A more specialised health care insurance market – private long-term care (LTC) insurance – is absent or very limited in countries with comprehensive public long-term care benefits, such as in Scandinavia, the Netherlands, Japan and Luxembourg. In Germany, LTC cover is statutory for every resident. It is obtained from sickness funds for individuals covered by social insurance, and from private insurers, for those individuals holding primary private health coverage, as well as for a small number of individuals opting voluntarily for private LTC insurance and for employees of the railway and postal services companies (Verband der Privaten Krankenversicherung, 2003). It is, however, non-existent or embryonic in most.
