Health Insurance Options - Private vs. Public

Private Health Insurance vs. Public Health Insurance

Health insurance plans for freelancers, employees, students and German visa & residence permit holders.

Since 2009, everyone living in Germany must be covered by health insurance.

Our Health Insurance Service Explained

 

Public or Private Health Insurance Plans for Employees, Freelancers, Students & Visa Holders.

 

In brief:

  • If you are employed and earn more than 64,350€ a year, we recommend you to choose Private Health Insurance. Get a free quote either from Feather or Ottonova (our favourite providers).

  • If you are unemployed, self-employed or currently looking for a job and you've just moved to Germany from a non-EU country, then you should sign up for Expat Health Insurance (limited to 5 years). Once you have a steady income, you can easily cancel and switch to Public or Private Health Insurance. Sign up now either via Feather or Ottonova.

  • If you are already a freelancer working in Germany with a steady income (more than 5,400€ a year), take out Private Health Insurance. This is often the only solution you have. Get a free quote either from Feather or Ottonova.

  • If you need health insurance to get a visa or residence permit then we recommend that you take out Expat Health Insurance. You can cancel anytime. Once you find a job in Germany, you can easily cancel and switch to public health insurance. Sign up now either via Feather or Ottonova.

  • If you are a university student under the age of 30, be sure to take out Public Health Insurance. TK has an incredibly affordable offer made just for students so be sure to take advantage of it! Sign up here. [Add-on: Dental Insurance].

  • If you are in any other situation (job seeker, au pair, holiday workers, language student, guest researcher, tourist, etc.), we recommend that you take out Expat Health Insurance. This will not only make sure that you are covered in case of an accident, but it will also fulfil the legal requirement for living in Germany. You can switch easily to Public or Private Health Insurance at a later stage. Sign up now either via Feather or Ottonova.

WHAT TYPES OF HEALTH INSURANCE ARE AVAILABLE IN GERMANY?

PRIVATE HEALTH INSURANCE

It is not easy to be part of the private health insurance system. Private health insurance covers around 10% of the population in Germany, particularly employees earning over 64,350€ a year (legal threshold) and freelancers with a steady income.

The costs of private health insurance depend on your age, your occupation and your health condition, not on your income.

Advantages of private health insurance:

  • It is cheaper than public health insurance if you earn more money as premiums are not based on your income.
  • It is cheaper than public health insurance if you are young, healthy and don’t have dependent children: your children and/or non-working spouse need to get insured separately.
  • You can customize your coverage, including special treatments, dental coverage, travel insurance, and so on.
  • Physicians make more money from private health insurance companies, so they will treat private-insured patients first and better. You will be prioritize over public-insured patients!
  • If you rarely need to go to the doctor, you can take a higher deductible, so you will pay less insurance each month!

Disadvantages of private health insurance:

  • It is more expensive than public health insurance if you are old, have dependent children or a non-working spouse.
  • It is more expensive than public health insurance if you have some pre-existing conditions (i.e. heart problems, diabetes, etc).

Who can take out private health insurance?

  • Employees in Germany who earn over 64,350€ a year (before taxes). This is the law! Private health insurance companies are not forced to accept you.
    The costs of private health insurance depend on your age, occupation and health condition. Your employer will pay half of your monthly contributions.

»» If your yearly gross income is over €64,350€ (before taxes), you can take out private health insurance either via Feather or Ottonova (Premium Economy or Business Class). Our partners will help you find the option that best fits your budget and meets your needs. ««

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  • Freelancers (Newly Arrived): If you are a freelancer and you just moved from a non-EU country, then Expat Health Insurance might be your only solution. Sign up now with Feather! It only costs 72€ a month. Alternatively, you could take out Expat Health Insurance ("First Class Expats") via Ottonova. They have a tariff starting at €165 a month. You can easily switch to private or public health insurance once you have a steady income.

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  • Freelancers (with a Steady Income): If you are a freelancer working in Germany, then Private Health Insurance might be your only solution.

»» Freelancers can always choose private health insurance. You can take out private health insurance either via Feather or Ottonova (Premium Economy or Business Class). Our partners will help you find the option that best fits your budget and meets your needs. ««

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  • University student who are over the age of 30:
    • Private & public health insurers offer special rates. However, you should probably consider getting an Expat Health Insurance as it is the cheapest solution available until your studies are over.
    • Once you find a job after your studies, you can easily take out private or public health insurance.

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  • Language students, doctoral candidates, trainees, researchers & au-pairs:
    • You can take out private health insurance if you get accepted. However, you should probably consider getting an Expat Health Insurance as it is the cheapest solution available for short-term stays or until your studies are over.
    • If you decide to stay longer (i.e. you find a job after your studies), you can then easily switch to private or public health insurance with no back payments.

 

EXPAT HEALTH INSURANCE

Expat health insurance is a type of health insurance that was especially designed for expats staying temporarily in Germany. Expat health insurance covers you in Germany up to 5 years. You can easily switch to a proper private or public health insurance with no back payments if you decide to settle in Germany.

Expat health insurance (sometimes referred to as “incoming insurance”) is a great solution for your first years in Germany. It’s good, affordable coverage that fulfils the legal requirements for obtaining a visa or residence permit. Signup is simple and payments are made month-to-month. Cancel anytime with just one click.

Advantages of expat health insurance:

  • It is cheaper than public or private health insurance.
  • It fulfils all German legal requirements for obtaining a visa or residence permit (not for renewals).
  • It is easier & quicker to get than public or private health insurance. It usually takes a few minutes.
  • It is flexible. You can cancel anytime with one click.
  • This health insurance covers any unexpected medical treatments and procedures, as well as associated follow-up costs.
  • If a sudden illness requires treatment or hospitalization, this health insurance covers all costs.
  • If an injury or health problem requires you to be transported by ambulance to a medical facility, costs will be covered.
  • In particularly serious cases, you may need to return to your home country for treatment. This expat plan will cover the travel costs.
  • You can customize your coverage (dental check ups, visual aids like glasses or contacts, etc).
  • You can easily switch to a proper private or public health insurance with no back payments if you decide to settle in Germany and can afford something better.

Disadvantages of expat health insurance:

  • This expat insurance is a temporary health insurance (valid for up to 5 years).
  • This expat insurance is not accepted for residence permit renewals.
  • This expat insurance is not accepted if you need to change to a different residence permit.
  • Long-term treatments are 100% covered, but you sometimes have to pay a small deductible for basic treatments (i.e. simple check ups).

Who can take out expat health insurance?

  • Non-EU citizens moving to Germany and wanting a temporary health insurance (for up to 5 years).
  • Non-EU citizens moving to Germany and wanting a coverage that fulfils the legal requirements for obtaining a visa or residence permit.
  • Non-EU citizens moving to Germany and wanting an affordable health insurance with no paperwork and in English.
  • Working holidaymakers.
  • Language school students.
  • Job seekers.
  • Minijobbers (a 450€ job).

Reminder: Employees who earn under 64,350€ per year are only entitled to public health insurance! Also, university students under the age of 30 are usually covered with public health insurance.

What are the best Expat Health Insurances in Germany?

We, at myGermanExpert, have been dealing with expats moving to Germany on a daily basis for almost 10 years, and we can recommend 2 options to you:

Feather: Expat health insurance starting at €72 a month. Founded in 2008 in Berlin, this young start-up is here to last. This insurance is flexible. You can cancel anytime with one click.

Ottonova: Expat health insurance ("First Class Expats") starting at €165 a month. Founded in 2005 in Munich. They offer unique health care plans for everyone working in Germany. You can choose between different plans, depending on what coverage you are looking for. All in one app and in English. You can even book a doctor's appointment directly through their app.

PUBLIC HEALTH INSURANCE

Public health insurance, also called statutory health insurance, is the most popular option in Germany. In fact, 90% of Germany's population has public health insurance.

Advantages of public health insurance:

  • It is cheaper if you earn less money.
  • It is cheaper when you are old.
  • It is cheaper for university students under the age of 30.
  • Your children and/or unemployed spouse are covered for free.
  • It is cheaper if you have pre-existing conditions. There are no extra costs for them!

Disadvantages of public health insurance:

  • It is more expensive than private health insurance if you are young, healthy and earn a high salary.
  • It is more expensive than private health insurance if you are young, healthy and have no spouse or children.
  • Physicians make more money from private health insurance companies, so they tend to treat private-insured patients first and better.
  • You cannot customize your coverage: no special treatments are included, everyone gets the same.
  • If you are a freelancer, a language student or a doctoral student (with a scholarship) and you just moved from a non-EU country, then it's almost impossible to get public health insurance.

Germany's largest and most popular health insurance provider is TK (source: Focus Money business magazine).

Public health insurance is mandatory if:

  • you are employed in Germany and earn under 64,350€ a year (before taxes). This is the only option available to you. Statutory health insurance funds are forced to accept you!
    The costs of public health insurance depend on your salary. You contribute 14.6% to 15.6% of your income every month. Half of it will be paid by your employer!
  • you are a university student under the age of 30 (until you reach your 30th birthday or until your 14th term of study).
    • You will pay around 104€ a month.
    • If you are a EU citizen, you can use your EHIC card. You will have to use your EHIC to register with a statutory health insurance fund in Germany. The insurer will then provide a confirmation for the enrollment at the university.

If you only qualify for Public Health Insurance, you can take out public health insurance yourself and become a member of TK now! It's free and in English! TK is the most popular health insurance provider in Germany.

If your yearly gross income goes over €64,350€ (before taxes), you can take out private health insurance either via Feather or Ottonova (Premium Economy or Business Class). Our partners will help you find the option that best fits your budget and meets your needs. ««

Public health insurance is optional if:

  • you are a freelancer.
  • you are a university student over the age of 30.
  • you are an employee and earn more than 64,350€ a year (before taxes).
  • you have a minijob.

In those cases above, you can choose public or private health insurance. However, public health insurance funds are not forced to accept you! Check ou the "Private Health Insurance" section above for more details.

STATE HEALTH INSURANCE

(Public Health Insurance)

This type of health insurance is provided by the German government.

It is mandatory to take out state health insurance if you are employed and earn less than €64,350 per year. A basic level of insurance cover will be deducted from your gross annual income in a fixed percentage. In addition, you will have to take out long-term nursing cover.

In 2020, state health insurance payments are set at 14,6% + roughly 1% supplementary charge (varies per provider), and 3,05% (3,3% if over 23 and childless) extra for providing long-term nursing cover. If your salary is €5,362.50 per month or less, these deductions will apply to you.

If you are employed rather than freelancing, your employer must cover 50% of the amount: they will pay up to €367,97 + €71.48 (nursing care) per month. If you earn more than €4,687.50 per month, you will need to make a personal contribution of €367.97 + €71.48.

Are you employed in Germany and earn under 64,350€ per year?

If you earn less than 64,350€ per year (gross), you are required to join a Public Health Insurance fund. You cannot take out private health insurance!

Become a member of TK – the largest health insurance fund in Germany. Fill in the online application in English and become a member of the Techniker Krankenkasse, named Germany’s best health insurance fund in 2020.

Do you need a Supplementary Dental Insurance?

When it comes to dental treatments, public health insurance generally covers the bare minimum. By signing up for a dental insurance (from only 9€ a month), you’ll have access to the best treatments at any time.

This is only available for patients who have public health insurance in Germany.

PRIVATE HEALTH INSURANCE

Private health insurance is becoming increasingly popular in Germany, largely due to the fact that many state health services have been cut or downgraded.

Contrary to what one might expect, in Germany, it is more cost effective to take out private health insurance rather than state health insurance as private policies provide more comprehensive cover and better value.

The key private healthcare services include:
• the ability to access private or semi-private hospitals;
• prescription glasses or contact lenses;
• access to various other health services.

Private patients can also access priority dental care, and priority treatment and doctor's surgery or hospital. Some health professionals only provide care to private patients. An employer will cover half of the cost of private health insurance up to the amount that he would have to pay for the statutory insurance, which works out as a contribution of up to €367.97 for health cover and €71.48 for long-term nursing cover. These are the same maximum amounts as for state health insurance.

EXPAT HEALTH INSURANCE

FOR

VISA & RESIDENCE PERMIT HOLDERS

Non-EU citizens who plan to stay in the country for more than 90 days need to apply for a visa or a residence permit. Check out here if you need a visa to enter Germany.

The German Residence Act (Section 5 (1) (1)) states that for a residence permit to be granted, the applicant needs to prove that s(he) will be self-sufficient while living in Germany. Section 2(3) of the act states that part of self-sufficiency involves having adequate health insurance coverage.

When it comes to taking out health insurance, applicants for a German residence permit have two options: German private health insurance or international health insurance cover. However, international health insurance companies do not always fulfill the requirements demanded by German law.

German law states that foreign nationals lacking German state health insurance must provide evidence of another type of health insurance cover that meets the same requirements as German statutory health insurance.

That means that the policy must not:
• comprise any large-scale exclusion from benefits;
• demand high excess payments from the insured person;
• place limits on the costs that can be reimbursed if the insured person becomes ill;
• involve any indemnity or expiration clauses related to the age of the policyholder,
the activities they take part in, or any changes to the purpose of their residency in Germany.

Moreover, the policy must function as life insurance, i.e. it must not be designed to expire, or it must be automatically extendable or renewable.

The Bonn-based Bundesanstalt für Finanzdienstleistungsaufsicht (the German Federal Supervisory Authority for Financial Services) stipulates that all German statutory requirements for German health insurance, as laid out in Book 5 Sect. 257(2)(a) of the German Social Security Code, must be met by any agreement between an insured person and their insurers.

If you wish to discover whether your international health insurance policy is valid in Germany, one option is to ask the insurance company to confirm that they meet the German legal requirements. If they cannot provide such confirmation, it is likely that they do not meet the requirements.

Need help finding the right health insurance?

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