A Guide to Health Insurance in Germany for Expats and International Students

Marle

Updated on Aug 11 • 6 minute read

Health insurance in Germany ranks #12 in the world. In fact, the Euro Health Consumer Index 2018 puts Germany on top because of its wide range of recovery measures. Best of all: as an expat working in Germany, you get full access to the healthcare system, just as every other German citizen does.

Before you set foot in Germany you’ll be faced with the decision of which health insurance to choose. No worries, we will guide you through the jungle of health insurance companies, explain how it works and what costs are involved, so you can easily choose your health insurance!

How does health insurance in Germany work?

Compared to countries such as the USA, health insurance is not an option but an obligation. Every citizen must have some form of health insurance – whether as a student, expat or child. The choice is yours: you can either register with the public health insurance (gesetzliche Krankenversicherung; short: GVK) or private health insurance (Private Krankenversicherung, short: PVK). A third option exists where you have a combination of public health insurance with supplementary private insurance.

Private health insurance versus statutory health insurance: Decisions, decisions, decisions

Decisions upon decisions: Which health insurance to choose? The answer is entirely up to you, but if we look at the current sentiment in Germany, it's striking that 90% of the country's residents rely on public health insurance.

This obviously does not necessarily mean that it’s the best match for you. However, if you’d like to choose private health insurance, there’s a number of criteria you’ll have to fulfill:

  • You are self-employed.
  • You are a civil servant
  • You earn more than the required salary threshold
  • You're not eligible for the public healthcare
  • You're a student with no access to your home country’s insurance

What’s the difference between private and public insurance, you wonder? Among other things, the bills for publicly insured persons go directly to their insurance company. Privately-insured persons must pay the amount beforehand and then receive reimbursement from the insurance company.

What’s covered by the health insurance?

With a statutory health insurance you are covered for the following events:

  • Medical examination by your registered doctor
  • Regular check-ups
  • Hospital Care (both in-and out-patient)
  • Basic dental treatment
  • Prescription drugs
  • Providing certified sick notes for your employer
  • Pregnancy care
  • Statutory Sick Pay (Once your employer’s duty of paying your wage up to 6 week is over, you’ll receive up to 70 percent of your net salary for a maximum of 78 weeks (over a three-year period))
  • Health insurance for non-working dependents living at your address (spouse, civil partner, children up to a certain age).

However, if you hold public health insurance, you’re not covered for these scenarios:

  • Consultation hours with private doctors
  • Private rooms in hospitals
  • Alternative treatments
  • Dental implants
  • or glasses/contact lenses for adults.

What does public health insurance cost?

Nine out of ten citizens in Germany are opted-in to the public health insurance system. In fact, any person in employment or vocational training (including traineeship or apprenticeship) and earning more than 56,250 euros (2020) per year is obliged to join the public health insurance scheme as soon as they have signed their employment contract.

The costs of public health insurance depends entirely on your gross salary. You will only pay your contribution if you earn more than 850 euros a month –prior to that you are not liable to pay your contribution.

The health insurance contribution equals 14.6% of your gross income per month – this is the rate you will pay with any public health insurance company. The good news: the contribution is shared equally between you and your employer, so both sides pay 7.3% of your gross salary (with a cap of 4,687.5 euros per month).

Best of all: you won't have to take care of anything. Just sit back and relax, the contribution will automatically be deducted from your monthly salary.

Wondering if you have to pay to see a doctor in Germany? Yes, in every quarter of the year that you see a doctor, you have to pay a fee of 10 to 15 euro. On the other hand, if you don't go to the doctor for a quarter, you won't have to pay this fee.

Private health insurance is offered by more than 40 different companies to suit all budgets. Usually, the contribution depends on your income and your health history. Remember: Private health insurance companies do not always cover other people in your household, such as spouses or children.

This is how you get your health insurance as an expat

Are you planning to settle down in Germany for the next few months, maybe even years? One of your first steps will then be to head to the local residents' registration office (Einwohnermeldeamt) to register. After your registration you’ll receive your social security number (Sozialversicherungsnummer) with which you can pay your insurance contributions and thus be entitled to the same health care system as any other German citizen.

Typically, it is your employer who signs you up with a health insurance company right away. The choice is yours though: you can either stick with the health insurance company chosen by your employer or you can pick another one. Just notify your employer within your first two weeks of your employment. Among the most common health insurance companies are AOK, Barmer GEK and TK. Good news: The websites of the major health insurance companies are usually also translated into English!

Let’s sum up the three steps: 1. Residents' registration office: Check 2. Social security number: Check 3. Insurance: Check

Great! As a newly-registered member of the health insurance scheme, you’ll soon receive your health insurance card (Krankenkassenversichertenkarte), which you must then take with you to each visit to the doctor.

So, you want to take the step into private insurance? Take a look at comparison portals to find the match that suits you best (e.g. Check24).

How to get health insurance as a student

Every (international) student in Germany needs to be covered by health insurance. International students from another EU country have a domestic advantage here: Up to the age of 25 they are covered by their family insurance – also in Germany.

However, students without family insurance are entitled to pay lower health insurance rates thanks to their student status. So, you can benefit from a reduced rate for students, which is about 110 Euro per month.

You wouldn't be in Germany if this wasn't linked to further rules! The reduction is tied to an age limit: from the age of 30 (or up to your 14th semester) you are no longer eligible for the public insurance for students and therefore have to pay the regular contribution for private or public health insurance.

Time to find your doctor!

Once in a while, you might feel the need to see a doctor. For instance when you have been sitting at home with a cold for 3 days already, you will need a medical certificate (Krankenbescheinigung) to be issued by your doctor for your employer. The best way to find a doctor is via recommendations, online comparison portals or simply on Google Maps. Once you have chosen your ideal doctor, you have to fill out a short survey about your medical history on your first visit.

Your visit to the doctor

Most of the doctors work with appointments that you can arrange on the phone or in person with the medical assistant in English. As many doctors are overbooked and the next available appointment might be weeks or months in the future, there are additional consultation hours for patients. It is best to arrive early to avoid long waiting times.

If you want to go to the dentist or gynaecologist, you do not need a referral from your GP. The health insurance companies ensure that every woman has access to a gynaecologist where women over the age of 20 are screened annually for cervical cancer, breast cancer and ovarian cancer. Would you like to see a specialist (e.g. cardiologist)? Then your GP will usually refer you to a specialist.

Medicine in German: crash course

The doctor's assistant (Arzthelfer/in) will issue you with your medication, fill in your medical certificate and arrange your next appointments. As the medical assistants may not speak English very well, it is worth remembering a sentence or two:

  • Doctor - Arzt
  • GP - Hausarzt
  • Dentist - Zahnarzt
  • Gynecologist - Frauenarzt
  • I need a medical certificate - Ich brauche ein Krankenschein
  • I need an ambulance - Ich brauche einen Krankenwagen
  • I need a hospital - Ich brauche ein Krankenhaus
  • Heart attack - Herzinfarkt
  • Common cold - Erkältung
  • I am sick - Ich bin krank
  • I feel sick - Mir ist schlecht
  • I'm allergic to… - Ich bin allergisch gegen...
  • I have a sore throat - Ich habe Halsschmerzen
  • I have a stomach ache - Ich habe Bauchschmerzen
  • I have a headache - Ich habe Kopfschmerzen
  • I have a toothache - Ich habe Zahnschmerzen

Here we go, it's time to get your health insurance

So, what are you still waiting for? Start reaping the benefits of one of the best health insurances in the world! Once you have an employer in Germany, you hardly have to worry about a thing: as soon as you are registered in the city and you have a social security number, your employer signs you up with an insurance company. You still have the choice of private or public insurance and among different providers. As an expat with a family, public insurance will be a better deal as it allows you to insure your family along with you.

Students from EU countries will be lucky enough to remain in your home family insurance. But also for those who are not covered by family insurance, there’s a reduced student rate of 110€ per month! (Unfortunately, this only applies to students until the age of 30 or 14th semester). We hope you feel ready to navigate the German health insurance system.

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