As a major economic power located in the heart of Europe (9 border countries in total!), Germany continues to attract expatriates from all over the world. Like the major Swiss cities, many German cities top the world rankings of cities with the best quality of life: Munich, Düsseldorf, Frankfurt, Hamburg, Berlin… The dynamic job market and career opportunities are also attractive factors for expatriates who move to Germany.
What about the health care system in Germany? Unlike other European health systems (see our page dedicated to European health insurance), Germany has compulsory health insurance, the oldest in the world! It is renowned for the quality of care and the performance of its system. You have two choices: public or private health insurance. Rules apply, we explain in more detail how it works.
The public health insurance system: Geseztliche Krankenversicherung (GKV)
This is the country’s universal public health insurance scheme, and most of the German population is affiliated to it.
Who is covered?
All employees, cross-border commuters and persons whose income is below a mandatory income ceiling (Versicherungspflichtgrenze or Jahresarbeitsentgeltgrenze). Employees with a higher income and employees with a gross monthly income of less than € 450 are not obliged to join the public scheme. The same applies to self-employed persons, who must then turn to the private insurance solution.
In 2021, this threshold is set at €64,350. It has been gradually increasing in recent years (€62 550 in 2020 and €60 750 in 2019), forcing some employees to join the public health insurance scheme. There are, however, criteria in place to determine whether an employee insured in the private sector can remain there.
Employers are responsible for notifying the health insurance scheme, so there is no need for the employee to do anything. The contribution is deducted directly from the salary, at a rate of 15.9% in 2021.
How do I choose my health insurance company?
If you are affiliated to the public insurance scheme, you can choose your health insurance fund from among more than 150 approved partners. A list of the various health insurance companies can be found on the GKV website, the best known being AOK, Techniker Krankenkasse or DAK. You can easily change from one health fund to another after one and a half years. The rate of reimbursement may vary depending on the choice of health insurance fund, so be sure to ask!
How am I covered?
The level of cover is enough but not optimal and complete. Visits to the general practitioner are automatically reimbursed; prescription drugs (with a 10% contribution), check-ups and hospital care are also reimbursed. Dental care, optical care and sick leave are generally not covered.
The private health insurance system: Private Krankenversicherung (PKV)
Who is concerned?
Private health insurance concerns civil servants, students or self-employed and freelance workers; employees with an income of more than €64,350 who are not obliged to contribute to the GKV.
What level of cover?
This time, you will be able to choose between different levels of health cover, from the most basic to the most comprehensive. You can be covered for dental and optical care and be reimbursed more comfortably for hospital stays. Medicines are also better reimbursed. You will be able to consult any doctor, paying in advance and claiming reimbursement once you receive the bill.
The contribution will depend on the level of cover you choose and your medical history and conditions. As the rate is no longer fixed, households with higher incomes and above the compulsory limit usually opt for private health insurance, as they can choose cover that is just right for them and contribute proportionately less.
- While it is easy to leave the public health system, it is less easy to return to it, as you will have to meet the criteria of the public system again.
- Länders in Germany have authority over the regional health insurance funds. The Order of doctors and healthcare professionals differs from one Land to another, so it is useful for you to check before deciding on a health Insurance provider.
Also note that if you opt for a local private insurance solution, some insurers require a minimum period of residence in Germany, which can sometimes be up to 2 years. So, if you have just moved to Germany, you may not be able to buy local health insurance immediately upon arrival.
Buying international health insurance in Germany
Unlike the above, an international or expatriate health insurance policy will not require a minimum period of residence. You can join the insurance before or after your departure.
Like private insurance, it provides access to a wide range of benefits and reimbursements. It is also flexible and allows you to choose between different levels of cover. The real advantage is its worldwide coverage, which means that you will be equally well covered in Germany and in all other countries – including your home country.
The price of the insurance will again depend on your age, medical history, chosen cover and deductible.
Choosing a Foyer Global Health plan means getting comprehensive international cover at a competitive price (optical, dental, maternity care according to the different plans). Our insurance solution is ideal for your expatriation and your travels around the world.
Contact our experts in health Insurance in Germany to get personalized advice according to your situation To compare our plans and find your ideal cover, go to our table of benefits.