Table 1

Key elements of the health insurance schemes in the old insurance system compared with the new insurance system
Old system New system
Social health insurance (ZFW) Alternative private health insurance (PHI) Private social health insurance
Insured people People under a certain income ceiling (two-thirds of the population) People above a certain income ceiling (one-third of the population) The whole population
Mandatory/voluntary Mandatory primary healthcare package and voluntary additional healthcare package Voluntary Mandatory primary healthcare package and voluntary additional healthcare package
Premium rating Income-dependent (85%) and community rating (15%) Dependent on the risk profile of the person requesting the insurance Income-dependent (50%) and community rating (50%)
Benefits in kind/ benefits in cash Benefits in kind Benefits in cash Insurers are allowed to offer both
Voluntary policy excess No Yes Yes
Insurer choice Those insured could change insurer and additional insurance product yearly, but in practice choice options were limited Those insured could change insurer and insurance product yearly Those insured can change insurer and additional insurance product yearly
Provider choice Free choice among contracted providers Free choice among all providers, but may receive only partial reimbursement Free choice among all providers, but may receive only partial reimbursement

Victoor et al.

Victoor et al. BMC Health Services Research 2012 12:441   doi:10.1186/1472-6963-12-441

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