Most residents in Germany are enrolled in the public healthcare system, but some individuals qualify for choosing a private health insurer instead. Private health insurance can cost a lot more or a lot less than statutory coverage. The fees 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.
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 healthcare insurance choose to take it, and that’s because the public healthcare scheme is excellent; for some, there may not always seem like a lot to gain from going private.
However private insurance can sometimes mean a higher level of care, shorter waiting times and additional services. For instance, private dental insurance may offer cover major dental work 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 to 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.
In some instances, it’s 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%.
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 (which is automatic). They can do this by letting both their employer and the public healthcare fund know. It's important to understand that once someone has chosen to be covered by a private fund, it's not an easy process to come back to the public system. However, it is possible if, for example, your wages have reduced.
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 automatically enrolled in the public healthcare system. Make sure you know the name and details of your private insurer, as the contributions will still be deducted from your wages, so you will need to provide this to your new employer. Also, it is very important to check if a private insurer meets the strict guidelines of the German government.
Private health insurance can range hugely in cost. Unlike public healthcare insurance, which costs the same (in terms of contribution %) for everybody, the cost of private healthcare insurance premiums will depend more upon age and health (risk). Those with chronic health conditions may find that public healthcare insurance is significantly cheaper because their private premiums would be so high. People who gain the most from private healthcare are young people in the highest wage brackets with good health.
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 freelancers, it’s worth knowing that up to 80% of the cost of private healthcare insurance is tax deductible.
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.
At Expatrio we can help international students register for discounted student healthcare and nursing cover with TK, before they move to Germany. See our Health Insurance for International Students page for more information.
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 travel too. If you plan on travelling from Germany, whether it be for work or leisure, to other countries, consider adding a travel insurance element to your private healthcare cover.
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 will opt for private health insurance, try to organize this online and with the help of provider support before you arrive.
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. Remember to budget for paying for your doctor’s visits and treatments as you will have to do this before being reimbursed.
If you have private health care cover in your home country, you may be able to move to Germany and still be covered by the terms of your insurer to use private doctors and hospitals in Germany, but it’s really important that you check this first.
If you have public healthcare insurance then your children are covered under your plan. This may not always be the case for private healthcare. Make sure you choose a provider that covers your family.