Most residents in Germany are enrolled in the public healthcare system, but some individuals qualify for both public and private, and can choose which they would prefer. The costs mainly depend on the level of coverage and monthly earnings of the insured person.
This article will take a look at how private healthcare in Germany works, who is eligible to use it, and how the costs come together.
It is mandatory for everyone living in Germany, even temporarily, to have valid health insurance for the entire time they are in the country. If you opt for Private Health Insurance, try to organize this online and with the help of provider support before you arrive. Expatrio offers Health Insurance via the Value Package and Health Insurance Plus plans.
Private Health Insurance
Private Health Insurance or private Krankenversicherung, often shortened to just PKV, is chosen by around 10% of the German population. You can only sign up for private healthcare insurance if you fit into one of a set of criteria. This includes:
Not all of those who qualify for Private Health Insurance choose to take it. Often, this is because public healthcare in Germany offers great coverage. For some, there may not always seem like a lot to gain from going private.
What are the advantages of Private Health Insurance in Germany?
Private insurance can sometimes mean a higher level of care, shorter waiting times, and additional services. For instance, private insurance may cover major dental work, coverage of visual aids, and worldwide coverage, which public healthcare does not. Other times, it means getting a private room after an operation or hospital treatment.
Those on private healthcare schemes have a greater choice of doctors and hospitals as they are able to go to both public healthcare doctors and private-only doctors. Private insurees may also experience shorter waiting times and have the opportunity to find and speak to a doctor who can communicate well in their native language. But because the healthcare system in Germany is so good, most people don’t feel a big difference between the two aside from these few perks.
The general advantage of Private Health Insurance is that you can choose the coverage that meets your needs. Do you want to pay less premium, or do you want to have more coverage?
It’s also possible to register for public healthcare, but add private elements to the cover, such as dental insurance. Those who do this are still counted as members of the public healthcare system and fall into the 90%.
How to get Private Health iInsurance in Germany?
There are just over 40 private healthcare insurers in Germany, so the first task is to do some research in terms of both cover and prices.
In order to register with a private company, German residents need to unenroll with the public healthcare system. They can do this by letting both their employer and the public healthcare fund know.
If you qualify for Private Health Insurance and you’ve found the right insurer and tariff for you, you have to do a health check before you can take out a Private Health Insurance tariff.
Your premiums are calculated by your age, your health status, and your chosen coverage. With the Private Health Insurance ottonova, this process is all digital.
It's important to understand that once someone has chosen to be covered by a private fund, it's not always an easy process to come back to the public system.
However, it is possible if, for example, your wages have reduced, or if you're status has changed from student to non-student.
Foreign workers moving to Germany need to inform their new employer before they even start, if they are choosing a private healthcare insurer and who their chosen provider is; this will prevent them from being enrolled in the public healthcare system. Make sure you know the name and details of your private insurer, as the contributions will be deducted from your wages, so you will need to provide this to your new employer.
If you come to Germany to study, you also have the possibility to take out Private Health Insurance (and in some cases, this is the only insurance you can take out as an international student). Private health insurers like ottonova offer special student tariffs, which you may be eligible for via Expatrio.
Also, it is very important to check if a private insurer meets the strict guidelines of the German government.
How much does private insurance cost in Germany?
Unlike Public Health Insurance, which costs the same (in terms of contribution %) for everybody, the cost of Private Health Insurance premiums will depend more upon age and health-risk. Those with chronic health conditions may find that public healthcare insurance is significantly cheaper.
The tariffs of Private Health Insurance often have a deductible. This is one way to lower your monthly private insurance contributions is by opting to increase the excess that you will pay yourself each year for certain treatments; this is known as Selbstbehalt. The ottonova tariffs offer options with or without deductibles, so you can choose.
People who gain the most from private healthcare are young people like students or employees and self-employed in the highest wage brackets with good health because they would pay the maximum rate in Public Health Insurance which is then often higher than their premium for Private Health Insurance.
How does the reimbursement process work with Private Health Insurance?
Unlike public healthcare, where the doctor or hospital claims back money from the insurance fund to cover treatment, those with private insurance are often required to pay the hospital or doctor’s fees and claim the costs back from the insurer themselves.
For higher invoices like a hospital bill, you can arrange direct cost coverage with your private insurance company.
This reimbursement process may sound like more paperwork than in Public Health Insurance, but if you choose a digital Private Health Insurance like ottonova, there is no paperwork at all. Just take a photo of your invoice, upload it to the app, and keep the overview. You often have the money back from the Private Health Insurance before you have to pay the doctor.
Is TK insurance private or public?
Techniker Krankenkasse, known as TK, is a public insurance fund. It is one of the largest and most popular public healthcare insurers with over 8.8 million insurees and an excellent level of cover that includes online English support and dental hygiene cover. TK has won awards for being the best healthcare provider in Germany1 and also offers wellbeing courses, online application, and a handy app.
Travel Insurance in German
If you are travelling from one EU country to another, either from or to Germany, you can apply for an EHIC card which gives you access to the same basic public healthcare as residents in that country receive.
Those on private healthcare schemes in Germany may also be covered for worldwide travel too. In the tariffs of ottonova, you are covered worldwide for 6 months without a surcharge.
If you plan on travelling from Germany, whether it be for work or leisure, to other Non-EU countries and you have Public Health Insurance, consider adding a travel insurance element to your private healthcare cover.
Is my family covered by private health insurance?
If you have Public Health Insurance then your children are covered under your plan. If you choose Private Health Insurance your family can also be insured with your private provider. Every person then has to pay a premium - there is no cost-free family insurance like Public Health Insurance. However with private insurance, your whole family they profit from a broad coverage and even up to 2 to 3 children private health insurance can make sense financially.
Footnotes
1 In the issue 07/2023, Focus-Money business magazine awarded TK “Best Student Health Insurance Fund”.
