Health insurance in Germany is compulsory for all residents, including students and the self-employed.
The health sector is divided between public and private, even if in reality, 90% of the population is covered by the public health insurance system.
Here are a few explanations on how the German healthcare system works, and what is at stake as an expat, foreigner or student.
The organization of health insurance in Germany
Public health insurance
There are three types of health insurance in Germany:
- Public health insurance (GKV)
- Private health insurance (PKV)
- A combination of the above
Public health insurance is administered by the Ministry of Health and is compulsory for all employees up to a certain income level.
In the public system, contributions are proportional to income, and the insurance also covers the spouse and children. For low-income employees, it is possible to apply for an exemption from these contributions.
For employees whose income exceeds the maximum set each year by the Ministry, as well as for the self-employed and public officials, it is possible to opt for voluntary membership of the GKV, or to take out private health insurance.
Private health insurance in Germany
In the private sector, contributions are based on a medical examination, and the older the insured person is, the higher the contribution.
The advantage of taking out private health insurance in Germany is that you will have better coverage for certain treatments that are excluded from the public system (homeopathy and alternative medicine, for example), you will have access to a more extensive network, and you will receive better reimbursements for optical, dental and hospital care.
But beware: once insured in the private system, it will be very difficult to return to the public system, and it is even impossible beyond the age of 55.
For people who are affiliated to the public health insurance system in Germany, it is also possible to purchase a private complementary insurance to benefit from better optical, dental or hospital reimbursements, without leaving the public system.
Costs of health insurance in Germany and what it covers
Basic care, free but with a co-payment
The public health insurance system in Germany covers hospital care, routine medical care with a registered doctor, basic dental care, as well as optical care for minors and people with severe visual impairments.
Health insurance costs in Germany will depend on the care you require. The general rule is that necessary care is free of charge and supplementary care is paid for, but a quarterly co-payment of 10 euros is applied if a doctor is consulted during that period.
For medicines, there is no advance payment, but a financial contribution must be paid by the insured.
Hospital and dental care can be expensive
In case of hospitalization, a fixed fee of 10 euros per day is payable by the insured person of legal age, as well as additional costs related to special services (single room, etc.).
If the patient chooses a hospital other than the one recommended by his or her doctor, the hospitalization is at the patient’s expense.
Generally, dental care is very expensive in Germany, and justifies the purchase of a supplementary insurance. As for consulting doctors in the private sector, the prices are also much higher than in the public sector (from 25 to more than 100 euros for a consultation with a general practitioner).
Which health insurance for foreigners in Germany?
Seconded workers and stays of less than one year
For seconded workers, the question of health insurance in Germany does not arise: it is still the Social Security that manages the coverage of health care.
You will only have to make sure that you take out a supplementary health insurance policy that covers all the costs of international healthcare.
For stays of less than one year, a European Health Insurance Card (EHIC) will allow you to benefit from the same medical care as German residents without affiliation to the local health insurance system.
A complementary health insurance plan may also be useful to be sure to cover all health expenses in Germany.
Health insurance for expats and students in Germany
In all other situations, you will have to opt to purchase a health insurance plan in Germany.
Although taking out an international health insurance policy does not exempt you from this process, it is nevertheless a solution that should not be overlooked for several reasons.
On the one hand, if this insurance plan is managed by a company from your home country, it will be accessible in your own language, contrary to the procedures related to the German health insurance.
On the other hand, this insurance will protect and cover you everywhere in the world, including your home country, contrary to local insurance.
An online comparison tool will allow you to obtain different quotes and check the offers available more clearly. But be careful: if the insurance you choose is not registered in Germany, you will have to take out insurance before your departure or meet certain professional requirements for it to be valid.
