在德國，相比法定醫保，參保私人醫保有什么優勢（二）
What are the advantages of having a private health insurance in Germany vs a public health insurance?
譯文簡介
網友：在德國，私人和公共醫療保險都有，而且都有其優缺點。與公共醫療保險相比，在德國擁有私人醫療保險有一些優勢：獲得更廣泛的醫療服務：與公共醫療保險相比，私人醫療保險可能提供更廣泛的醫學服務和治療........
正文翻譯
What are the advantages of having a private health insurance in Germany vs a public health insurance?
在德國相比公共健康保險，擁有私人健康保險與的優勢是什么?
評論翻譯
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In Germany, both private and public health insurances are available, and both have their advantages and disadvantages. Here are some advantages of having private health insurance in Germany compared to public health insurance:
Access to a broader range of medical services: Private health insurance may offer a broader range of medical services and treatments compared to public health insurance. Private insurance plans may cover alternative therapies, elective treatments, and access to specialized medical facilities that may not be available under the public system.
Shorter wait times: Private health insurance plans may offer shorter wait times for medical appointments, procedures, and surgeries compared to the public system, as private insurers may have agreements with private medical providers.
在德國，私人和公共醫療保險都有，而且都有其優缺點。與公共醫療保險相比，在德國擁有私人醫療保險有一些優勢：
獲得更廣泛的醫療服務：與公共醫療保險相比，私人醫療保險可能提供更廣泛的醫學服務和治療。私人保險計劃可能涵蓋替代療法、選擇性治療和使用公共系統可能無法提供的專業醫療設施。
更短的等待時間：與公共系統相比，私人醫療保險計劃可能提供更短的醫療預約、流程和手術等待時間，因為私人保險公司可能與私人醫療提供商達成協議。
原創翻譯：龍騰網 http://www.minocquamortgage.com 轉載請注明出處
Greater flexibility: Private health insurance plans may offer greater flexibility in terms of coverage options, deductibles, and copays, allowing policyholders to tailor their coverage to their specific needs.
However, there are also some disadvantages to having private health insurance in Germany. Private health insurance premiums can be more expensive than public health insurance premiums, and private insurers may deny coverage or charge higher premiums based on pre-existing medical conditions. In addition, private health insurance policies may require policyholders to pay for medical services upfront and then file claims for reimbursement, whereas public health insurance typically covers the costs directly. Ultimately, the choice between private and public health insurance in Germany will depend on individual circumstances, including income, health status, and personal preferences.
更個性化的服務：私人醫療保險計劃可能會提供更個性化的醫療服務，因為投保人可以選擇他們的醫生、醫院和治療計劃，這在公共醫療體系下可能是不可能的。
更大的靈活性：私人醫療保險計劃可能在保險選項、免賠額和自付墊底費方面提供更大的彈性，使投保人能夠根據自己的具體需求調整保險范圍。
然而，在德國擁有私人醫療保險也有一些缺點。私人醫療保險費可能比公共健康保險費更貴，私人保險公司可能會基于預先存在的醫療狀況拒絕承?；蚴杖「叩谋ＹM。此外，私人醫療保險政策可能要求投保人提前支付醫療服務費用，然后提出報銷申請，而公共醫療保險通常直接支付費用。最終，在德國的私人和公共醫療保險之間做何種選擇將取決于個人情況，包括收入、健康狀況和個人偏好。
Is it true, that in Germany, after you once try private health insurance, you cannot switch to the government insurance anymore?
Originally Answered: Is it true, that in Germany, after you once try private insurance, you cannot switch to the government insurance anymore?
The question refers to health insurance.
Yes, if you have opted into private health insurance (as an employee earning more than (as of 2017) 57,600 €/year or as a self-employed person), it is hard or even impossible to switch back.
在德國，在你嘗試過私人保險后，你就不能再轉向政府保險了，這是真的嗎？
這個問題涉及醫療保險。
是的，如果你選擇了私人醫療保險（作為年收入超過（截至2017年）57600歐元的員工或自營職業者），你很難甚至不可能重新投保。
When younger than 55 years, you can only switch back when you are employed and your wage is lower than the point where you must enroll in statutory insurance (i.e. there are cases where you must ask your employer to lower your wage)
When 55 years or older, it is almost impossible - except when you are married to a person insured in the statutory insurance, then you can rejoin the statutory insurance by becoming unemployed and being covered as a dependent by your partner’s statutory insurance.
這樣做的原因是為了避免人們在年輕時選擇私人醫療保險（保費=固定金額），在年老時重新選擇法定保險（保費＝工資的百分比；兒童和非工作配偶不需要額外費用），私人醫療保險的保費更高，因為老年人需要更多的醫療護理。
當你不到55歲時，只有當你有工作并且你的工資低于你必須參加法定保險的水平時，你才能換回來（即，在某些情況下，你必須要求雇主降低你的工資）
當你55歲或55歲以上時，這幾乎是不可能的——除非你嫁給了一個參加法定保險的人，然后你可以通過失業和作為受撫養人參加伴侶的法定保險來重新參保法定保險。
A different way of calculating the Premium. For public it is based on a percentage of your income (not a tax though), for private it is a fixed amount. So for people with higher income private is cheaper, for people with lower/medium income public is cheaper. That is the biggest thing about what this is. Payment amount.
You get 1–2 bed room in hospital, chief doctor treatment and a higher percentage of coverage for dental care (dental care is one of the few regions where in Germany you have a Copay, public only pays 60% of Dental Care usually). People with public can take this sort of stuff as an optional addon insurance though (my wife - on public - for example raised her dental coverage from 60% to 90% by a price of 35 EUR per month, the 1–2 bed room and chief doctor treatment for her cost us 40 EUR per month - it is still cheaper than private for her - for me it is the other way round).
A few examinations are not covered by public. But they are rare .
保費方面是不同的計算方式。對于公共醫療保險的保費來說，這是基于你收入的一個百分比（但不是稅），對于私人醫療保險的保費來說，它是一個固定的金額。因此，對于收入較高的人來說，私人醫療保險更便宜，對于收入較低/中等的人，公共醫療保險更便宜，這是最重要的一點：保費支出費用。
你可以在醫院獲得1-2張床位、主治醫生治療和支付更高比例的牙科護理費用（牙科護理是德國少數幾個擁有自付額的地區之一，公共醫療保險通常只支付60%的牙科護理費用）。不過，有公共醫療保險的人可以把這類作為一種可選的附加保險（例如，我妻子的公共醫療保險，以每月35歐元的代價將她的牙科保險金支付比例從60%提高到90%，為她提供的1-2張床位和享有主治醫生的治療方面每月花費我們40歐元——對她來說，這仍然比私人醫療保險便宜——對我來說，情況正好相反）。
有幾項服務是公開醫療保險沒覆蓋到的，但它們很罕見。
You might have to wait less in the waiting room
Acupuncture, etc. is usually included by default for private. For public you have to request it (does not cost extra though - but some public insurances might not offer it)
Massages covered by insurance are a few minutes shorter if you are insured public
You need no referral to go to a specialist (public insured need this unless it is an emergency, also some fields are excepted from the referral even if no emergency, like male/female medicine, dental care, eye care)
Private also has disadvantages though:
你可能不用在候診室等那么久了
針灸等通常默認為私人醫療保險使用。對于公共醫療保險，你必須提出要求（盡管不需要額外費用，但一些公共醫療保險可能不提供）
如果你是公眾醫療保險，保險范圍內的按摩會縮短幾分鐘
你不需要轉診就可以去看專家（公共醫療保險需要轉診，除非是緊急情況，而且一些領域即使沒有緊急情況也不包括在轉診范圍內，如男性/女性醫學、牙科護理、眼科護理）
私人醫療保險也有缺點：
When you get older the price raises
Kids also cost, while for public insurance they are free (their insurance does not cost the same like for an adult though)
Once you have been in private for some time, you cannot switch back to public (to avoid people going for private when young and public when old)
Remember it is the SAME doctors to whom you go. There are no special “for private only” doctors
So yeah - mostly it is a decision based on what is cheaper for you.
你可能會提前1-2周預約（然而如果你是一個?？?，無論參保私人醫療保險還是公共醫療保險，你通常都會以同樣的速度預約上）
你必須提前付款（盡管通常人們會這樣做，比如把賬單交給保險公司，從他們那里拿到錢，然后付錢給醫生——付款金額通常足夠多）
隨著年齡的增長，保費會上漲
兒童也要付費，而公共醫療保險方面兒童是免費的（他們的保險費用與成年人的保費不同）
一旦你參保私人保險一段時間，你就不能再轉回參保公共醫療保險（以避免人們年輕時參保私人醫療保險，年老時參保公共醫療保險）
記住，你去找的是同一個醫生。沒有專門的“只針對私人醫療保險”的醫生
所以這主要是基于對你來說哪種更劃算而已。
What is the difference in quality between private and state health insurance in Germany?
We refer not to ‘state’ but to ‘statutory’ health insurance in Germany because the carriers of statutory insurance are not agencies of the state but highly regulated non-profit institutions.
The main incentive to choose private insurance is that with statutory insurance your premium is a percentage of your wage, while with private insurance it is a fixed amount, depending on your age/health. So, a young, healthy person who earns a very high wage pays less in premiums in private than in statutory insurance. The catch is that once you are in private you cannot change back when your age, or having children (covered under statutory insurance at no extra cost) or income would make statutory insurance a better deal.
Quality pros of private health insurance
德國私人醫療保險和國家醫療保險在特征上有什么區別？
在德國，我們指的不是“國家”，而是“法定”醫療保險，因為法定保險的承運人不是國家機構，而是高度受監管的非營利機構。
選擇私人醫療保險的主要動機是，在法定保險中，你的保費是工資的一個百分比，而在私人醫療保險中，保費是固定金額，這取決于你的年齡/健康狀況。因此，一個年輕、健康、工資很高的人在私人醫療保險中支付的保費比法定保險少。問題是，一旦你參保私人醫療保險，當你的年齡因素，或者有孩子了（參保法定醫療保險范圍，不收取額外費用）或收入方面參保法定保險變得更好的時候是不能轉變為參保公共醫療保險的。
私人醫療保險的優勢
原創翻譯：龍騰網 http://www.minocquamortgage.com 轉載請注明出處
Some but not all private health insurance schemes pay for a better ‘hotel’ component of a hospital stay, e.g. a single room where someone in statutory insurance would share a larger room with another patient.
Quality cons of private health insurance
Hospitals are a bit more likely to subject you to unneccessary procedures (as they can bill a higher rate with private insurance).
You pay out of pocket for your doctor visits and must file with the insurance for reimbursement - more paperwork compared with statutory insurance where the doctor directly bills the statutory insurance.
在非緊急情況下，你可以提前預約私人診所的醫生。對于某些專業的體檢類預約，延遲時間約為幾天到幾周，有時甚至幾個月。從醫學意義上講，當時間至關重要時，你的全科醫生（你是可以在短時間內預約上的，對許多全科醫生來說，你走進去然后等一會兒就行）會讓他的辦公室打電話給專家。
一些但不是所有的私人醫療保險計劃都會為住院期間更好的“酒店”類病房費用買單，例如，單人病房，而參保法定保險的人將與另一名患者共享一個更大的病房。
私人醫療保險的劣勢
醫院更有可能讓你接受不必要的手術（因為反正有私人醫療保險可以報銷）。
你必須先自費看醫生，再向保險公司申請報銷——與醫生直接開具法定保險賬單的法定保險相比，這需要更多的文書工作。
Germany has a mixture of private and public health insurance, how does that system work?
All residents of Germany must have health insurance. There are two systems – the public and the private health insurance. These are the main differences:
Public health insurance:
Your contribution depends on your salary: the more you earn, the more you have to pay.
Premiums can reach up to € 977.55 a month which you share with your employer. As a self-employed person, you must cover the full costs yourself.
Coverage is quite limited and benefits can be cancelled at any time.
德國既有私人醫療保險，也有公共醫療保險，這個體系是如何運作的？
所有德國居民都必須參保醫療保險。有兩種體系——公共醫療保險和私人醫療保險。這些是主要區別：
公共醫療保險：
你的貢獻取決于你的薪水：你賺的越多，你必須支付的就越多。
保費最高可達每月977.55歐元，由你與雇主共同支付。作為一個個體經營者，你必須自己承擔全部費用。
保險范圍非常有限，而且隨時都可以取消。
Your monthly premium does not depend on your salary.
Premiums depend on your health status, the desired scope of benefits and your age of entry: the earlier you decide to switch to private health insurance, the lower your monthly premiums will be.
Coverage is much more extensive and benefits are guaranteed for the entire duration of your contract.
Eligible for private health insurance are these persons: employees with a salary above the annual income threshold of €66,600, self-employed persons and civil servants
私人醫療保險：
你每月的保費并不取決于你的工資。
保費取決于你的健康狀況、所需的保障范圍和你的入職年齡：你越早決定轉為私人醫療保險，月保費就越低。
保險范圍要廣泛得多，在你的整個合同期限內都有保障。
這些人有資格享受私人醫療保險：年收入超過66600歐元門檻的雇員、自營職業者和公務員
What is the most affordable private health insurance in Germany?
What for? Unless you are really in the upper levels of the income range, as an employee you will be automatically insured through the public system (though you can pick among about 200 insurance providers. The premiums are similar, a percentage of your gross income, with your boss paying half). Even as self employed or student you can join them.
Compared to private insurance (where the premiums are calculated based on age, sex and previous diseases and might be cheaper for a young, healthy male, but become very expensive once you get older) the public system is quite hassle free.
With the private insurance you will usually have to forward the payment of the medical bills, but will get re-imbursed later.
I’m an employee with an income well above average and I decided that I will stay in the public system.
德國最實惠的私人醫療保險是什么？
為何？除非你收入范圍真的處于較高水平，否則作為一名員工，你將自動通過公共醫療保險系統投保（盡管你可以在大約200家保險公司中選擇。保費是相似的，占你總收入的一個百分比，你的老板支付其中的一半）。即使是作為個體經營者或學生，你也可以參保公共醫療保險。
與私人醫療保險相比（保費是根據年齡、性別和既往疾病計算的，對于年輕健康的男性來說可能更便宜，但一旦你長大，保費就會變得非常昂貴），公共醫療保險系統會相當輕松。
參保私人醫療保險，你通常必須提前支付醫療費用，但稍后再報銷。
我是一名收入遠高于平均水平的員工，我決定參保公共醫療保險系統。
The main difference is that the cost of insurance is dependant on income when you are insured publicy and is dependant on age when you are insured privately. The catch is, once you are insured privately it is very hard to switch back. You might want to if are getting old.
The consequence is, when you are young and you have a high income private insurance is very competetive compared to public insurance for the moment. This is why private healthcare insurance is sold almost exclusively to young people. For elder people private insurance is much more expensive than public insurance. No one tries to sell private health insurance to someone who is over 50. It’s not even a contest.
Because there is no switching back you should think very thoroughly if you will be able to afford private insurance when you get old. If you are 80, for example, you can expect costs of 20k Euros or more per year just for private health insurance. Which is somewhere around the cheapest rate as per now, but expect much more in 50 years. With public health insurance the cost for the 80 year old person would be a percentage of your income.
Let’s say you have the average income for a 80 year old (you plan to become old, do you?). This means your income would be around 30k Euros per year. 30k - 20k = 10k which is what you would have left if you are privately insured. This puts you well below the official poverty threshold. Yuck! With public health insurance you would have left roughly 25k Euros which is more than twice you would have left if privately insured.
Of course you will have better and more healthcare if you are insured privately. Still you better plan to get rich and have a good chance at it otherwise you won’t be able to afford your healthcare if you are getting old. Better, switch to private healthcare after you have got rich, because just in case. However you may find that when you finally are rich private healthcare has become unattractive because you are getting old.
主要的區別是，參保公共保險的保費取決于收入，而參保私人醫療保費取決于年齡。問題是，一旦你參保私人醫療保險，就很難再轉回公共醫療保險了。其實如果你變老了，你可能會想轉的。
結果是，當你年輕，收入高的時候，私人醫療保險比公共保險更有競爭力。這就是為什么私人醫療保險幾乎只賣給年輕人。對老年人來說，私人保險比公共保險貴得多。沒有人會把私人醫療保險賣給50歲以上的人。這甚至不具競爭性。
因為私人醫療保險不可轉公共醫療保險，所以你應該仔細考慮當你老了之后是否能夠負擔得起私人醫療保險的保費。例如，如果你80歲了，僅私人醫療保險每年的費用就可能達到2萬歐元或更多。這大約是目前最便宜的價格，但預計50年后會更多。參保公共醫療保險，80歲老人的費用將僅占你收入的一定比例。
假設80歲時達到80歲老人的平均收入（你做變老的打算，是嗎？）。這意味著你每年的收入將在3萬歐元左右。30000-20000=10000，如果你參保私人保險，這就是你剩下的錢。這使你遠遠低于官方規定的貧困線，哎！參保公共醫療保險，你會留下大約25000歐元，這是私人醫療保險的兩倍多。
當然，如果你參保私人醫療保險，你會得到更好、更多的醫療保健。盡管如此，你還是要計劃致富，并有很好的機會，否則如果你老了，你將無法負擔醫療保險的保費。更好的做法是，在你變得富有后，轉向私人醫療保險，這樣可以以防萬一。然而，你可能會發現，當你終于富裕起來時，私人醫療變得沒有吸引力，因為你越來越老了（費用越來越多）。
Another thing I know personally because my brother has private healthcare: if you are privately insured there is a tendency for doctors to get you over treatment. Doesn’t sound bad? Well, expect to get unnecessary treatment because you are the one that get’s the doctor his next Porsche. You will stay longer than necessary at the hospital because you are the gold mine.
There are definitely differences in waiting times to get to see a doctor. This is the huge drawback when insured publicly. Two episodes that happened:
To me (public healthcare): I was in need to see a specialist to exclude a certain cause for high blood pressure. This is nothing life threatening and there is only one specialist in the particular field in my city of 350.000 inhabitants. My waiting time to get an appointment was 13 months. More than a year! That’s an extreme case but when you need to see a specialist expect to have waiting times for more than a month on average.
To my brother (privately insured): “I have a certain health condition and I would like to see a specialist. When can I have an appointment?” - “How about right now?” - “No, it’s short before noon and I’m hungry. I have to eat something.” - “Well, then come after you are finished, no problem.”
This is the difference between having a platin class private health insurance and public healthcare. But when he goes to the hospital because of a fever at a Friday evening he is invited to stay at the hospital for the weekend because the head physician would want to have a look at his new Porsche patient but is back only Monday while the public healthcare patient would get two Paracetamol and being sent home (also happened).
So if you are rich, get what fits you best. If you are not, think twice.
如果你參保公共醫療保險，這不是問題。如果你想要并且負擔得起，你可以隨時私下獲得額外的醫療保健。你想買多少就買多少。最后，如果你做變老的打算，你參保公共醫療保險方面會更靈活，而且會更便宜。
我個人知道的另一件事是，因為我哥哥有私人醫療：如果你參保私人保險，醫生會傾向于讓你接受過度治療。聽起來不錯吧？好吧，那就等著接受不必要的治療吧，因為是你讓醫生開上了保時捷。你在醫院待的時間會比必要的時間長，因為對醫生而言，你是“金礦”。
去看醫生的等待時間肯定是有差異。參保公共醫療保險時，這是一個巨大的劣勢。發生了兩件事：
對我來說（公共醫療保險）：我需要去看專家，以排除高血壓的某些原因。這并沒有威脅生命，在我這個擁有35萬居民的城市里，只有一位特定領域的專家。我等待預約的時間是13個月，一年多！這是一個極端的情況，但當你需要看專家時，平均等待時間會超過一個月。
對我的兄弟（私人醫療保險）：“我有一定的健康狀況，我想看?？漆t生。我什么時候可以預約？”，“現在怎么樣？”，“不，中午前時間太短，我餓了。我得吃點東西?！?，“好吧，等你吃完了再來，沒問題?！?br /> 這就是白金級私人醫療保險和公共醫療保險之間的區別。但當他在周五晚上因為發燒去醫院時，他被邀請在醫院度過周末，因為主治醫生想看一看讓他換上新保時捷的病人，他周一才出院，而參保公共醫療保險的病人只服用兩粒撲熱息痛就被送回家（也發生過這種情況）。
所以，如果你很富有，就買最適合你的。如果不富有，請三思。