Health insurance in Germany for foreigners (2024)

Contents

• The German health insurance system
• Health insurance in Germany – who needs it?
• Public health coverage in Germany - how to get it
• Public health insurance – how much does it cost?
• Public health insurance – what does it cover?
• Private health insurance in Germany – who can get it?
• Private vs public health insurance in Germany – key differences
• Health insurance in Germany – when should I get it?
• Health insurance for researchers and scientists
• European Health Insurance Card in Germany

The German health insurance system

Since 2009, everyone who is a resident in Germany has been legally required to have health insurance, including, in most cases, foreign researchers and scientists. Under the law, all residents must have a policy with an insurance provider (called aKrankenkassein German) that offers at least the minimum level of coverage permitted.

There are three options for expat health insurance coverage while living in Germany:

• the government-regulated public health insurance system (Gesetzliche Krankenversicherung, GKV)
• private health insurance from a German or international insurance company (Private Krankenversicherung, PKV)
• a combination of the two that supplements coverage not included in the public health insurance policy.

Choosing healthcare insurance is one of the most important decisions a person can make when moving to Germany, and it can also have long-term ramifications for personal finances and for the care provided. It is thus important to research the options available as well as the advantages and disadvantages offered by public and private insurance respectively.

Health insurance in Germany – who needs it?

Public health insurance in Germany is known asGesetzliche Krankenversicherung (GKV), which translates as “statutory health insurance”, and it covers the vast majority of the country’s residents – around 90 per cent. In 2023, those earning a gross salary of less than €66,600 per year, or €5,550 per month are required by law to be insured under a public, statutory health insurance scheme from a provider of their own choosing.

Public health coverage in Germany - how to get it

Once a job offer is in hand, employers can offer assistance in getting registered, although everyone has the right to choose their own insurer and does not have to necessarily go with suggestions provided by employers.

Four of the largest providers of health insurance in Germany areAOK,Barmer, DAK andTK. While there are over 100 (a complete list – in German – isavailable here), these four companies offer good English language websites.

Providers can offer slightly different rates and different incentives, such as cash back for quitting smoking or engaging in regular fitness activities, so it is worth researching and seeing what the options are. ThisGerman-language websitehas a comparison tool that allows for the comparison of different policies.

Once registered with an insurance provider, they will provide an insurance card, called aGesundheitskartein German. The insurance card has a chip to store personal data and must be presented the first time a doctor is visited each quarter.

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Public health insurance – how much does it cost?

All public health insurance providers in Germany charge the same basic premium of 14.6 per cent of gross income (2023), plus a supplemental charge that is an average of 1.6 per cent of gross income, with those premiums capped at a monthly income of €4,987.50.

Those who earn more than that will not pay a higher insurance premium. The basic premium is split equally between employee and employer: 7.3 per cent each. Since 2019, employers have been required to pay half of the supplemental charge as well.

Residents of Germany and their dependents must also become members of the country's long-term nursing care scheme (Pflegepflichtversicherung). This covers some of the cost of meeting personal nursing needs, including the bathing and feeding of those who become substantially disabled.

The nursing care scheme cost varies based on the number of children a person has, although it generally runs from 3.4 per cent of a person's gross salary with at least one child or 4.0 per cent (with a maximum of €199.50 per month) for a person with no children, of which the employer pays a maximum of €84.79. These figures vary slightly for the state of Saxony, where costs start at 2.2 per cent for a person with one child and 2.8 per cent for childless individuals. The employer contribution in Saxony is also lower, at 1.2 per cent.

Public health insurance – what does it cover?

The minimum threshold all health insurance coverage in Germany has to meet includes:

• in-patient (hospital) care as a ward patient
• out-patient care from a general practitioner or medical specialist (such as a cardiologist)
• prescription drugs
• pregnancy care
• basic dental care
• employee sick note
• statutory sick pay when the employer’s duty to pay it is over (up to 90 per cent of a person's net salary)

In addition, all non-working dependents – spouse, civil partner and children (up to a specified age) – living at the same address as the policyholder in Germany will be covered under the plan at no additional cost. They simply need to be registered with the same health insurance provider as the paying member.

Although the medical provision provided by public health insurance in Germany is fairly extensive, additional care may require additional payment – so it is essential to know what coverage is included. For example, while basic dental care is covered, aesthetic teeth cleaning may incur an additional fee.

Private health insurance in Germany – who can get it?

Germany does offer the opportunity to opt for private health insurance (private Krankenversicherung or PKV for short), but only for:

• those who earn more than a predetermined amount (€66,600 per year in 2023),
• those who are self-employed,
• and university students, who can choose private health insurance for the duration of their our studies

However, even if one of these criteria is met, no one is obligated to choose private health insurance. Anyone can still opt for statutory health coverage.

Private insurance – how much does it cost?

There are a few important factors that should be reviewed before considering private insurance. Although not impossible, it can be extremely difficult to enter or return to the statutory healthcare system once a person has a private insurance policy. In addition, monthly insurance premiums for private policies are not pegged to a person's salary. Germany's leading consumer reports organization, Stiftung Warentest, writes that the average person who first signs up for private insurance in their mid-thirties can expect their premium to rise to at least three times the original price by the time they retire.

Private health insurance – where to get it

A complete list of all private health insurance providers is available on thisGerman-language website. However, given the differences in premiums and scope of coverage available, it is worth using a commercial price comparison website likeCheck24,Krankenkassen DeutschlandandPKV-Gesundheit or a locally based health insurance broker, who can provide purchasing advice.

Private vs public health insurance in Germany – key differences

Although everyone has access to all healthcare institutions for doctor’s appointments and medical treatment with both types of policy, it is worth knowing the differences. For example, public health insurance does not cover needs such as dental implants, glasses or contact lenses or private rooms in hospitals, but a private insurance policy might cover several or all of these.

• While basic premium rates for public health insurance are the same (14.6 per cent) for all residents of Germany, regardless of income, private health insurance charges higher premiums that vary according to income, health and potential future health problems, and the risks a policyholder is willing to accept when purchasing a policy.
• Although pre-existing conditions are not an issue with public health insurance policies, that is not the case for private coverage. Still, because private health insurance providers in Germany are legally obliged to accept anyone, nobody can be denied coverage because of a pre-existing condition.
• German private health insurance adopts the same style of system found in any general insurance policy. Each month, a monthly premium is paid and a level of excess (or deductible) is selected on top of that. For example, a €400 excess translates to the policyholder paying the first €400 of healthcare costs before the policy kicks in.
• Under the public health insurance scheme, policyholders face a co-pay of 10 percent of the cost of any prescription medicine, up to a maximum of 10 euros and a minimum of 5 euros per prescription. Those with private insurance policies must pay the full amount for prescriptions up front but will then be full reimbursed after submitting the receipt.
• It is important to note that while public health insurance policies also cover additional family members, this isn’t always the case with private health insurance. It is thus necessary to check the details of any private insurance policy, as it might be necessary to organise separate healthcare provisions for dependents.

Supplementary private insurance

Those who have public health insurance in Germany but want further coverage options can opt to enhance it with supplementary private insurance. While this will incur extra costs, it could come in useful for those seeking coverage for things not included in their public health insurance policy, such as additional dental care or treatment in a private hospital.

Health insurance in Germany – when should I get it?

Ideally, those coming to work in Germany from another country in the EU should get their health insurance as soon as they arrive and are registered as a resident of Germany. Still, there is no cause for panic: Germany offers a brief grace period from the date of registration, and employers will also provide guidance through the process.

Those coming from a country outside the EU, will need proof of valid German health insurance to obtain a residency permit. In such cases, new arrivals must have secured insurance coverage prior to arrival in Germany.

Health insurance for researchers and scientists

Even those coming to Germany to work as guest researchers or scientists must have a valid health insurance policy. Universities are able to accept proof of insurance policies held in guest scholars’ home countries if the coverage is equivalent to that provided by a German statutory health insurance policy. Don’t forget that if family members are also joining, they will also need have health insurance during their stay in Germany.

Germany has social insurance agreements with a number of countries, including the member states of the European Union and those in the European Economic Area. In such cases, policies held in home countries are valid in Germany as well.

Those from a non-EU country planning to stay in Germany for a longer period of time will need to obtain the compulsory health insurance from licensed insurance companies in Germany. It is possible to purchase a policy tailored for guest scientists and researchers, such asEDUCARE24, IHC-COMPANY’sInternational Science Healthcare PlanandMAWISTA Science.

European Health Insurance Card in Germany

Citizens of other EU countries, EEA countries and Switzerland who have a European Health Insurance Card are eligible for free access to some health treatments while visiting Germany on a temporary basis. This might be useful for jobseekers coming to the country to explore the possibility of living and working there. However, this isn’t a substitute for German health insurance, and as soon as residence or employment are established, all are required to have proper policy coverage.

Authors

DACHA Media

Source

academics - July 2023