Public health insurance in Germany
Germany's state-run public healthcare system is funded by employers and employees through social security insurance contributions and is also subsidized by the government, so that those on pensions and unemployment benefits can still access healthcare. The vast majority of the population are enrolled in the public healthcare insurance system or Gesetzliche Krankenversicherung (GKV), with the other 10% choosing/having access to private healthcare insurance or Private Krankenversicherung (PKV).
You can only opt out of the public healthcare system if you qualify for one of a few criteria, such as being self-employed, earning over a €60,750 year, being a student aged 23-29 (in some cases), or working as a civil servant. Once somebody has opted out of the public healthcare system, it's not that easy to get back into it, although it is possible.
How much does public health insurance cost in Germany?
In Germany, all employed workers pay a statutory healthcare insurance contribution as part of their social security contribution. This is normally 7.3% of their gross paycheck, and this is typically matched by the employer who pays a further 7.3%. totaling 14.6%. This amount rises to just over 8% for higher earners but is capped at €683 a month. A new law in 2019 allows healthcare insurers to charge an additional contribution of up to 0.9%, which is again shared by both employer and employee. Employers and employees also share a 3.05% nursing care insurance contribution, intended to help fund care in later life.
Student public healthcare costs
Students are able to pay a set and discounted amount for healthcare at €117.50 a month (for students aged 23 to 30). This fee is related to long term care and it includes a contribution to nursing costs. However, students aged under 30 are one of the only groups of people in Germany who can opt-out of the public healthcare system and choose private healthcare should they wish. The vast majority choose to pay €117.50 per month, which is often the more cost-effective choice and ensures their nursing contribution is being covered during this time.
How to apply for public health insurance in Germany?
For all employed staff, enrollment in the public system is generally automatic, and contributions will be taken from wages at source, although employees have the option of choosing which provider they use. There are over 100 non-profit insurance providers, known as Krankenkassen. These associations collect the contributions and pay out claims from hospitals and doctors every time one of their insured members uses a medical service. Some of these are very large and popular funds with millions of members, such as the Techniker Krankenkasse (TK), whilst others have a few thousand ‘insurees’.
An employer will take care of the process on behalf of the employee, but those who want to request a specific provider will need to let their employer know before they are enrolled. Once someone has contributed to a provider for more than 18 months, they can change to another provider should they wish. Although most providers offer similar benefits, there are small variances between them, so it's important to check what each one offers. Larger funds such as TK tend to offer the best in terms of both cover and member support.
Once registered, each individual will receive a public healthcare insurance number and a card which details their provider. It’s important to take this card to every doctor appointment, treatment, or hospital visit.
Tip: Take a look at Healthcare Providers Comparison page to find out how different providers match up.
What is covered by public healthcare in Germany
Public healthcare in Germany covers GP (general practitioner) appointments, in-hospital treatment, out-patient treatments, surgery, maternity services, and basic dental care. It is possible to get an additional private health insurance plan that covers aspects of health which are not covered by the basic system, such as major dental work or a private room for a hospital visit.
Can I choose a doctor or practitioner?
Yes, unlike most countries with a public healthcare system, those in the German public scheme do not have to go to a registered doctor but get an appointment with any doctor registered in the public healthcare system, called Kassenärzte.