PRIVATE HEALTH INSURANCE

Private health insurance is mainly for those who work on a freelance basis. Premiums are calculated based on your age and other risk factors, and policies often are more comprehensive than public health insurance, covering extra things such as glasses and contact lenses. See the frequently asked questions below for detailed information.

What you need to know

What are the most important types of insurance to get in Germany?

In Germany, there are two types of insurance which by law are mandatory:

  • health insurance
  • liability insurance for motor vehicles.

If you are planning to spend more than six months in the country however, you will definitely also want to consider investing in a household/home insurance policy to indemnify any loss or damage of your belongings. You will find the answers to any potential questions you may have regarding these types of insurance below, including an extensive section on of health insurance.

In Germany it is also quite common to get private liability insurance (Haftpflichtversicherung), as this kind of insurance is inexpensive (100 € a year) but offers good coverage. It provides protection for you in case of any kind of accidental negligence that causes an accident or damage to property, like your washing machine leaking water into the floor of your apartment, for example. Any damage claims could potentially be high, so this inexpensive insurance is peace of mind for a modest price.

Why is it mandatory to have health insurance coverage in Germany?

Healthcare is considered to be extremely expensive in Germany, so one of your first priorities should be ensuring that you are covered for any medical eventualities. As of the 1st of January 2009, anyone who resides in Germany is required to possess health insurance coverage from a provider licensed within Germany. As health insurance is mandatory for all employees and students in Germany, you will be unable to start working or studying without it. An important component of any application for a residency permit is proof of health insurance.

Holders of the European Health Insurance Card (EHIC) are entitled to receive medical treatment under the same terms as German citizens. However if they plan to stay in the country longer than a year, it is highly advisable that they sign up for insurance with a local health insurance provider.

What are my options for health insurance in Germany?

Unlike in many other countries, in Germany public and private health insurance system work in parallel:

1. Public health insurance:

This is run by the German government. Most foreigners (and Germans) are obliged to take out public health insurance. Employees, their dependents, students and trainees normally join the public system. Public insurance payments are income-based and will be deducted from your paychecks by an employer, whilst any dependents (spouses or children) you may have will be covered for free. Public insurance is also ideal for those with pre-existing medical conditions, as by law they cannot be denied entry to Germany based on their condition.

2. Private health insurance:

This applies only to specific cases. Self-employed / freelancers or government employees usually join the private health system. Private insurance is based on your age and personal risk factors, so if you’re healthy and young this option may be cheaper. Coverage for dependent spouses or children requires additional payment, and those with pre-existing medical conditions may be declined coverage. Overall, private insurance offers a more extensive coverage, but it may not be advantageous to all cases.

Almost everyone is entitled to join the public health insurance scheme, however only few people are allowed to leave this system for private insurance. To find out which insurance scheme is best for you, we recommend that you:

  • Find out whether you are eligible to choose between private and public insurance. If you are only allowed to join the public system, it will be irrelevant for you to compare it with private insurance.
  • If you are allowed to use private health insurance, we advise you to still assess the advantages and disadvantages of both systems before you make a final decision.

For whom is public health insurance mandatory?

The following groups must be covered by State Health Insurance (gesetzliche Krankenkasse) in Germany:

  • Employees whose regular income exceeds € 450 per month before deductions, and remains below  € 4,463 per month. If you are employed and earning up to a gross salary of € 53,330 per year, you must be therefore be insured by a state health insurance company.
  • Students frequenting state and state-approved universities.The current premium for health and nursing care starts at € 78.50 per month for a local student over the age of 23 with no children. International students can benefit from a temporary private insurance plan from around 30 Euro a month in the first 18 months of their stay in Germany.
  • People on work experience (internships) or in secondary education.
  • Old-age pensioners who have taken part in a statutory health insurance scheme, or have been insured as a family member for the majority of the latter half of their working life.
  • Unemployed people who are receiving benefits from the Federal Employment Services (Bundesagentur für Arbeit).
  • More information: http://www.bmg.bund.de/krankenversicherung.html.

You may additionally, within a period of three months from your arrival in Germany, join a state health insurance scheme voluntarily if you:

  • Have previously been a compulsory member but your membership is now terminated, and you have specific certified insurance periods.
  • Are an employee and your income from your first employment in Germany exceeds the governmental yearly limit.
  • Are gravely disabled.
  • Have been insured through a family member for a specified minimum period and this insurance has expired.

*Students originating from countries with which Germany has concluded a social security agreement and  which includes a specific insurance clause, may continue to be covered by their home insurance company during their stay in Germany. For an updated list of these countries please visit: http://www.dvka.de/oeffentlicheseiten/Fremdsprachen/Englisch.htm

For more detailed information on statutory insurance in Germany please visit: www.bmgs.bund.de

How does the public health insurance system in Germany work?

Public health insurance is supplied by a network of non-profit companies which work together with the German state to administer the National Health program (Gesetzliche Krankenkassen).

Your public health insurance contributions will generally be calculated as a percentage of your average income. This percentage is capped at a certain income level which reflects the average national income in Germany. Fifty percent of the entire social security contribution (including health insurance) will paid by your employer, and fifty percent by you.

The insurance company you choose will issue you a health insurance card, which you will have to  bring with you whenever you visit a doctor, dentist or specialist. The service provided by public health insurance funds predominantly offers outpatient services, hospital care, pharmaceuticals and remedies & rehabilitation services. Those who are covered by this insurance scheme are entitled to any services and benefits within the legal parameters set by the German law.
There are no territorial limitations to receiving access to these benefits within Germany, but there are differences between the levels of service offered by individual health insurance funds.

Under public health insurance you are free to choose your own health care provider. All those insured will have access to any accredited health care providers (alternative health providers are not covered by statutory health insurance). Some of these are:

  • Doctors and Dentists: General Practitioners and specialists may be consulted, although usually your GP will be responsible for referring you as a patient to a specialist or hospital.
  • Hospitals: all levels of hospital are covered; hospital care is usually provided on referral by a GP or a specialist, or directly in case of emergency.
  • Pharmaceuticals and prescriptions medicine: these will be available in pharmacies, with co-payment according to package size.

Public health insurance will also cover any dependent children or spouse (with no income), at no extra cost.

*In addition to your public health insurance it will also be mandatory for you to subscribe to nursing care insurance. The nursing care insurance normally adheres to your health insurance scheme. The obligatory nursing care insurance contribution rate in 2014 is 2.3 % for any fund (with children 2.05 %). 50 % of this will also be paid by your employer.

For more information see: http://www.bmg.bund.de/krankenversicherung.html

Who can choose to opt for private health insurance and how does it work?

Anyone not belonging to the categories mentioned, and for whom public insurance is therefore mandatory, will be able to select a private insurance scheme. Private health insurance contributions will not be based on your income, but rather on your risk profile. Calculations are based on the average cost for medical treatment for different groups. Therefore the older you are, the higher your contributions will be. Contributions are always equally split between employer and employee, independent of whether you are in a private or public insurance scheme.

When privately insured, rather than being automatically covered, you will most likely be paying doctor’s fees and medicine costs and subsequently sending receipts to your insurance company for reimbursement.

Private health insurance schemes provide more extensive cover than public health insurance. You will often be offered the option of choosing private/semi-private hospitals, alternative therapies, glasses and contact lenses and any other treatments that may not be available under public health insurance.

At the doctor, privately insured patients will often receive preferential treatment compared to state insured patients, and with private insurance you won't be expected to pay any additional co-payments for medicines and treatments.

* Switching back from private to public insurance may be very difficult! Before you make this decision, you should therefore carefully consider whether this system would truly benefit you.

How can I choose the best health insurance for me?

There are an endless number of public and private insurance companies in Germany. Choosing the one that will suit you best will depend on which criteria you value the most e.g. price, coverage, family planning or preventative care. Below is a list of some of the most popular public and private health insurance companies to get you started:

Public Health Insurance Companies:

Private Health Insurance Companies:

Will my company/employer provide health insurance for me if I have a full-time job in Germany?

Yes. When you are a full-time employee in Germany, your company or employer will deduct your insurance payments from your paychecks as well as making an employer contribution. If you make above € 4,463 per month (for 2014) you will automatically go into the public system. How much your payments will amount to will be based on how much you earn. All you have to do is tell your employer which health insurance company you wish to use and they will register you with them.

 

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