Private Health Insurance vs. Public Health Insurance in Germany 

insurance health
Health Insurance

Health Insurance is mandatory in Germany for all German citizens, expats & International tourists. Each month, you make a payment toward your health insurance, which also covers your medical expenses. Germany has two health insurance systems; private & public. One of the best healthcare systems in the world is found in Germany. The majority of German citizens and residents are covered by the government-run public health insurance programme, which is paid for by the taxpayers’ contributions. In turn, regardless of income or status, everyone gets access to high-quality, cheap healthcare. However, there are some gaps left by the public health insurance system which one can fill by opting for a private health insurance plan.

In this article, we will look at the pros and cons of both insurance systems so you can arrive at a decision of choosing the one that works for you. 

Private Health Insurance 

Chosen by around 10% of Germans, Private Health Insurance (Privat Krankenversicherung) or PKV can be signed up for if you fulfil certain criteria: 

  • Employees who earn over €66,600 per year as of 2023
  • Students aged over 23 but under 30 
  • Freelance (self-employed) individuals 
  • Civil servants (insurance is subsidized by employer) 

Because the public healthcare system is so good, not everyone who is eligible for private health insurance chooses to enrol in it. For some people, there may not always seem to be much to gain from going private. Only voluntarily insured individuals are eligible for private insurance. 

 However, having private insurance may occasionally result in better care, shorter wait times, and more services. For instance, whereas public healthcare does not, private dental insurance may offer coverage for extensive dental work. Other times, it entails receiving a private room following surgery or medical treatment. Additionally, patients with private insurance have the chance to locate and consult a physician fluent in their mother tongue.  

 The first step is to conduct some research on rates and coverage from the slightly over 40 private healthcare insurance in Germany. German people must withdraw from the public healthcare system in order to register with a private company (which is automatic). This can be done by informing your company and the government healthcare fund. It’s crucial to realize that switching back to the public system is not simple after someone has decided to be insured by a private fund. But it is conceivable, for instance, if your salaries have decreased. One can use popular comparison portals such as Verivox or TarifCheck, for doing this.

How can an expat enrol for Private Health Insurance?

You must get in touch with one of the private health insurance firms in Germany to become privately insured. However, you must first inform your current public insurance scheme, contact your employer, and begin the unenrollment process before you can leave the public insurance programme. 

You must let your employer know that you choose private insurance and which provider you prefer if you haven’t yet signed up for a public insurance scheme. 

Popular and recommended English-speaking providers are Feather, Ottonova and GetSafe. Feather, is an aggregator that incorporates most of the healthcare providers, on its platform, and is an online broker.

In Case you are still looking for a job, then it’s likely that neither the Public nor the private health insurance providers will offer you a package. In that case, new age digital providers, such as Ottonova , GetSafe etc will be your best interim bet, as they offer not only to have digital and English support, but some also have reduced packages for ex-pats, for the short term(living in Germany for less than 5 years). In fact, Ottonova also provides you with a free phone consultation, to tackle any nervous jitters up front, in English. Their principal is that since the younger generation, is a migrant and working generation, hence they do not charge hefty premiums in the earlier years, unlike the traditional providers. That is primarily the reason one gets Expat friendly packages from them if you stay in Germany lesser than 5 years, as earlier mentioned. Some of the popular services provided by Ottonova are for example  Expat health insurance, Private health insurance and Supplementary dental insurance.

But in case you intend to stay in Germany for a longer period of time or permanently, then we would suggest taking up a plan with Feather, which is like an insurance broker. This is, as earlier mentioned because Feather provides their support in English as well and is also digital.

What is all covered in private health insurance?

The same benefits as those provided by public health insurance are typically also covered. Health care that is required is always covered. Private health insurance gives you more discretion over what is covered. For instance, it might pay for additional services like spectacles, laser eye surgery, and dental treatment. Additionally, if you cover less or have a higher deductible (Selbstbeteiligung), your costs will be lower. 

You can see doctors and therapists who do not accept public health insurance, giving you more healthcare options. Patients with private health insurance are frequently given preference by physicians. 

How much does private insurance cost?

The cost of private health insurance might vary greatly. The premiums will be more influenced by age and health than public health coverage, which has a fixed cost for everyone. Young adults in the highest income categories who are in good physical health stand to benefit the most from private healthcare. 

Those with private insurance are frequently obliged to pay the hospital or doctor’s fees and claim the expenses back from the insurer themselves, in contrast to public healthcare, where to pay for medical care, a doctor or hospital will request reimbursement from the insurance fund. 

Advantages & Disadvantages of Private Health Insurance 

When you are young, private is affordable

If you are young and healthy, you may spend just 175 euros (or 350 euros for freelancers) a month for private insurance. If you are wealthy, this is significantly less expensive than government insurance. For employees, public health insurance may cost up to 470 euros per month, and for independent contractors, 900 euros per month. 

Private Insurance can be more expensive as you age. 

Although your salary declines when you retire, your insurance does not. It’s exceedingly challenging to return to public health insurance after the age of 55. You might be forced to purchase highly pricey health insurance. Because your insurer saves some of your contributions for later, if you enrol in the private system when you are young, it will be less expensive when you are older. 

If you have ongoing health issues, private care is pricey 

A health exam is typically required before purchasing private health insurance. They frequently reject applicants with major pre-existing medical conditions or charge exorbitant fees. This includes, for instance, expensive medication, psychotherapy, and chronic diseases. Once you are approved, your insurance does cost extra since you utilize it, but it will still pay for all the treatments you require. 

You decide what you require

You can decide to pay for dental work, travel insurance, specialized care, etc. Your insurance will cost more if you make more selections. It might be quite inexpensive if you pick fewer options. 

A bigger deductible can lower your costs

For instance, if you have a deductible of €3,000 per year (Selbstbeteiligung), you are responsible for the first €3,000 of your medical expenses before your insurance kicks in and covers the rest. With a high deductible, your monthly insurance costs are lower. A simple strategy to save money is to never visit the doctor. 

If you don’t utilise it, you pay less 

If you never use it, many private health insurances have lower rates. Your insurance may become more affordable after a year or two of no claims. You can save a lot of cash if you never get ill. 

 

Public Health Insurance

Almost 90% of Germans have public health insurance (Gesetzliche Krankenversicherung or GKV) which is also called statutory insurance.  

All citizens of Germany have access to a first-rate public (statutory) healthcare system that provides all forms of comprehensive medical care. The German government heavily subsidises the public healthcare system in order to guarantee that those who are unemployed or earning low wages continue to be covered and have access to necessary medical care. The public healthcare system is funded by a combination of employer and employee insurance contributions. Every German citizen is required by law to have public health insurance (unless they are part of the small percentage of the population with private coverage). 

Each resident in Germany for whatever reason or for whatever anticipated duration of time is required to have appropriate medical coverage under a medical reform that took effect in 2009. This is actually a huge advantage since many would otherwise choose to stay uninsured in the mistaken belief that they would significantly reduce their costs. However, the reality is that one will always require routine medical examinations and other medical care. In cases like that, having appropriate health insurance is always advantageous. 

Membership in the GKV (German Health Insurance) is required if your gross income is less than 64,350 Euros annually, or 5,362 Euros per month in 2022. You do not pay a higher insurance premium if your income is higher than this annual income cap. 

English speaking Public Health Insurance

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100% coverage of necessary travel vaccinations
Best cover for young families (incl. bonus programs)100% coverage of necessary travel vaccinationsGood osteopathy program

How do I enrol? 

If you decide to enrol in the German public health system, you can do so by registering with one of the 97 Government Health Insurance providers, non-profit organisations responsible for managing the public health programme. While some (like AOK, TK, BARMER, and DAK) are quite huge and have millions of members, others may only have a few thousand.  Then there are online aggregators like Feather, who incorporates most of the providers on their platform and have English support. You can also compare the various providers on Verivox or TarifCheck.

It would also be best to explore which optional supplemental programmes they offer in order to be able to participate in, for example, a no-claims bonus, free checks, or savings on supplemental health insurance. The rates may also vary significantly due to changing rules. To make your life easier, make sure you inquire about the possibilities of communicating in English, even if only a small percentage of Kassen providers genuinely provide this service and have English-speaking employees. 

What is all covered in public health insurance? 

The public health insurance provides access to basic dental treatment as well as in-patient (hospital) care as a ward patient with the doctor on call at your local hospital. It also provides out-patient care with registered doctors. Please be aware that there is no coverage for private physicians or surgeons, a semi-private or private hospital room, homoeopathic or alternative medicine, dental subsidies beyond the bare minimum, adult vision products, or any medical benefits outside of Europe. Your non-working dependents who are residing at your address in Germany are now covered without incurring any additional fees; they merely need to be registered with the same Krankenkasse as you, the paying member. 

It includes all required medical care. All necessary procedures and prescription drugs are always covered. Generally speaking, you never have to pay for medical care. For some medicines, there is just a minor deductible (5 to 10 euros per month). No additional deductible is present. 

You present your insurance card to the doctor when you visit, and they will bill your insurance provider. Before beginning a procedure, you will be informed if it is not covered. Both paying yourself and requesting reimbursement are not necessary. It is extremely easy. 

The removal of wisdom teeth is a necessary dental procedure that is covered by public health insurance. You are also entitled to two free dental exams each year. It excludes dental cleanings. To gain better coverage, many people also get dental insurance. 

How much does public insurance cost?

Public health insurance costs 14.6% of your income, plus 3.05% to 3.4% for long-term care insurance (Pflegeversicherung). Health insurance may potentially charge an additional 0.39 to 2.5%. In total, public health insurance costs 18.04% to 20.4% of your income. 

Currently, 12 months is the standard minimum time frame for membership with any Government Health Insurance provider. After joining for a year and giving two months’ notice, or if the supplemental premium goes higher, you can change government health fund providers. If you choose a private health plan and have been approved by the insurance provider of your choice, you are free to leave the GKV (German Health Insurance) at any time with a 2-month cancellation notice. 

Do hospitalization expenses get covered by German health insurance? 

The expense of hospitalization is not usually covered by the public health insurance programme. Typically, for a maximum of 28 days a year, you will have to pay €10 per night. If your hospital stay lasts longer than 28 days in a calendar year, there is no fee. 

Depending on your policy, private insurance may be able to compensate you for hospitalization expenses. In addition, you can request a private or semi-private hospital room with private insurance, which is not possible with public insurance.

How to Make an Appointment with a Doctor in Germany? 

You must phone or visit the office to schedule an appointment if you already know the doctor you want to see. Typically, you schedule the appointment with the medical assistant. Unless it is an emergency, you probably have to wait a few days before your appointment. 

When you arrive in Germany, there won’t be a General Practitioner assigned to you, so learn as much as you can about the local medical community before you arrive. By using the Kassenärztlichen Vereinigungen portal, you can locate doctors (Association of Statutory Health Insurance Physicians in Germany). You can enter your address, your zip code, or even the speciality you’re looking for, and you’ll be shown the nearby doctors and practitioners who fit the bill. 

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