Public Health Insurance in Germany
Everyone living in Germany needs German health insurance. It’s the law! Therefore, expats and foreigners moving to Germany should understand the German healthcare system. Fortunately, Germany has one of the best healthcare systems in the world. As an expat in Germany, you can choose public health insurance or private health insurance. About 90% of people have public health insurance, and the remaining 10% of people have private health insurance. This guide for expats explains the German healthcare system and covers public health insurance in Germany in detail.
Table of Contents
- Why do you need German public health insurance?
- How does the German healthcare system work?
- How does public health insurance in Germany work?
- What’s covered?
- What’s not covered?
- Who can get German public health insurance?
- Cost of Public Health Insurance in Germany
- Which insurance is right for you?
- Frequently Asked Questions (FAQ)
- German Health Insurance for Students FAQ
1. Why Do You Need German Public Health Insurance?
Everyone living in Germany needs German health insurance, so it should be one of the top priorities for anyone moving there. You have two kinds to choose from: German public health insurance and German private health insurance.
Many people, however, sign up with the first plan they see. As a result, many people end up overpaying, not getting the right coverage, or not understanding their coverage. We want to make sure that’s not you!
In some cases private health insurance is a better option. You are eligible for private health insurance if you are self employed, a civil servant, or earn more than €62,550/yr (2020).
2. How does the German healthcare system work?
Public & Private
Germany has public health insurance and private health insurance. The majority of people (about 90%) have public health insurance in Germany. The other 10% of people in Germany have private health insurance. Not everyone can get private health insurance. You can choose private health insurance if you are a civil servant (e.g. police officer), a student, a freelancer or if you earn more than €62,550 per year (2020).
German public health insurance and private health insurance are quite different. For instance, the cost of public health insurance in Germany is based off your income. Therefore, if you earn a high income then sometimes private health insurance is the cheaper option. On the other hand, German public health insurance covers all your dependents for no additional cost. Private health insurance works the opposite. With private health insurance, you have to pay separately for each dependent you want to insure. As a result, sometimes public health insurance is the cheaper option for families. This guide has all the information you need to decide what is the best choice!
One of the first things you need to do when you move to Germany is get German health insurance. Everyone living in Germany needs to have German health insurance – it’s the law! Furthermore, if you’re applying for a German visa/residency permit then you have to show proof of valid German health insurance. Therefore, make sure your health insurance company in Germany fulfills all the requirements for getting a visa!
It’s important to point out that the European Health Insurance Card (EHIC) does not fulfill this requirement. If you’re moving to Germany then you need to get German health insurance, regardless of whether or not you have the EHIC.
One of the Best Healthcare Systems
Germany has one of the best healthcare systems in Europe. You will have access to good medical care, regardless of whether you live in a bigger city like Berlin or a smaller city like Leipzig.
3. How does public health insurance in Germany work?
You can choose from over 100 public health insurance companies in Germany. After you choose your public health insurance company, you tell your employer. Your employer helps you set up payments. These payments are a percentage of your salary and are usually taken directly from your paycheck once per month. The rest is really easy! You can go to the doctor or hospital and get the treatment you need. That’s all!
What to Consider
Since there are over 100 public health insurance companies, it can be a little challenging to choose the right one. How do you know? Well, for the most part, all public health insurance companies provide the same level of coverage. What really makes these companies stand apart from one another are their services (e.g. customer support, website) and their additional contribution rates.
One of the first things to consider is what services are in English. If you don’t speak fluent German then you should choose a public health insurance company that offers services in English. For instance, try to choose an insurance company that has customer support, a website, and application forms available in English.
The German government sets the state contribution rate. As of 2020, it is 14.6% of your income. On top of the state contribution rate, public health insurance companies have an additional contribution rate. It’s a very small percentage of your income. Public health insurance companies can choose their own additional contribution rate, but for most it is around 1%.
4. What’s Covered?
All public health insurance companies in Germany cover necessary medical care. This is because The German National Association of Statutory Health Insurance Funds governs German public health insurance companies. Public health insurance covers general practitioner appointments, hospital services, prescribed medications, vaccinations, and dependents.
Sometimes you have to pay out-of-pocket for medical treatment that public health insurance companies do not classify as necessary. Examples include speciality treatments and major dental work.
Here is an overview of what public health insurance in Germany covers:
- Dependents (e.g. your children, spouse)
- Doctors visits
- Paid sick leave (after employer stops)
- Partial medication reimbursement
- Inpatient care
- Outpatient care
- Specialist visits
- Physical therapy
5. What’s Not Covered?
- Optometry services
- Major dental procedures
- Medical services outside the EU
6. Who can get German public health insurance?
If your income is less than €62,550 per year (as of 2020) then you have to get public health insurance in Germany. However, there are a few exceptions. You can choose to have either public health insurance or private health insurance if you’re a student, self-employed or if you’re a civil servant (e.g. a public school teacher).
7. Cost of Public Health Insurance in Germany
The cost of public health insurance in Germany depends on the type of coverage you have and your income. Generally it is between €180 (lower income) and €800 (higher income).
As of 2020 the German state healthcare contribution is 14.6%. Your employer pays for half of this cost and you pay for the remaining half (7.3%).
Your healthcare cost would be around €150 if you are making €2,000 per month. It is important to note that there is an income cap of €4350 per month. In other words, this means that your healthcare cost will not be deducted from any income you make above €4350 per month.
Below is more detailed information about how the cost of public health insurance in Germany is determined.
Simply put, how much you have to pay for public health insurance in Germany depends on how much money you earn. It is a percentage of your income. This percentage is known as the contribution rate. The German government sets the state healthcare contribution rate. All public health insurance companies in Germany have the same state healthcare contribution rate. As of 2020, this rate is 14.6% of your income. As mentioned above, this amount is split equally between you and your employer. Therefore, you only pay 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.
Additional Contribution Rate
In addition to the state healthcare contribution, public health insurance companies in Germany have an additional contribution. This is a very small percentage of your income. Every public health insurance company has a different additional contribution rate. It’s usually no more than 1%.
One of the biggest perks to public health insurance in Germany is that it covers all your dependents for no extra cost!
8. Which Insurance Is Right For You?
Techniker Krankenkasse (TK) is Germany’s largest public health insurance company.
TK offers reliable customer service in English, and the application forms are available in English.
This is the public health insurance we highly recommend. Our FAQ has more detailed information about TK’s benefits and services!
9. Frequently Asked Questions
Does Public Health Insurance Include Dental Care?
Public health insurance in Germany only covers basic dental care. For example, professional teeth cleaning is usually not included. Instead, the removal of tartar is part of the annual check-up. Since public health insurance companies only cover a very small percentage of dental work, many people living in Germany choose to get supplemental dental insurance. You can buy supplemental dental insurance from a private health insurance company.
What Is The Best Public Health Insurance For Expats Working In Germany?
TK Health Insurance
The best public health insurance in Germany for expats is TK. As mentioned before, TK’s premium is 0.7 percent. That’s really low. Above all, TK keeps their premium low and your benefits high. In other words, TK is incredibly affordable and provides you with the best access to outstanding healthcare services.
Is Public Health Insurance In Germany Free?
No. Public health insurance in Germany is not free. German private health insurance is also not free. The cost of public health insurance is a percentage of your income and the cost of private health insurance depends on many different factors, including your age and health.
What Are The Benefits Of TK Health Insurance?
Benefits of TK
- Services available in English: TK has customer support, a website, and an application in English!
- Family insurance: You do not have to pay additional fees to insure your family members.
- Coverage abroad: TK health insurance is valid in most European countries. The European Health Insurance Card (EHIC) is included with TK, and it is located on the back of your TK eHealth card. Present this card when you go to a hospital for medical treatment.
- Doctor of your choice: You can choose your doctor.
- Low rates: TK’s additional contribution rate is one of the lowest out of all of the German public health insurance companies. TK’s additional contribution rate is set at 0.7% of your income (2020). You only pay 0.35% if you have TK because the contribution rate is split equally between you and your employer.
What Services Does TK Offer?
Services TK Offers
- Vaccinations: TK covers all vaccinations recommended by the Standing Vaccination Commission (STIKO).
- Screening examinations: TK covers almost all screening examinations for adults, adolescence, and children. For example, blood testing in neonatal screening, Chlamydia infection testing, cancer screening, and newborn hearing screening.
- Dental check-ups: TK covers dental examinations twice per year.
- Rehabilitation and functional training: TK has prearranged contracts with many rehabilitation and functional training service providers. TK covers the costs for these services for a limited time.
- Medicines: TK covers the cost of all medications prescribed by doctors. Medicine is available in pharmacies. You cannot buy medicine from supermarkets or drugstores in Germany. Your co-payment is between 5 and 10 euros.
- Glasses: TK will pay the cost of glasses and lenses at a fixed amount with a prescription from your doctor. This fixed amount is between 10€ and 113€ per glass.
- Sleep therapy devices: TK has prearranged contracts with suppliers and will cover the base cost of a sleep therapy device.
- Outpatient medical care: You get to choose your healthcare provider. The only requirement, however, is that the doctor is a licensed statutory health insurance fund doctor. Show them your health insurance card, and TK pay the cost of your medical care. That is to say, the doctors will work with TK to settle your medical bills.
When Do I Need To Get German Health Insurance?
When You Need German Health Insurance
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 earlier rather than later.
If you are from a country within the EU then 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, you cannot substitute it 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.
What Is The Best Private Health Insurance Company In Germany?
Ottonova is once of the best private health insurance companies in Germany. It is especially for good for expats/foreigners. Ottonova has better prices for expats and offers all of its services in English. For example, the website and customer support is in English. Ottonova also provides really good coverage.
Can I Use My German Health Insurance In Other Countries?
When you get public health insurance in Germany you will receive the European Health Insurance Card (EHIC). With the EHIC, you can get medical care at public hospitals in the EU, Norway, Lichtenstein, Iceland and Switzerland for free or a reduced price.
It’s easy to confuse the EHIC with travel insurance, but they’re not the same thing. The EHIC does not offer coverage for private medical services. For instance, mountain rescues/emergency helicopter rescues are not part of the EHIC coverage. Health officials suggest getting travel insurance for private medical costs if you’re going on a trip abroad.
What Are The Benefits Of Public Health Insurance?
- It can be less expensive when you’re older: The cost of public health insurance calculated from a percentage of your income. Meanwhile, the cost of private health insurance depends on a variety of factors, such as your age and health risks. As a result, for some people, public health insurance is the cheaper option. However, it heavily depends on each individual’s situation.
- Dependents: Public health insurance in Germany includes coverage for dependents for free. That is to say, you don’t need to pay extra to insure your children and spouse under your public health insurance plan.
- Easy to manage: Public health insurance is really straightforward. For most medical care, all you need to do is show your health insurance card. The doctors and your insurance provider handle the payments.
What Are The Disadvantages Of Public Health Insurance?
- It can be more expensive for young adults with jobs: The cost of public health insurance is based on your income. Private health insurance, on the other hand, is mostly based on your age, health and number of dependents. If you are young, healthy, and you don’t have any children then public insurance could be more expensive for you than private health insurance.
- Longer wait times: Individuals with public health insurance oftentimes have to wait longer for doctor appointments, particularly with specialty doctors, than those with private health insurance.
- It only covers basic, necessary care: Public health insurance doesn’t cover non-essential medical care. For example, oftentimes you will have to pay out-of-pocket for major dental treatments and private rooms at hospitals.
How Does Sick Pay Work For Public Health Insurance In Germany?
Sick Pay in Germany
If you are out from work because you are sick, then your employer normally has to pay you 100% of your salary for up to six weeks. If you are sick for longer than six weeks, then your public health insurance provider will pay you 70% of your salary for up to 78 weeks.
What’s The Best Way To Pay For My Health Insurance?
It depends on which health insurance company in Germany you have. If you have TK then you can use TK’s Direct Debit Mandate to pay for your health insurance. Direct Debit Mandate is the simplest way to pay because TK will deduct your payments on a monthly basis. However, there is another option. You can pay the entire semester’s worth of health insurance costs at the beginning of the semester.
Do I Need German Health Insurance For A Residency Permit/Visa?
Yes – you need German health insurance to get a residency permit/visa in Germany.
In fact, you need to have German health insurance at all times. You should start the process of getting German health 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.
10. German Health Insurance for Students FAQ
What's The Best Health Insurance Company In Germany For Students?
Students Health Insurance in Germany
In Germany, students can choose between private health insurance and public health insurance. One of the best health insurance companies for students is TK, while Ottonova is one of the best private health insurance companies.
TK offers medical coverage outside of Germany, and it has an online application just for students! Furthermore, TK offers its services in English.
Ottonova has cheaper rates just for expats. It also has really good coverage. Ottonova’s website is in English and there is a mobile app! In addition, you can get insurance online before you arrive to Germany, and end your contract online when you leave Germany.
What Is Dependents Insurance?
Dependents Insurance in Germany
Dependents insurance is another way of saying that you are insured through your parent’s public health insurance plan.
As A Student, Can I Stay On My Parent's Public Health Insurance Plan?
If you’re a student then you can stay on your parent’s public health insurance plan under two conditions. First, you have to be 24 years old or younger. Second, your income cannot be more than 445€ per month. This ends if you earn more than 445€ per month for more than 3 months within 1 year.
What Happens If I Don’t Have Dependents Insurance Or It Expired?
TK will insure you as long as you meet the following requirements:
– You are enrolled at a state recognized university/ college.
– You do not have full-time self-employment.
– Your employer does not provide you with health insurance.
– You do not receive health insurance through unemployment services.
There are, however, two exceptions. You are not eligible for student health insurance if you are in one of the following situations:
1. You are in enrolled in preparatory courses for your study program.
2. You’re a visiting student.
Can I Extend My Dependents Insurance?
You can extend your dependents insurance (i.e. stay on your parent’s public health insurance plan) if your studies are delayed due to voluntary military service, federal voluntary service or for a voluntary social year. This extension is limited for up to one year longer.
How Much Does Student Health Insurance Cost?
Cost of TK Public Health Insurance in Germany
Health insurance: 66.33€ a month
Additional contribution: 4.45€ a month
Long-term care insurance: 19.79€ a month
For those over 23 without children: 21.42€ a month
If you do not have children, then your additional contribution is 0.25% more for long-term care insurance starting at the age of 23.
How Does Public Health Insurance In Germany Work For International Students?
Health Insurance for International Students
Students that already have public health insurance in an EU/EEA country might not need German health insurance. Usually students can use their European health insurance card (EHIC) when they go to a doctor or the hospital. On the other hand, students that are not from an EU/EEA country need German health insurance.
When Does My Student Public Health Insurance In Germany End?
Your student health insurance ends when you finish your degree, are no longer enrolled in courses or at the end of your 14th academic semester.
Am I Eligible For Student Public Health Insurance In Germany If I'm Studying And Working?
If your income is from the following employments then you do not have to pay extra for your student health insurance or long-term care insurance:
Small job: You earn less than 450€ a month. The number of hours you work is not relevant.
Temporary employment: Your work does not exceed 3 months (70 working days).
What Is The Electronic Health Card?
Everyone who is insured by German public health insurance (sometimes referred to as statutory health insurance) gets the electronic health card. You have to show this card anytime you go to a doctor, the hospital, or an approved therapist. There is a chip on the card. This chip has all of your insurance information (your name, insurance number, address, date of birth, etc.) This allows physicians and therapists to work out payments for their services with your health insurance company. All you need to do is show them your card. If you get German health insurance for students through TK, then you will receive TK’s eHealth card.
Do Students Need Health Insurance In Germany?
Health Insurance for Students
Yes. Everyone living in Germany needs health insurance. This includes students! As a student in Germany you must be covered through either your parents’ health insurance plan (dependents’ insurance) or have your own insurance. Techniker Krankenkasse offers student health insurance. TK insures over 440,000 students in Germany.
Who wrote this?
My name is Bastian and I am a certified, independent insurance broker in Germany. My wife is American and together we help English-speaking expats figure out insurance, banking, and other issues encountered when moving to/living in Germany.
I also own Germany’s biggest Youtube-Channel about insurance knowledge and was honored with the “Education Award of the German Insurance Industry” in 2018 and became “Young Broker of the Year” in 2017.