Health Insurance in Germany

health insurance in Germany

Much like registering to live in Germany, (click here to find out about the Anmeldung process) securing health insurance in Germany is mandatory.  In fact, expats have to show that they are enrolled in a Germany health insurance plan before they can get their German visa.

Health Insurance

In German, the word for health insurance is Krankenversicherung. There are two types of Krankenversicherung: public and private. Let’s break it down so you can get a better idea of which one is right for you.

Gesetzliche Krankenversicherung  – State public health insurance

The majority of employees in Germany are on the German state health insurance system, called Gesetzliche Krankenversicherung (GKV). State health insurance is mandatory for German residents who earn up to €62,500 per year before taxes (2020). This is the most common form of Health Insurance (Krankenversicherung) in Germany, with over 70 million people enrolled.

State health insurance covers general practitioner doctor visits, specialist doctor visits, in and outpatient hospital care, x-rays, sick leave, most medical treatments and medications, as well as rehabilitation. Basic dental care and child birth in Germany are also covered under state health insurance.

Need health insurance for your family? Spouses and dependents are covered at no extra cost with state health insurance, making it the most affordable option for those in need of family coverage.

How much does it cost? There are over 100 insurance companies (Krankenkassen) in Germany to choose from. These options may vary in coverage, but they all charge the same basic rate — 14.6% (2020), plus a median supplemental rate of 0.7%, of your gross salary.

If you are employed, your employer pays half of your health insurance premiums, up to €367.97/month for health care and €71.48/month for nursing care. Should the premiums be higher, the costs are covered solely by yourself.

Krankenversicherung  – Private insurance

Though only around one in 10 German residents choose private health insurance, some expats in Germany may find private plans more attractive. Expats are eligible for Private Krankenversicherung (PKV) if they earn more than €62,550 a year, are self-employed or work as a civil servant.

The premiums for private health care are based on age, overall health, and specification of the health care cover.

Who is the ideal candidate for private health insurance? If you are single and earning well, it is normally possible to obtain better health care coverage with a private plan than with the state health care plan. And premiums can be lower.

If you have a partner who does not work and/or several children, then private health care is normally less cost-effective than the state schemes. Private health insurance plans don’t cover children or partners without extra charges.

What are the advantages of private health insurance?  Private health insurance in Germany often means broader access to more specialised treatments, shorter waiting periods for specialists, and access to certain doctors and clinics that only cater to private health insurance customers. You may also have more luck finding an English-speaking doctor with a private health insurance plan.

There are approximately 40 private health insurance companies in Germany, each offering various benefit and premium combinations. If you wish to be privately insured but are moving to Germany for a work position, you should inform your place of employment as soon as possible to avoid any confusing crossover of predetermined insurance funds.

Note that once you are enrolled in a private health care scheme, it is very difficult to go back to the state health scheme should you wish to do so. After age 55 it becomes even more difficult to change to the state system.

How do I know what the best health care option is for me?

Choosing a health insurance company is a very personal decision. It is important to think about your income level, the size of your family, and your overall health. You also might want to take into account how comfortable you are with the German health system and the German language.

One of the main differences between the two options is that with private insurance you’ll most likely be covered for the entire amount charged, albeit you have to pay the practitioner first from your own pocket before claiming it all back with your insurance company. With state insurance, you may be required to pay a small co-payment at the time of picking up a prescription, or visiting a physician, and the amount will depend on the medication or service you are using. Dental coverage, for example is very limited with state health insurance.  You should expect to pay anywhere from 20% – 70% of the bill on state insurance. Private insurance covers much more in dental services.

The best advice on the topic of health insurance in Germany is to know exactly what you are covered for and how much you can expect to pay. But, regardless of if you are on private or state, insurance contributions are split evenly between employees and employers. You also need health insurance in Germany if you are wishing to apply for a residence permit or German visa.

For more detailed information on which health insurance is right for you, it is always best to ask the experts. We would be happy to put you in touch with our expat insurance broker.