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Health insurance in Germany

The German healthcare system has long been considered one of the best in Europe and is certainly the oldest of its kind. When it comes to funding, the model for medical insurance in Germany is a multi-payer system, funded by the government, employers, and private individuals. Most residents are enrolled into the public healthcare system, but around 10% choose private medical care.

This article will give you an overview of the German health insurance system (private and public insurance) and will cover more specific topics such as the costs of health insurance, how sick days work, and what to expect in Germany.

German Healthcare System Overview

When it comes to health insurance, Germany may appear to have a complicated system, but in fact, it's much more straightforward than it first appears.

How does German health insurance work?

The vast majority of residents in Germany are part of the statuary public healthcare insurance (Gesetzliche Krankenversicherung, GKV) system whereby contributions from employers and employees are paid via social security payments. This is paid to one of the main public healthcare insurers, such as the Techniker Krankenkasse, which hospitals and doctors make claims to whenever their services are used. The public healthcare system is heavily subsidized by the German government.

Those with private healthcare insurance (Private Krankenversicherung, PKV) can access the same services and doctors, as well as some private-only doctors, who will claim the private health insurer when their services are used.

What is the difference between private and public health insurance in Germany?

The main difference between public and private healthcare is how it is paid for. Public healthcare is paid for by a combination of employee and employer contributions and is deducted from the gross wage payment of the employee. Private healthcare may well also be paid for by a combination of employer and employee contributions (in the case of civil servants), but usually, payments come simply from the insured individual, directly to the provider.

Healthcare in Germany is excellent, and those who use the public system ultimately receive a similar level of care as those that use the private system; however, those on a private insurance package may also be able to access additional healthcare add-ons such as advanced dental treatment.

Find out more about private insurance on our Private Healthcare in Germany page.

What is statutory health insurance in Germany?

It is mandatory by law for all residents and visitors in Germany to have some sort of healthcare cover, whether that’s statutory public healthcare, private healthcare, or some other valid form for short-term visitors. You must have health insurance in Germany, no matter whether you are unemployed or employed.

Public healthcare is subscribed to by around 90% of the German population, and any employee earning under 60,750 € a year will automatically be enrolled for this kind of health insurance. Those earning above this amount, freelance workers, those working part time and earning under 450 € a month, and some students have the option to choose private healthcare insurance instead. Although enrolment in the public scheme is mandatory for most, individuals can still choose from different health insurance providers or Krankenkassen.

Find out more about statutory health insurance on our Public Healthcare in Germany page.

Foreigners

German health insurance for foreigners will still usually take the form of public healthcare, but not all Krankenkassen offer English-language support. If you are not fluent in German, try to find a provider that does offer English support, such as TK.

Do I need health insurance in Germany?

Yes, it is compulsory for every resident in Germany to be covered by healthcare insurance. As well as public and private healthcare, health insurance coverage for EU citizens living in Germany for the short term can come in the form of an EHIC (European Healthcare Insurance Card) issued from an applicable EU country. See our EHIC page for more details.

Health insurance coverage for non-EU citizens can sometimes take the form of private healthcare cover from your home country, but you will need to check that your plan covers you for living in Germany and for accessing German healthcare services.

Student visa

You will not be accepted for a student visa without proof that you have healthcare insurance, so make sure you have this organized first.

How to get health insurance number in Germany?

Once you have started contributing to the public healthcare system, or signed up to a private healthcare insurer, you will receive a healthcare insurance number and card (Krankenversichertenkarte). You will need to take this card along to all appointments.

What is the cost of health insurance in Germany?

The cost of healthcare in Germany for those choosing private cover can range hugely based on the provider that you choose to take insurance out with, your current health status, and the level of cover you opt for. Public healthcare contributions, on the other hand, start at 7.3% of your gross salary, which is matched by the employer for a total of almost 15%. Those in employment also automatically pay a compulsory nursing care contribution (Pflegepflichtversicherung) of around 2.5%, which is intended to cover the cost of care in later life.

For students aged over 23 and under 30, health and nursing cover costs 80.41 € a month, regardless of your level of income. EU students may be covered by their EHIC card, but only for those staying less than 12 months.

You can organize your student public healthcare plan quickly and conveniently with Expatrio. And find out more about student health insurance on our Health Insurance for Students page.

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What does health insurance cover in Germany?

German health insurance generally covers visits to doctors as well as basic dental care, surgery, out-patient appointments, and essential or non-cosmetic in-hospital treatments.

How to cancel health insurance in Germany?

Any social security contributions will naturally stop being made when you stop working in Germany; however, to cancel a private insurance plan you will need to contact the provider.

Dental care

Routine procedures such as check-ups, hygiene appointments and fillings are generally covered by the state public healthcare or your private health care insurer. This means that you do not necessarily need to take out any additional dental insurance, although the high cost of major dental work means that additional dental insurance could save you money in the long run. Major dental work includes procedures such as fitting crowns or dentures.

Always ask your dentist for a full cost breakdown (Heil-und Kostenplan) and show this to your healthcare insurer before proceeding with any work. Sometimes, an insurer will only pay out 60-80% of the work and you will need to cover the rest yourself.

Bonusheft

You can ask your dentist for a Bonusheft, which is a little booklet that is stamped or filled out every time you go to the dentist. This works as proof of your dedication to your dental hygiene and can even get you money off future dental work!

The quality of dentistry in Germany is considered especially high, and a good thing to know is that you should never experience a shortage of trained dental staff in Germany – not even outside of the major cities and in smaller towns.

Language barriers for non-German speaking residents can be an issue, but many dentists, especially in cosmopolitan areas, will generally have a good level of English. It is worth searching for English-speaking dentists if you require one, but just know that if you have public insurance, this may limit the number of professionals available to you.

Sick leave in Germany

Thanks to excellent employment laws in Germany, falling ill should not be too much of a worry when it comes to your job. Employers are required by law to pay for up to six weeks (for physical or mental ailments that mean you cannot fulfil your role) at full pay, but this can be extended should the circumstances require it to. After six weeks, employees can apply for Sickness Allowance (paid for by the state or by a private insurer) which is 70% of your pay and payable for up to 78 weeks.

Students who are unwell should inform their tutors that they cannot attend lectures. You may be able to get an extension on an assignment. Many universities in Germany place a huge importance on wellbeing and even offer free counselling to help deal with stress and anxiety. Take advantage of these free services wherever possible. You can always find out more about the sickness policy and wellbeing services at a given university by contacting the Student Services Centre.

Private healthcare

When you take out private healthcare insurance for students, it is worth ensuring you’re are also covered for sickness payment if you plan on working part-time during your studies.

Sickness in Germany, Dos and Don’t

  • DO Always inform your employer of your sickness before working hours begin and ideally before going to the doctor – basically, as early as possible.
  • DO always try to get an official sick note (Krankschreibung) from the very first day of being ill. This usually means you must go to the doctors on your first sick day, as the doctor will not always backdate sick notes. Some employers will say you do not need a sick note for the first three days of being ill, but always check this.
  • DO get your flu shot once yearly before winter; many doctor’s surgeries will issue this for free.
  • DON’T try to go to work or university if you have a cold or any other infectious illness; even if you feel you can struggle through, and you have plenty of work to do, coming to work with an infectious illness will not be appreciated by your colleagues.
  • DON’T fake sickness. Remember, you can’t always just call in sick to your employer; often, you will need to go to the doctor immediately to get a sick note and have the sick day authorized, so faking an illness will be particularly difficult and deceptive

Pharmacies in Germany

It’s important to familiarize yourself with the location of your nearest pharmacy (Apotheke). Pharmacies in Germany are easily identified thanks to a red ‘A’ logo which is displayed outside. Unlike in the US or UK, pharmacists are only allowed to own up to three premises, which means there are no chains of branded pharmacies. Don’t confuse a drugstore (Drogerie) with a pharmacy; the former is a place to buy toiletries and wellness products, while the second stocks prescription and over the counter medicine.

Pharmacists in Germany require a high level of training and can often be helpful in finding the right non-prescription medicine for your needs. You will need a doctor’s prescription (Rezept) to obtain medicine which has been prescribed to you, and will need to pay a small charge (Zuzahlungspflicht). The laws on dispensing medicine are relatively strict in Germany in comparison to other countries, which means medicines you can normally buy over-the-counter at home may require a doctor’s prescription for in Germany.

Opening hours

Familiarize yourself with the opening hours of your closest pharmacies. They are typically closed in the evenings, on Wednesday and Saturday afternoons, and all-day Sunday except for emergency ones (the locations of these change from week to week; find an online plan for your German city of the 24-hour and emergency pharmacies).

List of common words for health insurance in Germany

It’s a good idea to familiarize yourself with words and phrases associated with healthcare and healthcare insurance before you move to Germany.

Useful German healthcare words:

  • Apotheke = Pharmacy
  • Gesetzliche Krankenversicherung = Statutory public health insurance
  • Krank = Sick
  • Krankenkassen = Non-profit associations that administer public healthcare insurance, like Techniker Krankenkasse (TK)
  • Krankenschwester = Nurse
  • Krankenversichertenkarte = Health insurance card
  • Krankenwagen = Ambulance
  • Öffentliche Krankenhäuser = Public hospital
  • Pflegepflichtversicherung = Nursing care insurance
  • Private Krankenversicherung = Private health insurance
  • Private Krankenhäuser = Private hospital
  • Rezept = Prescription
  • Versicherung = Insurance

Useful German healthcare phrases

  • Ich bin krank = I am sick/ill
  • Ich fühle mich unwohl = I feel unwell
  • Ich fühle mich echt mies = I am feeling really unwell
  • Ich brauche einen Krankenwagen = I need an ambulance
  • Mir ist schwindelig = I feel dizzy
  • Ich habe Fieber = I have a fever

What to do in an emergency

In case of an emergency, call 112 for an ambulance. This number can be used in all EU countries. If you cannot explain what you need in German, ask for an operator that can speak English, there is no guarantee that someone will be available, however.

You can also phone 116-117 for non-urgent medical queries; this line is managed by the German National Association of Statutory Health Insurance Physicians.