Germany’s Comprehensive Health Care System

Learn About Health Insurance in Germany

More than 10 million foreigners live in Germany, making it the second most popular destination globally, after the United States. The country is well known for its comprehensive welfare system, secure jobs, good salaries, and clean environment. No wonder so many expats are considering Germany for their next living destination. However, before deciding to move there (or anywhere in the world, for that matter), there are several things every expat needs to consider, like getting a visa, learning the tax system, finding a place to live, and so on. 

Yet, maybe the most important thing is learning about the country’s health insurance system. Why? Simply because that is the number one requirement for getting a visa and establishing your life in Germany. 

With that in mind, let us go through all the information you need to know about Germany’s comprehensive health care system. 

Health care in Germany 101

All Germans and legal residents are entitled to free, “medically necessary” public healthcare funded by social security contributions. Importantly, as of 1 January 2009, everyone who resides on the country’s territory must acquire health insurance Germany-wide valid, which can be public (statutory), also known as the gesetzliche Krankenversicherung, or private, known as Krankenversicherung. Contributions from the members of both fund the country’s health care system. 

All the insured persons receive the same level of services with the statutory health insurance (SHI). That means that everyone has an equal right to medical care (and continued payment of wages when ill) regardless of their income and premium level. But those who earn more pay higher contributions. That is the principle of solidarity in effect. The general contribution rate in the SHI is 14.6 percent of salary, and half is paid by the employer. Notably, the SHI, in contrast to the private health insurance (PHI), coverage is extended at no extra cost to the children and the spouse of the insured if they have little or no income. 

The PHI contributions depend on a person’s health, the age at which they take out the insurance, their previous medical condition, the type of coverage, and similar. A privately insured person also has to pay for each additional person in the family individually, meaning not everyone in your family can be covered under your insurance policy. 

Typically, employees must make SHI contributions if their income is below a certain level (which in 2020 is €5,212.50 per month). Suppose a person’s monthly income exceeds this level. In that case, they can retain the SHI membership voluntarily or choose to take private health insurance. Like civil servants and self-employed, some groups are also exempt from mandatory contributions to the SHI regardless of their income level.

What is covered by public health insurance?

German public health insurance includes many different services across the board, regulated by law. The basic ones are, for example:

• Inpatient care at your nearest hospital and private clinics in cases of emergency,
• Shared room in a hospital,
• The hospital doctors on duty,
• Hospice,
• Preventive care and rehabilitation treatments for a maximum of three weeks, 
• Approved, prescribed, and pharmacy-only medicines,
• Approved, medically-prescribed treatments such as physiotherapy, massage, speech therapy or occupational therapy, etc. 

If you want private medical care or your private hospital room, there is also the possibility to pay for an additional private healthcare plan.

Some specialist care, such as eye care, dental care, and alternative medicine, comes with limitations on what you can claim or is not available in the public system. 

What is covered by private health insurance?

Private health insurance in Germany offers more comprehensive coverage for medical care than public health insurance. For example, many private health insurance companies provide better dental treatment coverage than public health insurance companies. Also, patients with private health insurance in Germany have better access to private practice doctors, private rooms in hospitals, and alternative treatments. 

Another advantage of private health insurance in Germany is that you can personalize your plan to fit your needs. Overall, PHI policies cover outpatient medical treatment, emergency ambulance transport, specialty treatments, doctor’s fees, vision aids, and prescribed drugs. 

Separate aspects of your health insurance

Sick leave – Statutory health insurance includes sickness benefits. The employer is paying you 100% of your salary for up to six weeks. After that, the health insurer pays 70% of your regular wage for a maximum of 78 weeks (over three years). However, keep in mind that the SHI pays up to €3,176 per month before tax, so you might want to consider purchasing additional sick pay insurance. 

Maternity care – State health insurance typically covers the necessary costs of pregnancy and childbirth. If you are privately insured, you need to check with your private health insurance company, which costs for the baby’s delivery, and care are covered.

Pharmacies – The SHI generally provides reimbursement for generic prescription drugs, though, with a co-payment, the scale depends on the cost of the medication. However, as a public patient, they are obliged to give you the lowest possible price for the generic medicines when you present a prescription from the registered doctor. 

If you are privately insured, brand-name medication will usually be covered, as long as you have a prescription. You will have to pay the prescription medicine’s full cost immediately and then submit the receipts to your insurer for reimbursement.

Dental care – Dental insurance in Germany is typically a supplement to your health insurance plan and costs around €10–20 per month. With the SHI, simple routine dental procedures like filling, dental hygiene, or dental emergencies are likely to be covered. However, for major dental work, expect that you will get only partial coverage. If you opt for PHI, the dental care coverage will depend on your individually agreed health insurance plan.

How to get your health insurance?

Typically, employers in Germany take care of registering their employees with a German health insurance company. However, if you want to choose on your own, let the HR department know beforehand. Remember that your employer will outline the health insurance costs to you and deduct them automatically from your salary. 

When it comes to health insurance providers, Germany has over a 100. They offer slightly different rates and different incentives, so it is worth researching and seeing what your options are. 

Once you choose and register with an insurance provider, they will issue you an insurance card- Gesundheitskarte. The insurance card has a chip that stores your data and must be presented the first time you visit a doctor each quarter.

Conclusion

Germany enjoys a high standard of health care and has a dense network of hospitals, physicians, and pharmacies. It really has a welfare system that puts the well-being of the individual in its center. One of the more beneficial perks for an expat is the fact that those who are insured in Germany may make use of the health services in the other states in the EU, as well as in Iceland, Liechtenstein, Norway, and Switzerland. They can be reimbursed by their health insurance providers once they are back in the country.