You’ve just arrived in Germany. Your job is sorted, you have waded through the bureaucracy of securing an apartment, and all that moving stress is causing you to feel a little under the weather. Let’s get that health insurance situation sorted out to make sure you can access that stellar German healthcare system when you need to.
Basic Overview of German Health Insurance
Health insurance in Germany is not optional. Luckily there are many options to choose from. Germany has one of the most thorough, inclusive, and complete healthcare systems in the world. Only 10% of it’s residents are on a private plan, with everyone else opting into the public scheme.
- Statuatory German health insurance scheme (German: gesetzliche Krankenkasse, or GVK)
- Private insurance scheme (German: private Krankenversicherung, or PVK)
Statutory German Health Insurance
We have Bismarck to thank for making health insurance compulsory and creating one of the world’s first welfare states. Since then, a lot has improved, and as of 2021, 90% of the German population uses statutory health insurance. 103 Krankenkassen are non-profit organizations administering the German government’s healthcare scheme.
You may be eligible for GKV if you are: employed, unemployed, in vocational training, an apprentice or a trainee, on a pension, or a dependent of someone on GKV.
As a dependent, you can often receive healthcare through co-insurance of your parents, provided you are under 23, or a student under 25. Co-insurance usually does not require you to make any payments. If you are a student studying abroad alone, you’ll need to pay a premium.
Your partner, provided they earn below 450 euros a month, and children under 21 are likely automatically covered for free.
This scheme generally covers both inpatient and outpatient care and there are restrictions on what you can claim in terms of dental work, eye care, and holistic healing options.
Health Insurance for Employees
You will be enrolled in GKV without needing to do anything. Your employer will take care of the paperwork and register you with a local health insurance company.
You can choose any of the providers that are available in your state. After 18 months, you can swap to a different one if you like.
Your employer pays 50% of the public health insurance premium.
Health Insurance for Freelancers and the self-employed
Unfortunately, if you are self-employed, you pay the full amount yourself. The money is taken out of your account every month and based on an estimated yearly income. You will be reimbursed retroactively if you have overpaid. Conversely if you have underpaid you will be required to make up the difference.
Freelancers who make over €58,050 a year will be expected to contribute the Selbstständige Höchstbeitrag, or ceiling fee for freelancers, of about €845amonth.
If you make less than €12,740 a year you will pay the Selbstständige Mindestbeitrag, or a minimum fee for freelancers, which is roughly €180. However, the best option might be through your spouse or parents. If they are on the public option, you may use their insurance for no additional cost.
Health Insurance for Students in Germany
Students can sign up for statutory health insurance at a discount. Alternatively, you may be able to use your home country’s health insurance if they are an EU or EEA member state.
To qualify as a student with your health insurance you should
- Be a matriculated student in a university in Germany
- not have health insurance in your home country that is recognized in Germany
- not be working as a freelancer or self-employed
- be 30 years old or younger
- not be a postgraduate or be on scholarship (without a work contract)
If you are a student studying abroad alone, you’ll need to pay a premium.
If you are under 30 years old that fee will be about €110 per month. Students over 30 will pay the Mindestbeitrag, of about €180
List of Some Statutory Health Insurance Companies in Germany and their Contribution rates
The Krankenkassen have different contribution rates. This means you may have to pay slightly more for some of them. The services are in most cases the same. There are a few bonus programs and additional services that a particular company might give as an incentive.
Here is a list of some handpicked statutory health insurance companies in Germany and the percentage you contribute.
There is a cap on contributions known as the Höchstbeitrag. You pay a maximum of 928.80 Euros
You can also research on your preferred company in a more exhaustive list here (in German)
| Health Insurance Provider | Contribution rate 2021 | Supplementary contribution rate 2021 |
|---|---|---|
| AOK Baden-Württemberg | 15.7 % | 1.10 % |
| AOK Bayern | 15.7 % | 1.10 % |
| AOK Bremen/Bremerhaven | 15.9 % | 1.30 % |
| AOK Hessen | 15.9 % | 1.30 % |
| AOK Niedersachsen | 15.9 % | 1.30 % |
| AOK Nordost | 16.1 % | 1.50 % |
| AOK NORDWEST | 15.9 % | 1.30 % |
| AOK PLUS | 15.8 % | 1.20 % |
| AOK Rheinland-Pfalz/Saarland | 15.5 % | 0.90 % |
| AOK Rheinland/Hamburg | 15.7 % | 1.10 % |
| AOK Sachsen-Anhalt | 15.2 % | 0.6 % |
| Audi BKK | 15.7 % | 1.10 % |
| BAHN-BKK | 15.8 % | 1.20 % |
| BARMER | 16.1 % | 1.50 % |
| BERGISCHE Krankenkasse | 16.0 % | 1.40 % |
| Bertelsmann BKK | 15.85 % | 1.25 % |
| BIG direkt gesund | 15.9 % | 1.30 % |
| BKK Achenbach Buschhütten | 16.2 % | 1.60 % |
| BKK Akzo Nobel Bayern | 15.9 % | 1.30 % |
| BKK Diakonie | 16.0 % | 1.40 % |
| BKK DürkoppAdler | 15.8 % | 1.20 % |
| BKK EUREGIO | 14.95 % | 0.35 % |
| BKK exklusiv | 15.59 % | 0.99 % |
| BKK Faber-Castell & Partner | 15.25 % | 0.65 % |
| BKK firmus | 15.04 % | 0.44 % |
| BKK Freudenberg | 15.9 % | 1.3 % |
| BKK GILDEMEISTER SEIDENSTICKER | 15.8 % | 1.20 % |
| BKK Herkules | 16.3 % | 1.70 % |
| BKK HMR | 15.95 % | 1.35 % |
| BKK Linde | 15.9 % | 1.30 % |
| BKK Melitta Plus | 15.8 % | 1.20 % |
| BKK Mobil Oil | 15.89 % | 1.29 % |
| BKK PFAFF | 15.0 % | 0.40 % |
| BKK Pfalz | 16.0 % | 1.40 % |
| BKK ProVita | 15.9 % | 1.30 % |
| BKK Public | 15.7 % | 1.10 % |
| BKK Scheufelen | 15.5 % | 0.90 % |
| BKK Schwarzwald-Baar-Heuberg | 15.58 % | 0.98 % |
| BKK Technoform | 16.5 % | 1.90 % |
| BKK Textilgruppe Hof | 15.5 % | 0.90 % |
| BKK VBU | 15.9 % | 1.30 % |
| BKK VDN | 15.9 % | 1.30 % |
| BKK VerbundPlus | 15.7 % | 1.10 % |
| BKK WERRA-MEISSNER | 16.1 % | 1.50 % |
| BKK Wirtschaft & Finanzen | 15.99 % | 1.39 % |
| BKK ZF & Partner | 16.4 % | 1.80 % |
| BKK24 | 15.6 % | 1.00 % |
| BOSCH BKK | 15.8 % | 1.20 % |
| Continentale Betriebskrankenkasse | 16.0 % | 1.40 % |
| DAK-Gesundheit | 16.1 % | 1.50 % |
| Debeka BKK | 15.5 % | 0.90 % |
| energie-BKK | 16.06 % | 1.46 % |
| Heimat Krankenkasse | 15.7 % | 1.10 % |
| HEK-Hanseatische Krankenkasse | 15.9 % | 1.30 % |
| hkk Krankenkasse | 14.99 % | 0.39 % |
| IKK Brandenburg und Berlin | 16.09 % | 1.49 % |
| IKK classic | 15.9 % | 1.30 % |
| IKK gesund plus | 15.7 % | 1.10 % |
| IKK Nord | 15.9 % | 1.30 % |
| IKK Südwest | 16.1 % | 1.50 % |
| KKH Kaufmännische Krankenkasse | 16.1 % | 1.50 % |
| Knappschaft | 16.2 % | 1.60 % |
| mhplus BKK | 15.88 % | 1.28 % |
| Novitas BKK | 16.14 % | 1.54 % |
| pronova BKK | 16.1 % | 1.50 % |
| R + V Betriebskrankenkasse | 15.8 % | 1.20 % |
| Salus BKK | 16.05 % | 1.45 % |
| SBK | 15.9 % | 1.30 % |
| SECURVITA Krankenkasse | 15.7 % | 1.10 % |
| SIEMAG BKK | 16.0 % | 1.40 % |
| SKD BKK | 16.3 % | 1.70 % |
| Techniker Krankenkasse | 15.8 % | 1.2 % |
| TUI BKK | 15.85 % | 1.25 % |
| VIACTIV Krankenkasse | 16.2 % | 1.60 % |
| WMF BKK | 16.2 % | 1.60 % |
Private Health Insurance
You can choose to opt-in to GVK or spring for private health insurance if the following apply to you. You are:
- earning over 64.350 euros per year
- a freelancer or business owner
- civil servant
Private insurance is dependent on your income. Those who might find private insurance a better option financially will include those who are healthy, young and make a substantial income.
Similar to public insurance, your employer pays half and freelancers still pay the full price themselves.
If you tick all the boxes, the cheapest this option gets is around €175 (or double that for freelancers) per month. For those with higher incomes, that makes this the most frugal option. The more add-ons you choose (visits to the dentist, therapist, special procedures, etc.) the higher the price tag.
Barriers to entry include pre-existing conditions and age, but buying in when you are young and healthy has its perks. They cannot raise your health insurance with illness and they will save throughout your lifetime to keep your costs low with old age.
Also, something to consider is how often you need medical attention. If you opt for a higher deductible (out of pocket payment for medical needs – Selbstbeteiligung), then your monthly insurance fees are reduced.
Some pre-existing conditions that private insurers will likely reject you for are mental health issues, severe asthma, AIDS – anything that requires consistent treatment over the long run. If they do accept you, your monthly fees are unfortunately likely going to be higher than average.
Why do around 10% of all German citizens opt for private healthcare?
You will likely be treated with “more” care in the German health sector as it helps supplement medical professionals’ incomes. The magical words ‘Privatversichert‘ can get you an appointment more quickly.
Note: If you are insured privately you have to pay your medical fees upfront and have them reimbursed later by your provider.
As an ex-pat, you may be able to find a doctor who speaks your language more easily as a ‘Privatpatient.’ But this really only applies in some cities. In Berlin for example you can easily find an English speaking doctor on public insurance. Here is a list of English speaking doctors in Berlin.
Private Health Insurance Companies in Germany
Editor’s tips:
Here are the best private insurance providers we found best for expats
Other alternatives
A Little Bit of Both – Supplementing Statutory Health Insurance with Private Health Insurance.
You can supplement your GVK with a side of PVK if you think you might have some additional needs such as:
- private rooms in hospitals
- dental reimbursement
- evacuation from outside of Germany
- alternative medicine
- eye care
Other Options
As an expat, there are other options available to you. Expat health insurance is a step up from travel insurance which lasts only a few weeks and is much more limited in coverage. Expat health insurance, however, will only cover you for up to five years and has its restrictions.
If you are from a country that is also a member of the European Union you can use your EHIC card for a period of time. This is only available to you until you begin working in Germany.
If you are a freelancer the Künstlersozialkasse, (KSK), could cut costs for you. The KSK is difficult to qualify for and time-consuming to apply to, but they will cover half of your payments if you make it through. Essentially they are able to do this because you will be government employed. Your eligibility will be reviewed every single year if you decide to go this route.
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