GKV

GKV stands for Gesetzliche Krankenversicherung, the statutory health insurance system in Germany. It provides health coverage to the majority of residents and operates through a network of sickness funds (Krankenkassen). The system has its origins in the Bismarck-era social insurance model and is a central component of Germany’s welfare state, alongside private health insurance and long‑term care insurance.

Funding and membership are based on payroll contributions. Contributions are typically shared between employee and employer and are calculated as a percentage of gross income up to a contribution assessment ceiling (Beitragsbemessungsgrenze). The exact rate is determined collectively by the sickness funds. In addition to health insurance, most people also pay into a separate long‑term care insurance fund (Pflegeversicherung). The GKV covers most residents earning below the income threshold; those with higher earnings or certain self‑employed individuals may opt for private health insurance (PKV), though many remain in the GKV.

Benefits and coverage are defined by the Social Code Book V (SGB V). Standard offerings include medical care by doctors and hospitals, medicines, dental care, preventive and screening services, rehabilitation, and maternity and child health measures. Some services require co-payments, and there are caps and exemptions designed to protect low-income groups and families. The system aims for universal access and solidarity, with benefits negotiated and regulated at the federal level.

Administration and governance involve several bodies. The GKV-Spitzenverband coordinates the funds; the Gemeinsamer Bundesausschuss (G-BA) determines which services are reimbursable and the scope of benefits; independent bodies such as IQWiG provide evidence-based assessments. The Federal Ministry of Health oversees the legal framework and reforms.

Overall, the GKV is the predominant, public pathway for health coverage in Germany, balancing broad access with cost-control mechanisms within a mixed health‑care financing system.