How to make sure that you have appropriate health insurance in Germany...
Foreign nationals visiting Germany should be insured before arriving in Germany, either by a reciprocal agreement between their country of residence and Germany or via private insurance, otherwise treatment must be paid for. EU citizens visiting Germany may use their European Union Health Card (EHIC) to obtain free necessary medical and dental treatment in Germany. This includes treatment in public hospitals (with doctor referral except in emergencies). However, payment must still be made for prescription charges. It is always wise to check with the doctor exactly what is covered before undertaking treatment.
In the case of a longer stay, some insurance companies offer private insurance to citizens abroad; this is tailored towards the needs of expatriates and can work out cheaper than German private health insurance.
Health Insurance for Residents
Since 2009 it has been mandatory for all residents of Germany to have either state or private health insurance. It is also a legal requirement for obtaining a residence permit. Public health insurance (Krankenkasse) is compulsory unless income is above a fixed sum (in 2014 this was €4,462.50 per month).
State health insurance
State health insurance costs approximately 15.5 percent of net income (dropping to 14.6 percent in January 2015).
The employee pays roughly half the contribution while the employer pays the remaining half. Payments are automatically deducted from salaries and the employer completes all the required paperwork.
There are over 100 state insurance companies and the employee can select which insurance company to sign up with.Some of the most popular public health insurance companies include AOK, Barmer GEK and TK (Techniker Krankenkasse).
The Krankenkasse provides a comprehensive package of medical care including visits to a doctor, hospital care (inpatient and outpatient), mental health care, dental care, sick leave reimbursement, prescription drugs, medical aids and rehabilitation. When choosing an insurance company it is important to research individual companies carefully to find one that suits the individual needs.
- The GKV Central Organisation provides more information on public (statutory) health insurance in Germany
- Their website also has a comprehensive list of all public (statutory) insurance companies (PDF in German)
- Krankenkassentariff.de is useful for comparing prices between different state insurers (in German)
Private Health Insurance
Self-employed people or those in a higher income bracket generally take out private medical insurance but must apply to opt out of the state system. Instead of being income-dependent the amount payable corresponds to the insurance risk an applicant presents. For example, a young man might pay around €150 per month whereas a couple in their 40s with two dependent children would pay approximately €700 per month. The employer still contributes half of this amount.
Private health insurance has many benefits. It is often more extensive than state insurance and the policy can be adapted to each individual; however, whereas public health insurance covers all family members, private health insurance requires each family member to be insured on an individual basis. This means that for families with children private insurance is only viable if both parents earn above the income threshold.
Everyone living in Germany is obliged to take out health insurance, including expatriates. Expatriates working in Germany can have the choice of taking out either public insurance or, if their income exceeds the threshold, private insurance.
Those who are not working can take out private insurance as its payment is not based on income. Private insurance is often favoured by expatriates as it offers packages more suited to those living abroad and in these cases can work out cheaper than German state packages. Private insurance also gives a wider choice of medical and dental treatment and patients can request to see a doctor who speaks English.
It is important to note that when taking out private insurance a request must be made to a public health insurer to waive the obligation for statutory health insurance, and that many private insurers require a minimum length of stay in Germany.
Getting private insurance
Once an application form has been completed the insurer requires the applicant to have a medical and dental check-up. The insurer then calculates the risk based on age, sex, health, pre-existing conditions and other factors, and provides a written offer which can be accepted or declined. The insurer can also help to waive the obligation for statutory health insurance and it is best to ask them for advice on how to do so.
- The PKV-Verband provides a list of private health insurance providers (in German)
- The 1A Verbraucherportal also has an extensive list of private health insurance providers
- For more information on private health insurance visit the Bundesministerium für Gesundheit wesite (in German)
Payment for private treatment
With private insurance payment for treatment is covered by the patient up front and receipts are sent to the insurance company for reimbursement.
Supplementary Private Health Insurance
For those with state insurance, supplementary private health insurance (Zusatzversicherung) can be taken out to cover inpatient, outpatient and dental treatment. For inpatient treatment this gives the patient free choice of hospital and the opportunity to be in a one or two bed room compared to a standard hospital ward which normally has three beds. Add-on insurance for dental treatment covers more extensive dental work. Outpatient supplementary insurance covers prescription charges and the €10 quarterly fee payable with the Krankenkasse. It also covers treatment abroad and repatriation costs.
Supplementary private health insurance packages can be obtained through private health insurance companies. Each package is different so it is important to research which one is most suitable.
- The PKV provides more extensive information on what supplementary private health insurance typically covers