Germany has a very complex social security system that offers many benefits. This system is special because it includes five types of social insurance: health insurance, care insurance, pension insurance (retirement money), accident insurance, and unemployment insurance. However, some parts of this system need to be understood carefully. People who come from other countries, speaking a different language and with a different culture, can feel overwhelmed by all the new information when they first arrive in Germany. Did you know that Germany has two types of health insurance? Many people do not know this. Life would be easier if you had a knowledgeable partner nearby who can explain the two systems (public and private health insurance), give you the right information, and help you make good decisions. This is why we are here—to give you advice and help you choose the right health insurance for your personal situation.
Public insurance – how it works
Solidarity is the main idea behind public health insurance (called GKV). This means that everyone in the GKV system helps each other. It is described as a community where people support one another (§1 SGB V) and where health insurance is paid for together in a way that shares the costs fairly (§3 SGB V).
The way public health insurance (GKV) is paid for is very different from private health insurance (PKV). In private health insurance, the costs depend on each person’s health risks, and people pay premiums (regular payments) based on that. In public health insurance, both the employee and the employer pay contributions together. These payments depend only on how much money the person earns, not on their gender, age, or health. The payments are based on the person’s gross income (the total money earned before taxes). Each public health insurance provider, called Krankenkasse, charges a basic rate of 14.6% of the monthly gross income. They also add an extra charge that can be between 0.3% and 1.6%. Everyone in Germany also has to pay for public care insurance, called Pflegeversicherung. This costs 3.05% of the gross salary if you have children, or 3.30% if you do not have children. These percentages are only applied up to a monthly income of 4,837.50 Euros.
For example, an expat who earns 5,000 Euros per month and has no children pays public health insurance with an extra charge of 1.3%. As an employee, he pays 384.58 Euros for health insurance and 85.87 Euros for care insurance. The total amount he pays is 470 Euros.
What does public health insurance cover?
All health insurance in Germany includes at least the following basic coverage:
- Care in the hospital where you stay in a shared room with other patients (called a ward).
- Care from a general doctor or medical staff without staying in the hospital.
- Medicine prescribed by a doctor that you can get from a pharmacy.
- Medical care and support during pregnancy.
- Basic dental care, such as regular check-ups and simple treatments for your teeth.
- Paid leave by law, where you receive up to 90 percent of your take-home pay (net salary) when your employer does not have to pay you anymore.
In addition, if you are unemployed or if your spouse, civil partner, and children live with you in the same home in Germany, they are covered by your health insurance plan at no extra cost. They must be registered with the same health insurance provider as you.
Although public health insurance in Germany covers many medical services, some extra care may cost more money. That is why it is important to know what your insurance plan includes. For example, basic dental care is covered, but cleaning your teeth for beauty reasons may require you to pay extra.
Right now, there are more than 100 different public health insurance providers in Germany. They mainly differ in the extra charges they ask for or the benefits they offer. We can help you choose the health insurance provider that best fits your personal needs and situation.
How does private insurance work?
Private health insurance gives the highest level of coverage. For some people, this is the most cost-effective choice. The cost of the premium (regular payment) depends on your age when you join, your health, and the level of coverage you choose.
If you have private health insurance, you are treated as a private patient. This means you can expect better service from doctors. You can even ask for a doctor who speaks your native language, and often this is possible. About 40 German insurance companies offer private health insurance. They have different prices and benefits to fit most budgets. The cost of full private health insurance depends on the benefits you choose, your age when you start, and any existing health problems. Since 2010, up to 80% of private health insurance premiums (regular payments) can be deducted from your German income taxes.
You might want to switch to private health insurance (called Private Krankenversicherung or PKV) instead of public health insurance if you earn more than 64,350 Euros per year before taxes (based on 2021 data). Self-employed people, civil servants, and those working part-time earning less than 450 Euros per month (called a “mini-job” in Germany) can also choose private insurance.
It is important to know that public health insurance also covers your family members. However, private health insurance does not always do this. If you choose private insurance, you must carefully check the policy. You may need to arrange separate insurance for your family members who depend on you.
What does private health insurance cover?
All health insurance in Germany covers up to a certain maximum amount for costs.
- Care in the hospital where you stay in a shared room with one or two other patients and are treated by a specialist doctor.
- Care from a general doctor or a top medical specialist, like a heart doctor (cardiologist), without staying in the hospital.
- Medicine prescribed by a doctor that is brand-name and not generic (not a cheaper copy).
- Medical care and support during pregnancy.
- High-quality dental care for your teeth and mouth.
- Care using alternative medicine methods, such as acupuncture (using small needles) and homeopathy (treatments using natural substances).
- Paid sick leave by law, where you receive 100% of your take-home pay (net salary) when your employer no longer has to pay you.
It is recommended to get professional advice because the rules and benefits can be different depending on your job. For example, IT consultants, engineers, and doctors often get more benefits with private insurance. We are happy to talk with you in detail about why this is and to help you use these benefits fully.
Private vs public health insurance in Germany – key differences
Supplementary private insurance
If you have public health insurance, either because you chose it or do not qualify for private insurance, you can protect yourself and your family by adding extra private insurance. These extra plans include additional outpatient care, hospital care, dental care, and paid leave coverage. These supplementary insurances help fill the gaps in public health insurance, both in the treatments covered and the costs. This way, you can cover extra needs that fit your situation. With these additions, you can get almost the same coverage as private health insurance.
What do the supplementary insurances cover?
- Check-ups and health screenings in public health insurance are limited in type and how often you can have them. If you want better or more frequent care, you must pay for it yourself.
- Hospital rooms with one or two beds where patients stay during treatment.
- Care and treatment provided by a specialist doctor or consultant.
- Paid leave you receive after your employer’s 6 weeks of payment have ended.
- Medicine prescribed by a doctor, which in public health insurance are usually generic drugs (cheaper copies). Because of this, you usually pay between €5 and €10 for each prescription, except for children.
- Care using alternative medicine and natural treatments, such as acupuncture or herbal remedies.
- Costs for dental treatments and artificial teeth (prostheses) that public health insurance does not pay for.
- Glasses and contact lenses are usually not paid for by public health insurance, unless you have a serious eye condition.
Would you like to know more? We are here to help you!