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Health Insurance in Germany The German Healthcare System

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Health insurance in Germany is obligatory for all German citizens, as well as for international tourists and expats.

Here’s how the German health insurance system works, the types of insurance you need to choose when travelling to Germany and how to get insured.

Health Insurance for Travellers & Expats in Germany

Everyone who enters Germany for whatever purpose or duration of time must be covered by adequate health insurance, either statutory (public) or private, issued by a licensed medical insurance provider.

However, when it comes to travel health insurance for tourists and expats in Germany, different criteria and requirements apply depending on the individual’s purpose of visit, length of stay, or country of citizenship.

There are different types of health insurance that you should get before moving to Germany and a few others that you can get once you arrive in Germany, all explained in much detail in the following links:

  • Travel Insurance for Visitors and tourist im Germany
  • Health Insurance for International Students in Germany
  • Health Insurance for Guest Scientists and researchers in Germany
  • Health Insurance for Foreign Employees in Germany
  • Health Insurance for Freelancers in Germany
  • Health Insurance for AU Pairs in Germany
  • Health Insurance for Refugees seekers in Germany

Germany Healthcare System

Germany’s healthcare system is recognized to be one of the best in the world. The majority of German citizens and residents are enrolled under the state-run public health insurance scheme, which is funded by taxpayers’ own national contributions.  In turn, everyone has access to high-quality and affordable healthcare, regardless of income or status.

However, some also turn to German private insurance, especially those who have a higher salary or want to fill in “gaps” left by public insurance.

Under German law, everyone who is a legal resident in Germany must have health insurance coverage. Germany’s health insurance system is divided into public or “statutory” health insurance (Gesetzliche Krankenversicherung) and private health insurance (Private Krankenversicherung). The type of health insurance you can get depends on your salary:

  • If you earn less than €64,350/year, you can only enrol in the public (statutory) health insurance scheme.
  • If you earn less than €64,350/year but are a freelancer, you can opt-out of statutory insurance and get a private insurance plan instead.
  • If you earn more than €64,350/year, you can either stay on public insurance or switch to private insurance.

Here are some quick facts about the German health insurance system:

Does Germany have universal healthcare

Yes, all German citizens and legal residents are required by law to have health insurance. Everyone, regardless of their income, has healthcare coverage and access to affordable medical care.

Does Germany have free healthcare?

The public health insurance system in Germany is funded by national contributions, which are automatically deducted from your salary every month, whether you visit a doctor or not. So, while you are mostly exempt from paying for medical treatment if the need arises, you still pay for healthcare through your monthly contributions.

What does health insurance in Germany cover?

Health insurance will cover most of the cost for doctor’s visits, medical and dental treatment, surgery, and prescription medication, but you still have to pay the following:

  • Up to €10 per quarter for a doctor visit.
  • The first €10 of most prescription medication.
  • Approximately €10 per day for hospital stays, for a maximum of 28 days per year.
  • The full price for prescription vision aids, such as glasses or contacts.

Can I get both public and private insurance?

If you do not qualify for private healthcare, you can still purchase a private plan as long as it is supplementary. This means that it will give you coverage in the gaps of German public health insurance, such as full reimbursement of medications, private or semi-private hospital rooms, more extensive dental care, etc.

How to Register for Public Health Insurance as an Expat?

In most cases, your employer will sign you up with a health insurance company. When you move to Germany, you have to register with the German authorities at the local Registration Office (Einwohnermeldeamt), where you will receive a German social insurance number (Sozialversicherungsnummer). This means that you have started to make contributions to the national insurance scheme.

Next, you have to register with a national health insurance company. Your employer may register you or give you the opportunity to choose.

Once you have signed you with your insurer, you will receive the Health Insurance Card (Krankenversichertenkarte), which you must show when you go to a doctor or hospital for medical treatment.

Some of the best public health insurance companies in Germany (also known as insurance funds) are:

  • AOK Baden Württemberg
  • TK-Techniker Krankenkasse
  • KKH – Kaufmännische Krankenkasse
  • DAK
  • Barmer

How to Get Private Health Insurance as an Expat?

To get privately insured in Germany, you have to contact one of the private health insurance companies. But first, you have to let your employer know you want to unsubscribe to the public insurance scheme, inform your current public insurance fund and start the procedure to unenroll.

If you have not yet enrolled in a public insurance fund, then you must inform your employer that you would rather be covered by private insurance and which company you choose.

Some of the private health insurance companies in Germany are:

  • AXA
  • DKV
  • HanseMerkur
  • Allianz
  • Mawista

Cost of Health Insurance in Germany: Is Public or Private Insurance Cheaper?

You contribute approximately 14.6% to 15.6% of your salary to public health insurance in Germany (e.g.: you pay 7.3%, and your employer matches the other 7.3%). The minimum amount you have to contribute, based on salary, is €180/month, whereas the maximum is around €400/month, regardless of whether your paycheck increases further.

When it comes to private insurance, there is no definite price because it depends on things like your age, whether you have pre-existing conditions, how much coverage you want to have, the deductible, as well as whether you have dependents. The price tags can be significantly different based on these factors.

As to which type of health insurance in Germany is cheaper, it depends on:

  • Family members: If you have dependent family members (children or an unemployed spouse), the public health insurance system allows you to add them to your own plan, so they also receive health insurance without any additional costs to you. In the private scheme, you have to pay additional fees for each family member.
  • Your age: Since monthly contributions in the public system are based on salary, your age will play no role in the cost. On the private system, on the other hand, companies usually increase prices for older individuals.
  • Your health: If you have pre-existing conditions, then public insurance will cover you at no additional cost, while private insurers will usually charge extra. On the other hand, if you are healthy, you can be covered by a private insurance company and pay less than your current contributions.

Can I Opt-Out of Health Insurance?

You cannot opt-out of health insurance entirely – you must always be insured, either privately or through the German state. However, if you have a salary higher than €62,550/year, you can opt-out of public insurance and be covered entirely by a private company.

Remember that once you decide to unsubscribe to public insurance, you may face difficulties trying to re-enrol in the future.

If it’s so good, who do people opt-out of German public health insurance? Many high-income individuals, especially those who are young and do not have children, choose to be covered by private companies since the monthly contributions associated with public insurance can become too high when the salary increases.

Does Health Insurance Cover Giving Birth in Germany?

Yes, the public health insurance scheme in Germany always covers pregnancy, including prenatal care (doctor’s visits, checkups, lab tests, ultrasound exams, etc.), childbirth, as well as postnatal care.

Private insurance companies also cover maternity, but you will have to make sure before you subscribe to a plan because that is not always the case. The amount of coverage you get may also differ from one company to the next.

Does German Health Insurance Cover Medication?

Yes, your health insurance plan covers the cost of prescription medication. If you are enrolled in public insurance, you have to pay the first €10 of each prescription, and then you are covered for the rest. If you are enrolled under a private insurance scheme, you have to pay the cost of the medication yourself, and send the receipt to the company for reimbursement.

Non-prescription medications, such as mild painkillers, flu medicine, etc., are not covered.

Do German Health Insurance Cover Hospitalization Costs?

The public health insurance scheme does not always cover the cost of hospitalization. You will usually have to pay €10/per night for a maximum of 28 days per year. You do not need to pay if your hospital stay exceeds 28 days in a year.

Private insurance can reimburse you the cost of hospitalization, depending on your policy. If you have private insurance, you can also demand a private or semi-private hospital room, which you cannot do under public insurance.

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