Starting a new life in Germany involves numerous essential steps, and securing the right health insurance is among the most critical. Whether you’re moving for work, study, or family reasons, understanding your options helps ensure you meet legal requirements and access quality healthcare without unnecessary expense or complications. This guide provides a detailed overview of the different health insurance types available in Germany, their costs, coverage, advantages, disadvantages, and practical steps to get insured.
Your Options
Germany offers a range of health insurance solutions tailored to various needs—public, private, and expat insurance. The optimal choice hinges on your personal circumstances, income level, employment status, and long-term plans. Carefully assessing each option ensures you select the coverage that best fits your situation.
Public Health Insurance
A significant majority of residents—about 87%—depend on public health insurance, also known as statutory health insurance (Gesetzliche Krankenversicherung). Managed by non-profit funds rather than the government itself, these insurers provide comprehensive coverage at predictable costs. While the coverage levels are broadly similar across providers, minor differences in service quality and additional benefits can influence your choice.
Cost of Public Health Insurance
Public health insurance premiums are calculated as a fixed percentage of your gross income, making them proportional and predictable. This structure benefits those with lower or unstable earnings, as costs adjust accordingly.
- For employees: Contributions range from approximately 9.6% to 11.2% of your monthly income, including long-term care insurance. This amount is deducted automatically from your paycheck, with minimum payments around €130 and maximum around €650 per month.
- For students: Typically, students pay about €150 per month under a special tariff. However, if you are over 30, the student tariff no longer applies, and you will pay around €250 monthly.
- For self-employed individuals: Contributions vary between 19.2% and 22.6% of estimated income, with minimum payments near €250 and maximums exceeding €1,300. Payments are made via bank transfer each month.
- For apprentices: Those earning less than €325 per month often receive free coverage paid by their employer. If earnings exceed this threshold, standard employee rates apply.
- For unemployed: The minimum contribution is roughly €250 monthly. During periods of unemployment, coverage may be partially or fully subsidized, and some treatments, like medication, can be free or involve small copayments.
Using tools like the public health insurance recommendation calculator helps estimate your specific costs based on your income and status.
Coverage Provided by Public Insurance
Public health insurance ensures access to necessary healthcare services, covering treatments that are medically essential. It pays for:
- All necessary treatments, therapies, and prescriptions
- Pre-existing conditions
- Family members (spouse and children) under Familienversicherung at no extra cost
- Long-term sick leave benefits
- Emergency care within the EU
- Psychotherapy and mental health services
- Basic vaccinations and cancer screenings
- Essential dental care, including wisdom tooth removal and biannual check-ups
However, certain services are not covered, such as:
- Cosmetic procedures like teeth whitening or orthodontics
- Prescription glasses and contact lenses (some exceptions exist)
- Alternative medicine such as acupuncture
- Travel vaccinations (some insurers may cover them)
When visiting a doctor, presenting your insurance card ensures direct billing to your Krankenkasse, eliminating the need for reimbursements or paperwork. To enhance coverage, supplementary dental or private insurance can be considered.
Benefits of Public Coverage
- Contributions are income-dependent, making insurance affordable for low earners and retirees
- Particularly advantageous for students, who pay minimal rates
- Family members are covered free of charge, making it cost-effective for larger families
- The system is straightforward: show your card, access care, and avoid complex paperwork
- Pre-existing conditions do not result in higher premiums or rejection
- It provides a reliable safety net, with consistent coverage options across providers
Drawbacks of Public Health Insurance
- High earners may find private options more economical
- Waiting times for specialist appointments can be lengthy
- Some treatments, especially cosmetic or alternative therapies, are excluded
- Certain groups—self-employed professionals over 30 or some students—are ineligible
- The scope of coverage may be limited in comparison to private plans, especially for specialized or elective procedures
Choosing a Public Insurer
Most public providers offer similar prices and coverage; differences are minor. Notable insurers like Techniker Krankenkasse and Barmer are popular for their extensive English support and customer service. For specific needs, compare their coverage for pregnancy, dental, or travel vaccinations. Switching providers is straightforward if you seek better service or coverage later.
Private Health Insurance
Private health insurance (Private Krankenversicherung) is an option primarily for high-income earners, self-employed professionals, civil servants, or students eligible under certain conditions. It offers tailored coverage, faster access to specialists, and often higher treatment quality but comes with complexity and long-term considerations.
Eligibility Criteria and Costs
- Income threshold: If earning over €77,400 annually as an employee or €35,000 as self-employed, private insurance becomes accessible.
- For students: Private plans are available but usually more expensive than public tariffs.
- Civil servants: Often opt for private plans tailored to their status.
Use the private insurance eligibility checker to assess your qualification.
The cost varies based on:
- Age at entry: Younger individuals pay lower premiums, as insurers save for future aging-related costs.
- Health history: Pre-existing conditions can lead to rejection or higher premiums. Health checks are often required upon application.
- Coverage level: Choosing extensive coverage increases costs, especially when insuring family members.
- Deductibles: Higher deductibles reduce premiums but increase out-of-pocket expenses when receiving care.
Employers typically cover half of private insurance premiums if you are employed. Self-funded individuals pay the entire amount, payable via bank transfer.
Interesting:
Advantages of Private Insurance
- Often more affordable for high earners
- Faster appointment scheduling and specialist access
- Superior treatment options and personalized care
- Flexibility to customize coverage for specific needs
- Potential for cost savings if no healthcare services are used in a year, through no-claims discounts
Disadvantages of Private Insurance
- Premiums are fixed and do not decrease with income changes or unemployment
- Certain treatments or services may be excluded or require additional coverage
- Reimbursement processes involve paying upfront and claiming later, which can be inconvenient
- Switching back to public insurance is difficult after enrollment
- Risk of rejection due to pre-existing conditions
- Long-term affordability concerns for retirees or those with chronic illnesses
Coverage Scope
Private insurance generally covers all necessary healthcare, with the possibility to add coverage for dental, vision, or alternative therapies. Plans often have unlimited coverage limits, but some may have annual caps or deductibles. Customization allows for better dental implants, hospital room upgrades, or specific treatments.
Expat Health Insurance
Expat or incoming health insurance is temporary coverage designed for foreigners residing in Germany for a limited period. It is inexpensive but has notable limitations and risks.
When to Consider Expat Insurance
- Temporary residence: Before your public or private insurance begins, such as during visa application processes
- Over 30 students: For short-term studies or internships
- Freelancers with low income: When applying for initial visas
- Retirees from non-EU countries: When long-term coverage is unavailable
This insurance is valid for up to five years, after which switching to standard public or private plans is necessary. It is crucial not to rely solely on expat insurance as a long-term solution, especially if health conditions develop.
Drawbacks of Expat Insurance
- Limited or no coverage for pre-existing conditions
- Excludes many preventive and specialist services
- Often requires upfront payment, then reimbursement
- Not renewable beyond five years
- Premiums tend to increase annually, with no ceiling
Recommended Providers
Trusted options include Feather, HanseMerkur, and April International. Many packages also bundle public health insurance options or include coverage for visa applications. Always consult an expert before choosing expat insurance.
Other Insurance Options
Free or Family-Dependent Coverage
- Under certain conditions, your parents’ or spouse’s public insurance can cover you at no cost, especially if your income is low and you are under 23 or 25.
- Insurance from another EU country may suffice temporarily using the European Health Insurance Card (EHIC), but long-term residence requires German coverage.
Travel Health Insurance
Designed for travelers, this covers emergencies abroad but excludes ongoing treatments or pre-existing conditions. If visiting Germany, a valid travel insurance is mandatory for visa applications. In Germany, travel insurance is inexpensive (~€40/year) and available from providers like Feather or Allianz.
How to Get Insured
Step 1: Assess Your Needs
Use online tools to evaluate whether public, private, or expat insurance fits your profile. For complex cases, such as freelance visa applications, consulting an expert significantly improves your chances of securing appropriate coverage.
Step 2: Consult an Expert
Professional brokers with experience serving newcomers can help navigate the options, compare offers, and avoid costly mistakes. Do not rely solely on comparison portals; personalized advice ensures optimal coverage.
Step 3: Apply for Coverage
The application process varies by insurer. For expat insurance, coverage can be immediate; for public plans, proof of insurance is often available same-day, with cards arriving in a few weeks. Private plans may require health checks and take around two weeks to process.
Step 4: Gather Necessary Documents
Once insured, you’ll receive:
- Health insurance card: Needed for doctor visits and proof of coverage
- Membership confirmation (Mitgliedsbescheinigung): For visas and residence permits
- Social security number: Required by employers; private plans may not issue automatically
Ensure your insurance covers your arrival date and upload all necessary documentation when applying for your visa.
Step 5: Pay Premiums Monthly
Public insurance deducts contributions directly from your salary. Private plans and self-employed individuals pay via bank transfer. Regular payments are essential to maintain coverage.
Next Steps and Additional Tips
- Inform your employer of your insurance status and updates
- Open a German bank account to facilitate payments
- Consider additional coverage, such as liability or disability insurance
- Always verify your insurance’s validity for visa renewal or extension
- Keep copies of your insurance documents for travel and official procedures
Need Assistance?
Consulting an experienced insurance broker can simplify your decision-making process. They will analyze your profile, compare options across multiple providers, and help you choose the best plan. Many brokers, like Feather, specialize in serving newcomers and speak English, making the process smoother.
Before making your final choice, always verify that your selected insurance complies with German immigration requirements and provides adequate coverage for your needs. Remember, selecting the right health insurance from the start can save you time, money, and stress during your stay in Germany.