Public insurance
How does the public insurance work?
Solidarity is a basic idea of the public health insurance (called GKV). This means that everyone in the community helps each other. The GKV is described as a solidarity community (§1 SGB V), and the costs of health insurance are shared together fairly (§3 SGB V).
The way public health insurance (GKV) is paid for is very different from private health insurance (PKV). With private health insurance, the cost depends on your own health risks, and you pay a premium based on that. But with public health insurance, the money comes from contributions shared by both you and your employer. These contributions are based only on your income, not on your gender, age, or health. The fee for public insurance is linked to your gross income (your income before taxes). Insurance companies charge a basic rate of 14.6% plus an extra 1.3% of your gross income, but only up to a monthly income of €4,600. For nursing care, the cost is either 3.055% or 2.8% of your gross salary, and if you have no children, there is a maximum monthly cost of €123. Your employer pays up to €56 of this. Usually, you and your employer each pay half of the charges, which means 7.3% each.
Public health insurance – what does it cover?
The minimum threshold all health insurance coverage in Germany has to include:
- in-patient (hospital) care as a ward patient
- out-patient care from a general practitioner or medical specialist (such as a cardiologist)
- prescription drugs
- pregnancy care
- basic dental care
- statutory sick pay when the employer’s duty to pay it is over (up to 90 per cent of your net salary)
Public insurance also includes mandatory long-term care insurance (called Pflegepflichtversicherung), which helps pay for care if you need support with daily activities over a long time.
Also, all family members who do not work, such as your spouse, civil partner, and children (up to a certain age), and who live with you in Germany, are covered by your public health insurance at no extra cost. They just need to be registered with the same health insurance company as you.
Although public health insurance in Germany covers many medical services, some extra care may cost you more money. So, it is important to understand what your insurance covers. For example, basic dental care is included, but cosmetic teeth cleaning might require an extra payment.
Germany has more than 100 different public health insurance companies. They mainly differ in extra charges and the services they cover. Because of this, we want to help you choose the best health insurance provider that fits the needs of you and your family.
Private insurance
For who could the private system be of interest?
Private health insurance offers very good coverage. For some people, it can also be the cheaper choice. The cost you pay depends on your age when you join, your health, and how much coverage you want.
If you have private health insurance, you are treated as a private patient and can expect better service from doctors. Private patients can often ask for doctors who speak their native language. About 40 German insurance companies offer private health insurance with different costs and benefits to fit most budgets. The price you pay depends on how much coverage you want, your age when you join, and any health problems you already have. Since 2010, up to 80% of private health insurance costs 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 insurance if your gross salary is more than 64,350 Euros per year (based on 2021 data). People who work for themselves, German civil servants, and those who work part-time earning less than 450 Euros per month (called a mini-job) can also choose private insurance.
It is important to know that public health insurance covers your family members too, but private health insurance does not always do this. So, if you choose private insurance, you should carefully check the details. You might need to get a separate insurance plan for your family.
Depending on your job, it is very important to get advice made just for you. Jobs like doctors, lawyers, and others have more benefits that let them choose private health insurance. Why is that? We are happy to explain this to you in more detail!
Private vs public health insurance in Germany – key differences
| Public health system | Private health system |
| Obligation to accept each individual | Freedom of contract & free competition of companies |
| Income related fee based on pay-as-you-go system | Risk adequate premium |
| Standardized health plan defined by law | Individual agreement of scope of services |
| Benefit in kind principle | Refund of expenses principle |
Supplementary private insurance
If you have public health insurance by choice, or if you do not qualify to have private insurance for yourself or your family, you can improve your public health insurance by adding extra insurance plans called supplementary insurances. Supplementary insurances cover the missing parts of public health insurance, both in the types of treatment you get and in the costs you have to pay. This way, you can choose extra coverage that fits your needs best. With these supplementary insurances, you can have coverage that is almost as good as private health insurance.
What do the supplementary insurances cover?
- Check-ups and screenings are limited in form and frequency. Should you wish for better or more frequent care you have to pay for it privately
- One or two-bed (single or double) rooms for inpatients in hospitals
- Treatment by chief or consultant doctors
- Sick pay, after 6 weeks
- Prescribed medications are solely generic drugs and for these you also have to pay between €5 and €10 per prescription (excluding children up to a certain age) as a publicly insured individual
- Alternative medicine and natural remedies
- The costs of dental treatment and prostheses that are not covered by the public health care
- Visual aids, such as glasses and contact lenses, are not paid unless you have a serious eye condition