6 things you need to know about german health insurance


There is no denying that the German healthcare system is one of the best in the world. It is also, however, very complex. Since German law requires everyone living in Germany to have German health insurance, it is important that you understand the basics of German healthcare. This article explains the top 7 things you need to know about German health insurance. 

1) German health insurance is required for a residency permit/visa.

You need to have insurance at all times. You should start the process of getting insurance before you arrive if you’re from a country outside the European Union (EU). As a non-EU citizen applying for a residency permit/visa in Germany, one of the required documents is proof of German health insurance. Therefore, it is important to start this process ahead of time.

If you are from a country within the EU, you need to start the process of getting insured through the German healthcare system when you arrive. If you are from the EU, European Economic Area (EEA) or Switzerland you can use your EHIC card for a limited time. Note that the EHIC card is only for temporary travelers in Germany. In other words, it can’t be used as a substitute for German health insurance.

For both non-EU expats and EU expats, you have 3 months from when you become a resident of Germany to apply for German public health insurance.

2) German public health insurance costs vary. 

The cost of German public health insurance depends on the type of coverage you have and your income. Generally you can expect to pay between 180€ (lower income) and 800€ (higher income).

In 2019, the German state healthcare contribution was 14.6%. Normally your employer pays for half of this cost and you pay for the remaining half (7.3%). For example, if you made 1000€ per month, you and your employer would owe a combined 146€. Your employer would pay 73€ and you would pay the other 73€. This payment is deducted directly from your paycheck.

3) How much you pay for private health insurance depends on your health risks. 

Private health insurance companies will charge you based on your age and health. If you earn more than 60,750€ per year, you can choose to have private health insurance instead of public health insurance. You can also have private health insurance if you are self-employed, a civil servant (such as a professor), or work part-time and don’t earn more than 450€ per month. 

4) The German health insurance “sick pay” system

If you are out from work because you are sick, your employer is normally required to pay you 100% of your salary for up to six weeks. If you are sick for longer than six weeks, your public health insurance provider will pay you 70% of your salary for up to 78 weeks. 

On the other hand, if you have private health insurance, you should check that your policy includes satisfactory sick pay. 

Keep in mind that sick pay is only valid if you are going to go back to work. Neither private health insurance nor public health insurance cover sick pay for permanent disability. To cover permanent disability, you would need to buy a separate permanent disability insurance policy. 

5) The German health insurance system is set up as a welfare state. 

Germany’s healthcare system is set up as a welfare state. In other words, all residents of Germany pay money into the system. You receive money from the system if you incur medical expenses. Your health insurance pays all or part of your medical expenses if you get sick, have to go to the hospital, need prescription drugs or require other preventive care. You don’t receive money from the healthcare system if you don’t require any medical care. 

6) Coverage for non-working dependents

Basic public health insurance premiums usually insure both you and all your non-working dependents, such as your children. On the other hand, you usually have to pay for each individual person on your insurance plan for a basic private health insurance plan. 

7) The EU gender directive

In March 2012 an EU law was modified to prevent insurance companies from charging their customers based on their gender. In other words, before 2012 insurance companies could charge a specific gender more for their insurance policy because it was statistically a greater financial risk. This law was for sexual equality. For example, oftentimes in Germany private insurance was more expensive for women. One reason is because women typically have longer lifespans than men. Therefore, women would cost the insurance company more money over the longterm. Another reason is because childbirth and gynecology doctor visits are expensive for the health insurance company. Since 2012, however, German private insurance companies can no longer have different prices due to gender.

Now you have an overview of the German healthcare system. It’s complex, but hopefully this article answered some of your questions.

One last thing! If you would like to learn more about German health insurance for expats working in Germany, click here.

Maybe you are already ready to get health insurance. Click here to read our article about the best German public health insurance for expats in Germany! 

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