Krankenkassen

Krankenkassen are health insurance funds in Germany that administer the statutory health insurance system. They are nonprofit organizations responsible for collecting contributions and paying for medically necessary services. Most residents are covered by a Krankenkasse, with membership typically tied to employment. Students, pensioners, and unemployed persons can also be insured under the statutory system, while higher earners may opt for private health insurance (PKV) instead.

The primary role of Krankenkassen is to provide access to comprehensive healthcare benefits. This includes doctor visits, hospital treatment, prescription drugs, dental care, therapies, and preventive services such as screenings and vaccines. They also administer maternity benefits and sickness benefits during periods of illness or incapacity to work. Benefits are defined by law and coordinated with healthcare providers through the statutory framework.

Financing and governance are structured around income-based contributions. Contributions are calculated up to a contribution ceiling and are generally shared between employee and employer for the standard rate. In addition, many Krankenkassen charge an individual supplementary premium (Zusatzbeitrag) that is paid by the insured. The funds are governed by member representation and operate within the national social security system, with benefits and regulations overseen by the relevant authorities and statutory bodies.

There are numerous Krankenkassen, ranging from large nationwide funds to smaller regional ones. Members can switch between Krankenkassen, typically once a year, to differ in premium levels, added services, or customer service. The system allows choice within the framework of the statutory health insurance, while individuals with PKV may opt out of statutory coverage.