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 Foreigners 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 travelling to Germany and a few others that you can get once you arrive in Germany, all explained in much details in the following links:

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 €62,550/year you can only enroll in the public (statutory) health insurance scheme.
  • If you earn less than €62,550/year but you are a freelancer, you can opt-out of statutory insurance and get a private insurance plan instead.
  • If you earn more than €62,550/year, you can either stay on public insurance or you can 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.

Differences Between Private and Public Health Insurance

Understanding the difference between private and public health insurance in Germany can be a little tricky, especially if you are an expat who is just learning about it. Here is a handy comparison between the two, to try and alleviate some of the confusion:

German Public Health InsuranceGerman Private Health Insurance
On what does the cost depend?The amount you have to pay monthly depends on your income and can be from 14.6% to 15.6% of your salary per month.

Prices do not increase with age.

The cost depends on your age, the coverage you want as well as if you have any pre-existing conditions.

If you are young and healthy, it may be relatively inexpensive, but for someone who is older or has a pre-existing condition, the prices may be too high.

Who pays the contributions?If you are employed, you and your employer pay the monthly contributions equally.

Freelancers pay their contributions themselves, in full.

If you are employed, you and your employer pay the monthly contributions equally

Your employer may not pay for a health insurance plan if it is supplementary.

Are family members included?Yes, if you have children and a non-working spouse, then they will also use the same health insurance policy as you.

You do not need to pay extra for them.

If you want to include your dependents in your health insurance plan, you can.

There is an additional fee for each family member you wish to include.

Does the amount of coverage change based on your monthly contributions?No, it does not.

Regardless of the monthly contributions/income, everyone has equal access to healthcare.

You have to choose what health insurance policy you want and how much coverage you want.

A health insurance plan with a higher policy maximum (thus more coverage) will cost more.

So in a way, you do have more coverage if you pay more.

Who is it available to?Everyone, regardless of their income.Usually, only to individuals with an income higher than €62,550/year, freelancers, and civil servants.
In which hospitals can you receive treatment?You can get medical treatment in all public hospitals as well as the majority of private hospitals.You can usually receive treatment in both public and private hospitals.
Can I have a private hospital room?No.Yes.
Are pre-existing conditions covered?Yes, you will be covered even if you have a pre-existing condition.

You do not need to pay extra.

Private health insurance companies in Germany are obliged by law to accept clients with pre-existing conditions.

However, in most cases, you would have to pay higher monthly contributions.

Is there a deductible?You only have to pay €10 per quarter for doctor’s visits. If you do not visit the doctor that quarter-year, you don’t pay this.Yes, the deductible depends on the insurance plan you subscribe to.
Is prescription medication covered?Yes, it is.Yes, it is.
How long are waiting times for doctor appointments?Depending on your situation, you may be expected to wait a few days or a couple of weeks for a doctor’s appointment.Waiting times tend to be shorter than in public insurance.

How to Register for Public Health Insurance?

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?

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 simply 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:

  • DR-WALTER
  • 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 with 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-enroll in the future.

If it’s so good, who do people out-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 exam, 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 medication, such as mild painkillers, flu medicine, etc., are not covered.

Does 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.

How to Get a Doctor’s Appointment in Germany?

If you know the doctor whom you want to visit, you will have to call or appear at the practice to make an appointment. You usually make the appointment through the doctor’s assistant. You likely have to wait a few days for your appointment, unless it is an emergency.

You won’t have an appointed General Practitioner when you get to Germany, so you should do your research beforehand regarding local doctors. One place where you can find doctors is via the Kassenärztlichen Vereinigungen portal (Association of Statutory Health Insurance Physicians in Germany). You can just enter your place of residence or postcode and even the area of expertise you are looking for, and you will be presented with the relevant doctors/practitioners in your area.

You can also ask the Embassy of your country or the German Embassy when you apply for a visa for a list of General Practitioners.

Germany Emergency Services

The emergency number in Germany are:

  • Ambulance services and fire brigade: 112
  • Police: 110 (although the 112 dispatcher can also connect you to the police, if need be)
  • To call an emergency doctor: 19 242
  • To call a non-emergency doctor on call: 116 117

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