Germany is well known for having one of the most demanding and comprehensive health insurance system. Majority of the population of Germany are insured by public health insurance and the remained minority are insured by private insurance. Since reform of 2007, everyone who lives in Germany is compulsory to register with either a statutory German health insurance scheme (gesetzliche Krankenkasse, GVK) or a private insurance scheme (private Krankenversicherung, PVK) that would provide coverage for at least hospital and patient medical treatment.
What kind of insurance are offered in Germany?
If you are employed and your annual payment for 2020 is less than 62,550 Euro (or 5,213 Euro per month) you are subject to mandatory public insurance (Gesetzliche Versicherung or GKV). The amount of insurance that is charged by the Krankenkasse is basic rate of 14.6 % plus a possible average supplemental rate of 1.1 % of your eligible gross salary with a cap set at a maximum monthly income of 4,688 Euros (2020 figures). If you earn more than this threshold amount the insurer will not charge higher. This threshold is set annually. Therefore the maximum amount that is paid to the insurer is 736 Euro that is paid 50%-50% by your self and your employer, each the amount of Euro 368. Under some conditions, you can decide to opt out for a private insurance, however returning back to the public insurance is not easy and you should actually be employed again with the condition that your salary would not be higher than the required maximum subject of mandatory public insurance.
Benefits of Public Insurance
The medical benefits offered in the GKV include in-patient (hospital) care with the doctor on duty at your nearest hospital, out-patient care with registered doctors (Kassenaerzte) and basic dental care. You can always apply for supplemental programs that GKV offer and you can apply for voluntarily.
One of the advantages of governmental insurance fund is its coverage, without any additional cost, for your non-working dependants in your family who live with you at the same address. The insurance covers the whole EU but is not applicable outside of EU, for which you may apply for travel supplemental insurance.
If you are employed but your salary is higher than 62,550 Euro, or if you are freelancer, self-employed or you are not employed and your age is over 55, you can easily opt out for a private insurance.
One of the major elements is your communication with your insurer as in different conditions you may have questions about your insurance coverage or its services. Therefore, you may seek for those funds that provide also services in English language.
You may choose a private health insurance (Private Krankenversicherung or PKV) instead of the governmental health plan if your gross salary is higher than 62,550 Euros per year (2020 figures). Self-employed persons, German civil servants and those persons working part-time and earning less than 450 Euros per month (mini-job) are also eligible.
Benefits of Private Insurance
Private health insurance plans cover a wider choice of medical and dental treatment and generally provide broad geographical coverage. You are considering as private patient and are granted with some premium services such as sooner appointments with the doctors, possibility to be checked directly by a specialist and a private room in hospital. As a private insured you can get the doctor who speak at your native language. In compare to GKV providers that are around 108 Krankenkasse in Germany, private medical insurance market is run by 40 German insurance companies. The premium in private insurance is ratified based on different elements, such as your age, your medical and health background, scope of benefits and supplements you wish to have.
Private insurance is paid individually by each person, while in public health insurance your non-working dependants are covered by your insurance. Therefore, if you have a family who live with you, having a private insurance shall become expensive as you need to pay for each member of your family a separate premium. In order that your private insurance recover your medical charges, normally payment of a franchise (deductible) by yourself is required.
What are different insurance for different professions?
As expat you are normally covered by international insurance. However not all of the international insurance are recognised under German system. Furthermore in Germany you need to provide coverage for both health care and nursing services and many of the international insurance do not cover nursing services. If your insurance would not meet with the German insurance requirements, you need to find a local insurance in Germany as a supplement or as a substitute for your international coverage. Depending on the fact that how much your salary is and who is your employer, you may have the options to decide private or public health insurance.
Self-employed, freelancer, business holder
If you have your own business in any way of being freelancer, Managing Director of your Company, freelancer or self-employed you may face with some limitation with respect to your health insurance. You may not have the option to be insured by pubic health insurance, unless you change from employment conditions to any type of independent profession activity. Although you can insure yourself in the private health system.
Depending on the type of your residency, you may be required by law to have membership with a private insurance. Your residency will be extended if your private insurance would meet specific requirements that is verified by law. You may ask for further information in this regard from the immigration centre that is in charge of considering your application.
If you are graduate of German university and upon graduation started to work independently or if you are already covered by public health insurance but would like to work as self-employed or freelancer, you can choose to continue your membership in the public insurance “freiwillig” or choose to move to a private insurance. Nevertheless, you should always check that your insurance type would meet with requirements for extension of your residency.
All students in Germany including international students should have a German insurance for the term of their study in Germany. This obligation also applies to the research students and applicants who come to learn German language. Depending on your nationality, your home insurance may cover you also in Germany. However normally you should get a new German compulsory or private insurance without which you can not get or extend your residency as student in Germany. For coverage of your home insurance you can check with your university international office.
The statutory health insurance providers in Germany are obligated to offer an affordable tariff for students up to the age of 29 years old or until the end of their 14th subject-related semester. Students who reach the age of 30 while studying in Germany and who are not insured for at least 12 months in the student tariff can not switch to the statutory health insurance for students and should be insured by a private insurance provider.
How Can I change my insurance?
From Public to Private Insurance
If you are already insured by public health insurance and would like to change to private scheme, it is advising to consider advantages and disadvantages of each system based on your individual conditions beforehand. You may consult with insurance brokers who have good understanding of conditions of each system. You should also note that between different insurance companies that provide the same scheme there could also be differences. Hence, if you have given the chance to choosing your own public health insurance, it worths to study about different service providers and choose the one that have higher benefits for your health support.
From Public to another Public Insurance
In order to switch between governmental insurance fund providers, you need to spend at least 18 months with your insurance. You can change your insurance then by giving a two months notice. As a voluntary member of GKV, changing into a private health insurance is possible at any time with a cancellation notice of 2 months and when the private insurance has accepted you.