Germany is renowned for its exemplary healthcare system, emphasizing comprehensive coverage and accessibility for its residents. Central to this system is health insurance— mandatory for every citizen and resident—a key component ensuring individuals have access to quality medical services without overwhelming expenses.
If you are planning to move to Germany, it’s important to understand the country’s health insurance system’s intricacies and enrollment requirements. As a mandatory provision, health insurance is a fundamental aspect of living in Germany and is essential for accessing healthcare services.
How Does the German Healthcare System Work?
The German healthcare system uses a mixed model combining public and private elements. It is based on mandatory health insurance, with coverage provided by either statutory health insurance (Gesetzliche Krankenversicherung) or private health insurance (Private Krankenversicherung). Statutory health insurance is compulsory for employees below a certain income threshold, while private health insurance is available for self-employed individuals and higher-income earners.
Both types of insurance offer comprehensive coverage for medical services, including primary care, specialist consultations, hospitalization, prescription medications, and preventive care. The system is funded through employee, employer, and government contributions. Individuals have the freedom to choose their healthcare providers, and there is a strong emphasis on preventive care and patient education.
| Did you know that the German health care system covers more than 80% of the pharmaceutical costs of its residents, making it the second most generous in the EU after Luxembourg? |
What Is Statutory Health Insurance?
Statutory health insurance (Gesetzliche Krankenversicherung–GKV) or public health insurance is a type of health insurance in Germany that provides mandatory coverage for most of the population. Statutory health insurance is highlighted by solidarity, as all members pay a percentage of their income as contributions. The contribution amount is income-dependent and is typically split between the employee and the employer. This ensures that healthcare is accessible and affordable for individuals across different income levels.
Under statutory health insurance, individuals are entitled to various medical services, including primary care, specialist consultations, hospitalization, prescription medications, and preventive care. The coverage extends to necessary treatments, procedures, rehabilitation, and long-term care services.
However, certain categories of individuals, such as higher-income earners or self-employed individuals, can opt out of statutory health insurance and choose private health insurance instead.
Who Is Eligible?
The following categories are legally required to be covered by German statutory health insurance:
- Employees whose income falls below a certain threshold (currently around €69,300 per year in 2024). This includes both full-time and part-time employees.
- Students up to the age of 30 who are enrolled in state-recognized educational institutions and do not have regular income exceeding the income threshold. Different rules may apply after the age of 30 or upon completion of studies.
- Individuals undergoing vocational training, such as apprenticeships.
- Family members of individuals covered by statutory health insurance, such as spouses and children.
What Does It Cover?
The services mentioned below are legally mandated to be included in statutory health insurance coverage in Germany:
| Primary care | General practitioner (GP) consultations, check-ups, and basic medical treatments. |
| Specialist care | Consultations and treatments provided by medical specialists, such as dermatologists, cardiologists, or gynecologists. |
| Hospitalization | Inpatient treatment and care in hospitals, including surgeries, diagnostic procedures, and rehabilitation services. |
| Prescription medications | Medications prescribed by healthcare professionals, subject to reimbursement regulations and coverage restrictions. |
| Preventive care | Preventive screenings, vaccinations, and health promotion programs aimed at early detection and prevention of diseases. |
| Maternity and childbirth | Prenatal care, delivery, and postnatal care for expectant mothers. |
| Rehabilitation | Rehabilitation services, including physiotherapy, occupational therapy, and speech therapy. |
| Mental health | Outpatient and inpatient treatments for mental health conditions, including therapy and psychiatric care. |
| Medical aids and devices | Coverage for necessary medical aids, such as prosthetics, orthotics, hearing aids, and mobility aids. |
| Dental care | Basic dental treatments include check-ups, cleanings, fillings, and extractions. |
What Is Not Covered?
The following medical services are usually not covered by statutory health insurance or are partially covered:
| Certain dental treatments | Extensive procedures like orthodontic treatment or cosmetic dentistry may not be fully covered by statutory health insurance and may require the patient to fully or partially pay for the services. |
| Alternative and complementary therapies | Public health insurance may not fully cover services like acupuncture, homeopathy, or naturopathy. Still, some insurance funds may offer partial coverage for specific alternative therapies. |
| Private hospital rooms | While public health insurance covers necessary hospitalization, opting for a private room or additional amenities in a hospital may require out-of-pocket expenses. |
| Non-prescription medications | Over-the-counter medications are generally not covered by public health insurance. Still, reimbursement regulations and coverage restrictions cover prescription medications prescribed by healthcare professionals. |
| Certain medical aids and devices | Basic medical aids such as prosthetics, orthotics, or hearing aids are covered. Still, some specialized or high-end devices may require additional coverage or out-of-pocket expenses. |
| Cosmetic procedures | Cosmetic surgeries or treatments performed for aesthetic purposes are typically not covered by public health insurance. |
How Much Is It?
The cost of public health insurance in Germany is typically based on a percentage of an individual’s income and, as of 2023, is set at a rate between 14.6% to 15.6%— depending on your salary. This percentage is shared between you and your employer, but if you are self-employed, you cover the entire cost alone.
Here is an example of premium costs for an individual who earns €3,900 each month charged by some public health insurance companies in Germany:
| Health Insurance Provider | Contribution rate 2023 | Supplemental Rate 2023 | ||
| Percentage (%) | Euros (€) | Percentage (%) | Euros (€) | |
| TK | 14.6% | €570 | 0.70% | €27 |
| BARMER | 14.6% | €570 | 1.10% | €43 |
| DAK Gesundheit | 14.6% | €570 | 1.50% | €59 |
| AOK Bayern | 14.6% | €570 | 1.10% | €43 |
| IKK classic | 14.6% | €570 | 1.00% | €39 |
| KKH | 14.6% | €570 | 1.50% | €59 |
| KNAPPSCHAFT | 14.6% | €570 | 1.10% | €43 |
| SBK | 14.6% | €570 | 1.30% | €50 |
| BKK Mobil Oil | 14.6% | €570 | 1.10% | €43 |
| Audi BKK | 14.6% | €570 | 0.70% | €27 |
What Is Private Health Insurance?
In Germany, private health insurance (Private Krankenversicherung- PKV) is an alternative to mandatory health insurance. It is a voluntary form of coverage available for individuals not required to participate in statutory health insurance, such as higher-income earners, self-employed individuals, civil servants, and certain professional groups.
Private health insurance operates on an individual contract basis, allowing policyholders to enter into personalized agreements with specific private insurance providers. Premiums for private health insurance are typically determined based on factors like age, health condition, and desired coverage, with younger individuals often benefiting from lower premiums. Private health insurance offers a wide coverage range, including additional services, alternative treatments, and access to private hospitals or specialized medical providers.
Who Is Eligible?
The following categories are eligible for coverage with private health insurance in Germany:
- Individuals exceeding the income threshold set for mandatory statutory health insurance.
- Self-employed individuals, including freelancers and entrepreneurs, regardless of their income.
- Students above the age limit for mandatory statutory health insurance (typically 30 years old) or who have private insurance as dependents of their parents.
Click here to check your eligibility and get a quote.
What Does It Cover?
The following are usually covered by private health insurance:
| Consultations and Examinations | Private health insurance often cover a wide range of medical treatments, including consultations, examinations, and diagnostic procedures. Both general practitioners and specialists can conduct these. |
| Surgeries and Hospitalization | Private health insurance typically provide coverage for various surgical procedures, both elective and necessary, as well as hospitalization costs for inpatient care. This includes access to private rooms or enhanced hospital accommodation. |
| Prescription Medications | Private health insurance policies generally include coverage for prescription medications prescribed by healthcare professionals, subject to the terms and conditions of the specific policy. |
| Dental Treatments | Depending on the policy and chosen coverage options, private health insurance may offer coverage for various dental treatments, including preventive care, fillings, extractions, and more extensive procedures. |
| Alternative and Complementary Therapies | Some private health insurance plans cover alternative and complementary therapies, such as acupuncture, homeopathy, or naturopathy, depending on the policy and specific coverage. |
| Additional Benefits | Private health insurance policies may offer additional benefits such as coverage for travel vaccinations, preventive screenings, health check-ups, and access to specialized clinics or medical centers beyond standard treatments. |
What Is Not Covered?
The services below are usually not covered by private health insurance in Germany:
| Pre-existing conditions | Private health insurance may exclude coverage for pre-existing conditions, which are health conditions that existed before obtaining the insurance policy. |
| Cosmetic procedures | Cosmetic surgeries or treatments performed for aesthetic purposes are generally not covered by private health insurance. |
| Experimental or investigational treatments | Private health insurance may not cover treatments that are still experimental or investigational and not widely accepted or proven effective. |
| Long-term care | Coverage for long-term care services, such as nursing home care or assistance with activities of daily living, may be limited or require separate insurance. |
| Certain alternative therapies | Coverage for alternative and complementary therapies may vary, and not all therapies may be fully covered under private health insurance. |
| Travel-related medical expenses | Private health insurance may not cover medical expenses incurred while traveling outside of Germany. Separate travel insurance is recommended. |
How Much Is It?
Unlike statutory health insurance, which is income-based, private health insurance premiums are determined based on individual risk factors— here are some possible prices of private health insurance in Germany based on your age:
- For younger individuals (under 30 years old)— monthly premiums for private health insurance typically start around €100. Depending on the desired coverage level and individual circumstances, they can go up to €300 or more.
- For individuals between 30 and 50— monthly premiums may range from €200 to €500 or more, depending on factors such as health condition, coverage level, and insurance provider.
- For individuals over 50 years old— monthly premiums may start around €400 and increase to €800 or more, depending on various factors. Premiums generally increase due to higher health risks associated with age.
You can always refer to a private health insurance calculator here, to get a better understanding of how much health insurance will cost you in Germany. Additionally, for affordable plans, popular private insurance companies like Dr. Walter and Feather Insurance offer competitive options tailored to your specific needs.
Germany Health Insurance for Foreign Workers
Foreign workers in Germany are subject to similar rules as citizens regarding health insurance. If their income exceeds the salary threshold, they can opt out of public health insurance and instead purchase a foreign workers’ private insurance policy. On the other hand, if their income falls below the threshold, they are automatically covered by public insurance.
Typically, the registration process is facilitated by the employer who signs up their employees for social contributions. However, it’s important to note that foreign workers can choose their insurance provider. This allows them to select a health insurance company that best suits their needs and preferences.
Read more about health insurance for foreign workers in Germany.
Germany Health Insurance for Students
Health insurance is mandatory for foreign students studying in Germany. Most foreign students are eligible for statutory health insurance, which offers comprehensive coverage for medical services. They can enroll in public health insurance through a German provider or use insurance from their home country. Statutory health insurance covers doctor’s visits, hospitalization, prescription medications, and preventive care. The cost is typically affordable, based on a percentage of their income.
Private health insurance plans tailored specifically for students may be an option for those without statutory insurance or who prefer additional benefits. It is important for foreign students to understand the health insurance requirements and explore suitable options to ensure they have the necessary coverage during their studies in Germany.
Read more about health insurance for international students in Germany.
Health Insurance for Au Pairs in Germany
Au pairs in Germany are generally not eligible for statutory health insurance. Instead, they are typically required to obtain private health insurance coverage during their stay, normally purchased by their host family. Au pairs must obtain private health insurance that meets the requirements and provides comprehensive coverage for their healthcare needs.
Some popular insurance providers that offer coverage for au pairs in Germany include Dr. Walter and Feather Insurance. These companies have established a strong reputation for providing reliable insurance solutions, making them popular among au pairs seeking quality healthcare coverage.
Read more about health insurance for au pairs in Germany.
Germany Health Insurance for Refugees and Asylum Seekers
Asylum seekers awaiting a decision and recognized refugees typically have access to public health insurance, which provides coverage for a wide range of healthcare services. Refugees and asylum seekers must register with the relevant authorities and obtain the necessary health insurance coverage to ensure they can access the full spectrum of healthcare services they need.
Read more about health insurance for asylum seekers and refugees in Germany.
Best Health Insurance Companies in Germany
Here are some of the best insurance companies in Germany:
Public health insurance companies:
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- AOK (Allgemeine Ortskrankenkasse).
- Techniker Krankenkasse (TK).
- Barmer.
- DAK-Gesundheit.
- KKH Kaufmännische Krankenkasse.
- BARMER GEK.
- IKK Classic.
- hkk Krankenkasse.
- HEK – Hanseatische Krankenkasse.
- KNAPPSCHAFT.
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Private health insurance companies:
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- Allianz Private Krankenversicherung.
- AXA Krankenversicherung.
- Debeka Krankenversicherung.
- DKV Deutsche Krankenversicherung.
- Dr. Walter
- Continentale Krankenversicherung.
- HanseMerkur Krankenversicherung.
- HUK-Coburg Krankenversicherung.
- Gothaer Krankenversicherung.
- LVM Krankenversicherung.
See the full list of health insurance providers in Germany.
Germany Healthcare System Pros and Cons
While it is world-renowned, Germany’s healthcare has its cons and pros:
| Pros | Cons |
| Universal coverage for all residents. | Long waiting times for non-emergencies. |
| High quality of care. | Bureaucratic administrative procedures. |
| Comprehensive benefits coverage. | Regional disparities in access to care. |
| Patient choice in selecting providers. | Rising healthcare costs. |
| The option to have private insurance | Limited private insurance eligibility. |
What to Do in an Emergency?
If you have a medical emergency in Germany, it’s important to remain calm and dial the emergency number 112 for ambulatory and emergency services or 110 if you need the police.
The emergency response system is well-developed and can effectively handle various medical emergencies. Emergency services in Germany are equipped to provide prompt and effective care, whether it’s a severe injury, sudden illness, or any other urgent situation.
Does Germany Have Free Healthcare?
In Germany, healthcare is partially free due to the social contributions to the public healthcare system. This means that individuals can receive medical services free of charge for the most part. However, some low copayments apply, such as the €10 charge for a visit to the general practitioner (GP) every quarter.
These nominal fees help ensure the sustainability of the healthcare system while still maintaining accessible and affordable healthcare for individuals in Germany. Therefore, while most medical services are provided without direct costs, some low copayments may apply as a contribution towards the overall healthcare expenses.
Can I Have Both Public and Private Health Insurance in Germany?
If specific conditions apply, you can have both public and private insurance. Individuals in Germany who exceed the income threshold can remain covered by public insurance while obtaining private insurance. Additionally, self-employed individuals can enroll in public insurance but must pay the full healthcare contributions themselves. This allows for dual coverage and provides flexibility for accessing additional benefits through private insurance while maintaining coverage from the public system.
Can I Choose My Doctor in Germany?
Yes, individuals in Germany have the freedom to choose their own doctors and healthcare providers.
How Do I Find a Doctor or Healthcare Provider in Germany?
You can usually search for a public healthcare provider here, for private doctors and hospitals, you may be required to turn to your local directories or immigration office to help you.
Are Mental Health Services Covered by Health Insurance in Germany?
Yes, mental health services are typically covered by health insurance in Germany, including outpatient and inpatient treatments.
Are Pre-Existing Conditions Covered in Germany?
Health insurance providers in Germany are legally required to provide coverage for individuals with pre-existing conditions, although certain waiting periods or exclusions may apply. It is important to review the policy terms for precise information. You may also notice that pre-existing conditions may not be covered by private insurance, or those policies are more costly.