Health Insurance Germany

All you need to know about Health Insurance / Krankenversicherung in Germany

Last update: 27 April 2020

Your health is your greatest wealth. Even if you are healthy and have no previous illnesses, this can change quickly. An accident or infection are just a few of the many possible causes of a medical emergency that can leave you with high bills. Even if everything is fine now, good health insurance should be a very high priority. In Germany, the state cares for the health care of its citizens and requires that everyone has at least a basic health insurance. That is the main reason good and reliable health insurances in Germany are the norm: It is more difficult to lose your health insurance than to get one – but to make the right decisions you have to know some important facts about the very complex health insurance system in Germany.

Public health insurance in Germany – Gesetzliche Krankenversicherung (GKV)

Most people in Germany are compulsorily insured in one of the public health insurances. Every employee who earns less than 62K€ a year automatically is insured by his or her company. The employer also takes responsibility for the monthly payments, which are equally divided between both. The rate is then set in relation to the monthly gross income. For

Although there are more than 100 different public health insurance companies, they usually not differ significantly. Neither the prices nor the coverage are typical reasons to choose one insurance over another. There are only minor variations between the services and benefits of different public health insurance companies. For example, some pay more for preventive measures like special physical education lessons, while others cover some alternative medicine like homeopathy or traditional Chinese medicine.

In most cases it is not possible to take out health insurance for foreigners in Germany with your health insurance company in your home country. As soon as you want to study or work here, you have to take out insurance with a German health insurance company.  Which of the many public health insurance companies you choose is not that important. Usually the bigger ones are a bit more attractive, because they have both very good online services and branches where you can talk with insurance agents immediately. Even providing services in English is not a problem for most of the major health insurance companies like TK, AOK, BKK, or DAK.

Pros and Cons

There are some advantages, but also some disadvantages of public health insurance in Germany. First of all you need to understand whether or not you meet the criteria to be accepted as a member in the public system. If you plan to get a regular job in Germany, this part will not be a problem. Otherwise, you will often need to prove that you are already insured in a public system in your home country.

In most cases, the public health insurance in Germany has the best price-performance ratio. Especially for students with or without part-time job the costs are very low. With usually around 100 € per month, every probable health risk is covered. If you are looking for health insurance in Germany for foreign students, the university and the Studierendenwerk usually can help you.

Once you are in, public health insurance in Germany is quite simple. You will receive a health insurance card, which looks like a credit card. Just put it in your pocket and whenever you need to see a doctor, give it to them to get the costs covered. Children are usually insured over public health insurance with their parents, unless they start to work or turn 25. They then have to choose health insurance for themselves.

Most public health insurances in Germany work with the “Hausarzt-Prinzip”. That means whenever you feel ill, are injured or just want to get a prescription for a medication, you have to contact your family doctor first. They will check whether they can help you there and if not redirect you to an suitable specialist. This slows down the whole process of getting an appointment. People with a public health insurance in Germany often have to wait many weeks to a few months for appointments with some specialists, but there are separate capacities for emergencies, so you do not have to worry about that too much.

Another disadvantage of the public health insurance in Germany is that they do not always cover the full costs of every treatment. Especially with dentists and expensive dentures, you often have to pay a large part yourself. Physical therapy and visual aids are a few more examples, which you usually have to pay partially for yourself. If medications are prescribed by a doctor, you pay only 5 € per box, the rest is covered by your insurance. There is a big and detailed catalogue, which lists everything that public health insurance pays or does not pay. Doctors will usually tell you if you need to pay something by yourself because it is not covered.

Comparison Calculator

With the below calculator you can calculate the monthly rate for your health insurance. Simply enter your monthly gross salary (Bruttogehalt) and the region (Bundesland) your living in.

Voluntary public health insurance in Germany – Freiwillige gesetzliche Pflichtversicherung

While most people are required to choose one of the public health insurances in Germany, some can decide between public and private health insurance companies. Usually every employee who earns more than 62K€ a year and Freelancers as well as self-employed workers and entrepreneurs can freely choose between public and private health insurance in Germany.

If they decide to enter into a public health insurance, they get the same benefits as everyone else. However, especially employees with a high income often pay much more because of the relational gross income contribution. For them it is often better to join a private insurance company that is more independent in designing good health insurance deals for different target groups. For example, they offer lower monthly rates if you are not going to visit the doctor regularly and even give you money back, if you do not use any insurance for a whole year.

Private health insurance in Germany– Private Krankenversicherung (PKV)

About 40 different companies offer private health insurance in Germany. Most of them address primarily employees with high income, who want more comfort than the public health insurance companies offer. While most public health insurances in Germany cover nearly the same costs, the differences between the private companies are more significant. They usually offer different options for different target groups with different budgets. The variety often consists of a basic model that covers nearly the same costs as the public health insurance in Germany, a medium model that covers a bit more and some premium models that cover even the most exclusive and not only the most necessaire therapy and health options.

Private health insurance in Germany is not accessible for every citizen. Only employees with high income above 62K€ and those that do not meet the criteria to be in public health insurance are allowed to get a private insurance. To have at least one form of health insurance is mandatory und you can neither start a regular job nor enrol in a university without validated health insurance.

Pros and Cons

Private health insurance in Germany is particularly popular among people with very high incomes. Unlike public health insurance, the monthly rate is not based on gross income, but on a fixed price. So for most top earners, private health insurance is much cheaper – even if they choose the best premium options.

For most Germans, private health insurance is also a risk: Once you leave the public health insurance system, it is difficult to get back in again. Therefore, if your income drops, you still have to pay the same amount for your insurance (in the public system your rate would drop with your income). Private health insurance companies have to offer cheap options for students or people who become unemployed. However, coverage within these options is usually worse than with public health insurance system. These options are only good if you do not end up getting sick.

Another benefit of a private health insurance in Germany is that the doctors often are paid more from private than from public health insurance. Therefore, if you are “Privatpatient” you often get an appointment within a week, where patients with public health insurance would have to wait for a few months. The coverage of different treatments differs not only between the different health insurance companies, but also within their different options. Therefore, you have to look carefully and plan well before you decide on one or the other.

Summary: Health insurance for foreigners and foreign students in Germany

For foreigners, German health insurance may look difficult, but once you have it, everything is usually fine. The question of which one to choose is not easy to answer. If you want to stay for more than a year, you should try to get in a public health insurance, because the prizes are rather low and the coverage is usually good. Especially health insurance in Germany for foreign students can also be covered by private companies. If you plan to stay for only one semester, do not have to go to the doctor regularly and only need insurance in case something bad happens, a private health insurance might be the cheaper option for you.

Disclaimer: This article reflects my personal opinion about the above mentioned insurance providers and their offered policies. I am not giving insurance advice nor am I working for the above mentioned companies. However the article contains affiliate links, meaning I earn a commission if you use those links.