutory equivalent employer-share capped amount and only for the portion of the PKV contribution that corresponds to the GKV-type benefits.
Both can be true at the same time and I don’t think that the extra dental insurance is a good comparison. Rather, take a contract that would guarantee you “Chefarztbehandlung” – treatement by the head doctor. This is one of the classic PKV services, that GKV simply does not provide and is completely outside of their catalogue of benefits.
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