Health insurance in Germany

Health insurance in Germany is one of the most essential insurances that should be completed after arriving in Germany. Most people in Germany have health insurance under the public health care system, as of 2015 there were 71 million people insured under this system. However there were 9 million people insured under the private health care system.

Public and private health care systems in Germany differ significantly

There are significant differences between the public and private health care systems in Germany. In general, private health care will provide you with shorter waiting times for appointments and it will also help you in securing appointments with heads of departments rather than a lower ranked doctor that is on duty at that specific time. There are also specialised private packages that will allow you to have treatment from highly experienced doctors if required.


For the public health care system, everyone is treated equally and everyone has the same level of protection. If you need extra care then you can pay for supplementary tariffs. For dental care for instance, if you need a tooth filling, the public health insurance will usually only cover some of the basic/cheaper fillings, but if you wanted something of higher quality you would need to pay for this yourself and this could be quite expensive. However if you had a supplementary dental insurance protection on top of your public health insurance then you could avoid high dental bills.


German public health system overview

Public health insurance works under the principle of solidarity which means that there is no discrimination due to age or health and all people pay the same percentage of their income up to a certain ceiling. The contribution rate is 14.6% of your salary up to a maximum payment of €635 per month. Half of this contribution is paid by the employer and half by the employee.


Children and spouses who do not earn any income are co-insured without contributions. However for students, self employed and other low income persons must still pay contributions into the public health scheme.


German private health system overview

Insurance providers under the private health care system in Germany are allowed to discriminate and reject people on the basis of health/age etc. The private system is not open to all people and only civil servants, self employed or salaried people who earn more than a certain amount are allowed to use private health insurance. For 2017 you had to earn more than €57,500 per year in order to be considered for private health care. For salaried people the employer would pay half of the premium but only upto a maximum of €318 per month (i.e. the same amount if under public health insurance).


Private health insurance is more expensive the older you get

Instead of insurance payments being based on salary, private health insurance is based on age, health and your chosen benefit extras. Furthermore, separate payments are generally required for spouses and children which means that insurance for families is quite expensive.


However, for younger people with no health issues and no family then private health insurance can be a lot cheaper. However, insurance premiums increase as you get older and contributions also increase after you retire. It is possible to lower your private health insurance premiums with regular health checks, but if something is found to be wrong then this will increase your premium.


Furthermore, it is important to note that in most cases it is almost impossible to switch back from private health insurance to public. This is to avoid people paying lower premiums on private when they are young and switching back to public when they are older.


What next? We recommend the public health system

In most cases we would advise you choosing the public health insurance system. The only instance when you should consider private medical is if you are young, single, do not want children and only plan on staying in Germany for a few years. However given how unexpected life is it means the public health insurance system should be the best option.


Most employers should arrange for you to be part of a public health insurance scheme automatically. However if not we would recommend two:


TK – This is one of the few public companies that have their website in English

AOK – This is one of the largest providers in Germany however not in English.


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