versicherte

Versicherte is a term used in German social and health insurance to designate individuals who are covered by a statutory or private insurance contract and therefore have a claim to benefits from that insurance. In practice, the concept is most common in the Sozialgesetzbuch (SGB) and is applied across health, pension, unemployment and long-term care insurance.

The insured status is typically granted by meeting certain criteria, such as being employed and subject to social security contributions, being a student or a family member in a family insurance arrangement, or having a voluntary arrangement in the case of private or optional public coverage. The status entails both rights to benefits and obligations, including the obligation to pay contributions and to comply with the rules of the respective insurance system.

Types and examples: In the statutory health insurance (Gesetzliche Krankenversicherung, GKV), individuals who are employed are usually Pflichtversicherte (mandatory insured), while students and dependents can become Familienversicherte (family-insured). Self-employed or high-income earners may be freiwillig Versicherte (voluntary insured) in the GKV. In private insurance, the term Versicherte is also used to refer to policyholders who hold a contract and are entitled to benefits.

Rights and duties: Versicherte have access to benefits provided by their insurance, such as medical treatment, sickness benefits, pensions, or unemployment benefits, depending on the system. They are usually required to report changes in personal status, income, or family circumstances and to pay the due contributions. They also have rights to information, appeals, and choice of insurer or plan within statutory regulations.

See also: Sozialversicherung, Krankenversicherung, Rentenversicherung, Arbeitslosenversicherung, Pflegeversicherung, SGB V.