Health Insurance in Germany (2024)

The German healthcare system has long been considered one of the best in Europe and is certainly the oldest of its kind.When it comes to funding, the model for medical insurance in Germany is a multi-payer system, funded by the government, employers, and private individuals. Most residents including foreigners are enrolled in the public healthcare system, but around 10% choose private medical care.

This article will give you an overview of the German health insurance system and will cover more specific topics such as the costs of health insurance, how sick days work, and what is the difference between statutory and private ones.

German Healthcare System Overview

It is mandatory by law for all residents and visitors in Germany to have some sort of healthcare cover, whether that’s statutory public healthcare, private healthcare, or some other valid form for short-term visitors. You must have health insurance in Germany, no matter whether you are unemployed or employed.

When it comes to health insurance, Germany may seem to have a complicated system, but in fact, it's much more straightforward than it first appears.

How does German health insurance work?

There are two health insurance systems: the public and the private health insurance.

The vast majority of residents in Germany are part of the statutorypublic healthcare insurancesystem (Gesetzliche Krankenversicherung, GKV) whereby contributions from employers and employees are paid via social security payments. This is paid to one of the main public healthcare insurers, such as our partner Techniker Krankenkasse (TK), which hospitals and doctors make claims to whenever their services are used. The public healthcare system is heavily subsidized by the German government.

Some can choose between public and private health insurance. If you’re eligible forprivate healthcare insurance (Private Krankenversicherung, PKV) such as our partner ottonova (e.g. as an international student), you can access the same services and doctors, as well as some private-only doctors and hospitals.

Healthcare in Germany is excellent, and those who use the public system ultimately receive a similar level of care as those who use the private system; however, those on a private insurance package may also be able to access additional healthcare add-ons such as advanced dental treatment or private doctor’s offices and hospitals.

What is the difference between private and public health insurance in Germany?

The main differences between public and private healthcare is the health coverage it offers, how it is paid for and who’s eligible for it.

Here are some of the differences between public and private health insurance at a glance:

Public health insurance:
• Almost everyone can take out public insurance.
• Your contribution depends on your salary: the more you earn, the more you must pay (up to a maximum rate).
• If you earn over €62,100, premiums can reach up to €1,050 a month for self-employed and €541 for employees.
• Medical providers bill the public insurance directly.
• Coverage can be canceled by the government.

Private health insurance:
• Employees with a salary above the annual income threshold of €69,300, self-employed persons, civil servants, and students are eligible for private insurance.
• Your monthly premium does not depend on your salary.
• Premiums depend on your health status, the desired scope of benefits, and your age of entry.
• Medical providers bill the insured person, and they submit the invoice afterward and get reimbursed by the private health insurance.
• Coverage can be more extensive (e.g., visual aids, single or double room in the hospital, dental care)
• Benefits are guaranteed for the entire duration of your contract.

Find out more about private insurance on ourPrivate Healthcare in Germany page.

What is statutory health insurance in Germany?

Around 90% of the German population use public healthcare. Any employee earning under €69,300 a year will automatically be enrolled for this kind of health insurance.

The premium for public healthcare is paid for by a combination of employee and employer contributions. A part of the employee's gross wage, totaling 14.6%, plus an average extra contribution of 1.7% (which varies depending on the provider), and possibly up to 4% for long-term nursing care insurance (for individuals over 23 without children), is deducted for your public healthcare.

If you are an employee of a company, you are entitled to employer contributions. However, if you are self-employed, you pay the whole amount by yourself. The coverage you recieve is the same for you regardless of whether you are a self-payer or not.

Although enrolment in the public scheme is mandatory for most, individuals can still choose from different health insurance providers (called Krankenkassen).

Find out more about statutory health insurance on ourPublic Healthcare in Germany page.

How does private health insurance in Germany work?

Employees earning above €69.300, freelance workers, self-employed people, civil servants, and students have the option to choose private healthcare insurance instead.

Private healthcare may also be paid for by a combination of employer and employee contributions (in the case of employees and civil servants; self employed pay as well the whole premium themselves). The premium is not calculated based on your income but on your age, your health status, your chosen tariff, and the coverage that you get.

So, with private health insurance, you can choose the level of your health coverage, which is often more extensive in many cases, like dental care, visual aids, or free choice of doctors and hospitals.

Find out more about private insurance on our Private Healthcare in Germany page.

Do I need health insurance in Germany?

Yes, it is compulsory for every resident in Germany to be covered by healthcare insurance. As well as public and private healthcare, health insurance coverage for EU citizens living in Germany for the short term can come in the form of anEHIC(European Healthcare Insurance Card) issued from an applicable EU country.

Health insurance coverage for non-EU citizens can sometimes take the form of private healthcare cover from your home country, but you will need to check that your plan covers you for living in Germany and for accessing German healthcare services.

How to get health insurance number and card in Germany?

Once you have started contributing to the public healthcare system, you will receive ahealthcare insurance number and card(Krankenversichertenkarte). You will need to take this card along to all appointments because the doctor's office bills the insurance company directly

If you’ve signed up for private health insurance, you will receive an individual insurance number as well but don't worry if you do not get an insurance card. Since you are billed as a private patient yourself by the doctor’s office, you will then submit the invoice to your private health insurer.

What is the cost of health insurance in Germany?

The premiums for private health insurance are not based on your income but on your age, your health, and your chosen coverage. So, the cost of healthcare in Germany for those who choose private cover can differ.

Public healthcare contributions, on the other hand, start for employees at 7.3% of your gross salary, which is matched by your employer to make up a total of almost 15%. Those in employment also automatically pay an individual surcharge depending on the chosen public health insurance, as well as a compulsory nursing care contribution (Pflegepflichtversicherung) of around 2.5-4%, which is intended to cover the cost of care in later life.

For students aged over 23 and under 30, publich health insurance with long-term care costs €125.21 a month, regardless of your level of income. EU students may be covered by their EHIC card, but they have to exempt themselves by providing a letter from a public health insurance fund. Students between 23 and 30 years old with a child, and students under 23 pay €120.34 for public health insurance and the long-term care.

The costs for private health insurance plans vary from provider to provider. With our partner ottonova you can take out private health insurance for students incl. long-term care without deductible starting at 111€ (depending on your age and health status.)

Health insurance for international students

You can organize your student public or private healthcare plan quickly and conveniently with Expatrio. Find out more about your options for student health insurance with our partner TK or ottonova on ourHealth Insurance for Students page.