Who is covered?
Coverage is universal for all legal residents. All employed citizens (and other groups such as pensioners) earning
less than €4,350 (US$4,874) per month (€52,200 [US$70,489] per year) as of 2013 are mandatorily covered by
SHI, and their dependents are covered free of charge. Individuals whose gross wages exceed the threshold, civil
servants, and the self-employed can choose either to remain in the publicly financed scheme on a voluntary
basis (and 75% of them do) or to purchase substitutive PHI. Especially for young people with a good income,
PHI is attractive, as the insurance may offer contracts with more extensive ranges of services and lower premiums.
PHI also plays a mixed complementary and supplementary role, covering minor benefits not covered by
SHI, access to better amenities, and some copayments (e.g., for dental care). About 86 percent of the population
receives their primary coverage through SHI and 11 percent through substitutive PHI. The remainder (e.g., soldiers
and policemen) are covered under special programs. Undocumented immigrants are covered by social
security in case of acute illness and pain, as well as pregnancy and childbirth. Services are provided by the
responsible authorities or physicians and hospitals.