Without getting into too much of the “nuts and bolts” and the intricacies of how the German health care system works, I will try and keep this as simple as possible and as specific as possible as how it relates to one’s VA disability compensation amount.
Health insurance in Germany became mandatory for everyone residing there as of 2007. Everyone must be able to show they are health insured either through the “Gesetzlichen Krankenversicherung” (Statutory health insurance – abv. as “GKV”) or a “privat Krankenversicherung” (Private health insurance – abv. as “PKV”), or be able to prove similar coverage through other means such as TRICARE etc… Generally, anyone earning €5.550,- (gross) or less a month -yearly €66.600,- or less (2023)-called “Jahresarbeitsentgeltgrenze”- must be insured through on of the many Statutory health insurances such as the AOK, IKK, BKK, Barmer, TK or the Mobile Krankenkasse etc… Anyone earning more than the above amount can seek health insurance through either a Statutory health insurance on a voluntary basis or a private company.
"Gesetzlichen Krankenversicherung" (GKV):
There are two types of Statutory health insurance: 1) the “Pflichtversicherung” (mandatory) and 2) the “Freiwilligeversicherung” (voluntary);
"Privat Krankenversicherung" (PKV):
If someone has earned income of €5.550,- (gross) a month or more, is self-employed or a Freelancer, a Student, is retired (and not covered by their retirement provider), a Soldier, or a Civil servant, they may elect to be health insured through a private company. However, being insured through a private company is based on one’s health and not on one’s income. For someone receiving VA disability compensation, this will probably not be an option.
O.k. so now we come to how VA disability compensation plays into all of this;
NOTE: If you’re under your Spouse’s Statutory state-runed health insurance as “Familienversichert” and your only income source is VA disability compensation, then you should still be retained as a family member at no additional costs. As stated above VA disability compensation is excluded from consideration due to being considered as income under the “Bundesversorgungsgesetz.” Generally, once a year the state-runed health insurance will send out a questionnaire requiring the family member to report all income sources. VA disability compensation should be reported on this questionnaire, but with reference to the "§31 BVG" and should not be used in their "Beitrag" calculations. If the "Krankenkasse" does use your VA disability compensation as income, then see below;
Below is a Court case by the "LSG Berlin/Brandenburg" stating that VA disability compensation is not considered as 'income' and falls under § 31 BVG. They also referenced the "Bundessozialgericht (BSG)" and how they see similar income. In addition, is the Court case from the "Bundessozialgericht" explaining how and why income considered under § 31 BVG is not countable income towards one's monthly "Beitrag." Also, below are two letters from two different German state-run health insurances (Barmer and BKK) stating -after appeals were filed by veterans- VA disability compensation is not used to calculate one's monthly "Beitrag." If your "Krankenversicherung" is using your VA disability compensation to determine your monthly "Beitrag," then take the below four .pdf documents to them so they can refigure your monthly amount without your VA disability compensation. If after showing your "Krankenversicherung" these documents and they still refuse to leave your VA disability compensation out of the equation, then you can first file a written "widerspruch" (appeal) against your health insurance using the below word.doc. by flling in your presonal deatils where indicated by the yellow highlighted area. If this "widerspruch" does not rectify the problem, then you can use the same word document as a "Klage" (official Court complaint filing) with your local "Sozialgericht" in your jurisdiction.
**Please note** filing appeals against your "Krankenkasse" and/or filing a "Klage" before your local "Sozialgericht" or "Landessozialgericht" can be done without using a lawyer!
In addition to the above, if you’re not working or are unable to be insured under your Spouse’s Statutory state-runed health insurance as a family member due to your own 'countable' income exceeding the €520,- limit, then they may outright deny health insurance coverage on the basis that you’re supposedly already health insured through the VA’s “Foreign Medical Program” and that is “analog” to coverage such as TRICARE. This is also incorrect too! Coverage from the Foreign Medical Program only encompasses service-connected disabilities and is generally not an “anderweitige Absicherung im Krankheitsfall,” and also should be appealed. Below is an appeal to a Statutory state-runed health insurance and can be used as a template.