Health Insurance Requirements for Foreign Workers in Germany

No matter personal circumstances every foreign worker must get proper health insurance coverage to be allowed to live and work in Germany.

Existing laws related to insurance clearly specify that everyone willing to enter and reside in Germany must be properly health insured beforehand and foreign workers make no exemption.

As one of the strongest economies in the world, Germany is the most precise description of how a perfect working environment looks like. Salaries are high and prospects of career development are just limitless. Working facilities and overall conditions are above excellent while security is never a thing to stress about. It is therefore clear why many thousands of foreigners head toward Germany each year to find a job or start a professional career.

Despite that working conditions in Germany are above global standards, workers are continually exposed to various unexpected (and often hard to avoid) risks in their workplace and elsewhere. That in mind, getting health insurance is always a decision that pays for itself.

It is surely a well-known fact that Germany prides one of the highest developed health care systems. However, it’s quite normal for young expats to lack a proper understanding at the beginning. Below is a detailed explanation concerning health insurance for foreign workers in Germany.

There are two types of health insurance in Germany

  • Public health insurance GKV.
  • Private Health Insurance PKV.

Among others, the German health care system is distinguished for its flexibility thus allowing residents to get a combination of two types of health insurance given above.

Foreign workers are not found among expats who are exempted from the German public health insurance scheme. According to existing laws in Germany, every foreign worker is by default entitled to public health insurance. Private health insurance, on the other hand, becomes an available option if the person meets specific criteria mainly having to do with his/her yearly income.

As it stands, everyone who earns above €60,750 annually has the opportunity to switch to private health insurance. One must note that even in that situation membership at statutory health insurance can be kept on a voluntary basis.

The public health insurance system in Germany is built upon the principle of solidarity. This means every participant shares the same proportion of their net income to contribute to common insurance funds and everyone enjoys the same medical benefits.

How much does public health insurance cost in Germany?

Foreign workers are charged the same insurance premiums as everyone else undertaking public health insurance in Germany. Currently, everyone who is insured under a recognized public health insurance scheme in Germany is required to share 14.6% of his/her net salary. This amount of money is collected equally from the German employer and his/her foreign worker.

Let’s say a foreign worker has found a job in Germany and has a monthly salary of €4,500. In that case, it means €660 of his/her total earnings will be allocated for public health insurance.

In recent years the cost of public health insurance in Germany has been regularly increasing mainly due to continual demographic expansion and medical cost inflation. Consequently, many insurance providers (Krankenkasse) fell short on funds and unable to cover the ever-growing medical needs of their clients.

Due to this, public health insurers in Germany were given permission early in 2019 from the government to charge a small supplemental rate to fill their budgetary vacancies. The cost of this small charge ranges from 0.9% to 1% of clients’ net salary and is not always required.

Nursing Medical Care Insurance (Pflegepflichtversicherung)

In addition, German insurance laws foresee that every public health insurance plan must necessarily include nursing medical care insurance too. 

Oftentimes people get sick or seriously injured during accidents and proper assistance by professional medical practitioners is vital for their health. In situations where an individual in Germany has unbearable difficulties to carry out his/her daily activities, then the nursing care will be provided.

Essentially, the eligibility for nursing care is determined by taking into account the person’s inability to

  • Maintain his/her personal hygiene.
  • Eat.
  • Move freely.
  • Housekeeping.

So far the cost for nursing care insurance accounts for 3.05% of one’s net monthly salary. The percentage share to nursing care scheme increases to 3.3% if the insured person has no children.

What does public health insurance cover in Germany?

In addition to making it mandatory, German insurance law also obligates insurance companies to provide coverage and benefits above a certain minimum limit.

The medical services foreign workers receive while having proper public health insurance:

  • In-patient hospital care
  • Out-patient hospital care
  • Costs for prescription drugs
  • Regular medical check-ups
  • Mental health care rehabilitation
  • X-rays screenings
  • Basic dental care
  • Pregnancy
  • Ambulatory medical assistance

In addition, people in Germany undertaking recognized public health insurance can get a few other medical services while paying only for a certain proportion of its total cost.

Similar to everyone entitled to the public health insurance scheme, if a foreign worker seeks medical treatment within a quarter of the year he or she must pay €10 whatsoever. If medical treatment is needed more than once for this period of time, patients pay only once, whereas if no treatment is required they won’t have to pay anything.

How do providers collect contributions from foreign workers?

Foreign workers don’t have to reach the public health insurance provider each month to pay for their insurance plan. The whole process is carried between the employer and that particular insurance company.

Usually each month a foreign work is paid by his/her German employer the amount of money dedicated to public health insurance is subtracted from his/her total earnings.

Which health insurance provider to get?

The governmental health insurance scheme in Germany is governed by federal authorities and administered by around 110 health insurance providers (Krankenkasse). Normally, employers in Germany take care of getting their foreign employees properly insured, but in the end, it’s upon each one’s own decision to choose to which company they want to get health insurance.

The number of insured clients at some public health insurance providers in Germany is as high as a few million while most of them count only a few thousands of subscribers. However, all insurance providers are legally obligated to meet specific requirements in terms of coverage.

Therefore, one should not necessarily base his/her selection entirely on popularity. Instead, foreign workers must collect specific information concerning coverage, monthly premiums and certain benefits.

Foreign Public Health Insurance in Germany

Foreign workers who are insured under public health insurance taken in an EU or EEA country, they’re going to enjoy the same coverage and benefits while working in Germany. In addition, Germany runs social security agreements with several other countries which obligate both parties for bilateral recognition of public health insurance scheme.

Except for the EU, Norway and Switzerland, public health insurance taken in the following countries are recognized in Germany:

Bosnia and Herzegovina, Iceland, Israel, Liechtenstein, Morocco, Macedonia, Montenegro, Serbia, Tunisia and Turkey.