No Physical For You!

...my new doctor said to me on Monday, albeit somewhat more professionally. But I'll get to that part later.

Before I left for Berlin and people would ask me why I was moving, towards the end of my spiel I always threw in a line like, "and at least I'll have health care over there!" Whomever I was talking to would generally respond with a nod and widened eyes at the idea of a land where everyone is insured. It's Germany, they have socialized medicine right? Isn't it free over there or something? Doesn't everyone just automatically get it?

Well, kind of. The truth is, I didn't know much about the system before I got here and went through the steps to get it. I'm still no expert, but after registering with a Krankenkasse (health insurance company) and having one doctor's appointment, I'm ready to weigh in.

1) Health insurance is not an option in Germany, this much is true. It's a Pflicht, or obligation. However this doesn't mean you just show up in the country and have it, and it does not mean it's free. If you're a student, or employee, or have some sort of other label, health insurance is included in your "package." As an employee, it comes automatically out of your paycheck. If you are status-less, like me at the moment, then you are responsible for obtaining health insurance. This means picking a Krankenkasse and paying a monthly fee (generally around 140 euros) similarly to how you would go about acquiring an individual plan in the US.

2) It really is Pflicht. If you live in Germany and do not have insurance, you will literally pay. In fact, you will end up paying retroactively for the time you went uninsured. So for example, since I registered as a resident of the city on November 22nd but did not get insurance until the 30th, I was required to pay for that insurance free week. The one loophole I know of is if you are unable to work or find work and qualify for a social benefits program called Hartz IV. In this case, the government pays.

3) Besides the obligation part, it sounds similar to the US, right? Wrong, because it's a hell of a lot less complicated. Although there is a choice of Krankenkassen, they are pretty much all equal. You don't pick a particular plan (maybe this does apply in certain exceptional cases, but not for the majority) and everyone has the same insurance for the most part. There is apparently some kind of special luxury insurance, but I don't know anyone who has that. When I went to AOK*, my Krankenkasse, I was signed up automatically for the 140 euro plan and didn't have to sift through brochures trying to figure out what I wanted, what deductibles were right for me, what drug prices I wanted to pay, etc.

4) Drugs! They are cheaper here, which I'm sure does not surprise any of you. I easily acquired a prescription for more asthma medication yesterday and can take it to any Apotheke (drug store- they are literally on every corner in this country) and fill it.

5) I can go to virtually any doctor I want and appointments are made quickly and conveniently. I called one office about 15 minutes away from me and made an appt. for the following Tuesday, and then cancelled it when I noticed a new doctor's office had opened up around the corner from me. I walked in on a Friday to make an appt. and had one for Monday. Neither place asked what insurance I have and at my doctor's I was not asked to fill out any bothersome paperwork. One sheet explaining my basic medical history and a copy of my card later and that was it.

6) 10 euro co-pay. Everywhere and anywhere. This is one of the things I think is best about Germany's system. Besides that everyone is insured of course. Because there are no separate plans for each company that have different co-pays, deductibles, etc., you know what you are going to get at all times. There's nothing to figure out and there's nothing to be wary of. It feels so much more... honest. Neither the insurance providers nor the doctors seem to be out to get anyone or wiggle extra money out of people. It's refreshing, especially after being a member of an HMO all my life that got me hooked on expensive asthma drugs and then dropped my drug benefits as soon as I was no longer on my Dad's government plan and applying for an individual one.

7) Now the story about the forsaken physical. I decided to make an appt. since I finally had insurance again and hadn't been to the doctor in over a year. When I went in on Monday (no wait time) my doctor seemed confused as to why I was there. "Well, is there something wrong?" she asked. I explained that I was just there for a normal check-up and told her in the US it's called a physical and the doctors check your reflexes and your ears and throat and such. She looked amused and then explained that in Germany, women don't get yearly check-ups until age 35. Because of my asthma she checked my lungs for a few minutes and then sent me off with my prescription. I was surprised but also slightly relieved that I didn't have to do cardio in my undies like I did during a check-up in France.

*AOK: cute name, right? I find it reassuring. Like, "don't worry! you're going to be a-ok!"