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The right health insurance for expats in Germany - which one is the best for you?

March • 28th, 2021
by the Expat in the City Team

Expat Insurance consultant

Private vs. public health insurance in Germany


If you are moving to Germany to work as an expat, there is a lot to think about and organize. Good news first, as an expat living in Germany, you too can enjoy the benefits of one of the world’s best medicine and the security of universal healthcare!


When do you choose private or public health insurance?


Already while applying for a German residence permit or Visa (which means you are planning to stay for more than 90 days), you must get a valid German health insurance. Here you will face the same choice as everyone living in Germany: private or public health insurance?


When it comes to health insurance in Germany, the definition of an expat differs too. The country from which you are moving to Germany is one factor; how long you plan to stay in Germany is another. For example, the law in Germany allows people with a temporary residence permit to take out special expat health insurance plans. Even though around 88% of the population in Germany is a mandatory or a voluntary member of the public health scheme, private insurance might be the better choice for you as an expat. 


Because we know the whole German healthcare system can seem a little complicated at first, we made a brief overview of both options for you. In collaboration with our partner Ottonova we want to help you find out the key facts about private as well as public health insurance and which one will work best for you as an expat! 


To get started, here are some general facts about both types of insurance systems: 


Private Health Insurance (PKV) in Germany 


How does the system work?


  • Policyholders’ premiums cover the rising costs of their healthcare as they grow older.
  • Risk assessments protect the insurance collective from being overburdened.
  • Focused on the individual but assumes solidarity between the healthy and the sick.


How are the premiums determined?


  • Premiums are dependent on the chosen tariff, age at entry, and state of health. 


Coverage scope


  • Treatment coverage is contractually stipulated and remains effective for a lifetime.
  • Payments for treatments are settled between you and your doctor. 


Benefits of private health insurance


  • For higher-paid professionals, private health insurance can be less expensive than the state scheme as contributions to the state scheme are based on your gross income.
  • A wider choice of medical and dental treatment and generally provide broad geographical coverage.
  • No co-payments for medicine.
  • Access to private practice doctors. 
  • May offer more comprehensive cover for a procedure.
  • Access to semi-private and private rooms in hospitals.
  • A higher level of service from the medical profession.



Public Health Insurance System (GKV) in Germany


How does the system work?


  • Young and healthy people finance the care of the elderly and sick. 
  • Nobody can be rejected on account of the state of their health. 
  • Based on the intergenerational contract and designed in accordance with the principles of the social state. 


How are the premiums determined?


  • Premiums are based on income. 


Coverage scope 


  • Treatment coverage is determined by legislators and can be amended at any time. 
  • Payments for treatments are settled between your doctor and your public insurance provider.  

Benefits of public health insurance


  • As a voluntary member of the GKV you can opt-out at any time with a 2-month cancellation notice if you prefer a private health plan and have been accepted by the insurance company of your choice.
  • Spouses, civil partners and children (up to age 23, or 25 if studying) of someone covered by state healthcare insurance are eligible for family co-insurance in certain conditions.
  • State health insurance typically covers the basic costs of pregnancy and childbirth.
  • Contrary to private health insurance you will not have to pay a higher fee as you get older.


Which insurance you can chose depends on your income 


Health insurance in Germany works slightly differently to many other developed countries, in that the type of insurance you can access depends on precise earning amounts: those earning more than 64,350 EUR a year can choose private insurance, while those who earn less than 64,350 EUR are automatically enrolled to public health insurance.


What is included? 


German public health insurance includes inpatient care at your nearest hospital and out-patient care from doctors. These basic services are available across the board, but if you want private medical care or your own hospital room you’ll need an additional private healthcare plan. Some specialist care, such as eye care, dental care and alternative medicine isn’t available in the public system or comes with limitations on what you can claim. This means the state is likely to only offer partial coverage for major dental work. Residents with private insurance should review their plan to see what dental coverage is on offer. Otherwise, dental insurance in Germany is either a supplement to your health insurance plan or a stand-alone form of insurance. 


Ottonova is a private German health insurance start-up that works easily through an App (just like N26) and offers 24/7 service and help in English for Expats. You can also book English - speaking doctor's appointments directly through the app. They offer a free first-time consultation for expats, where you can find out anything you want to know - they will explain to you their especially for expats designed insurance packages and tariffs for EU and non EU-citizens that fit the needs and life of international professionals! 

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Book your free consultation with Ottonova here!

It's up to you which German health insurance you pick 


If upon arrival in Germany you wish to be privately insured, you will need to inform your company's human resources department within 14 days of your employment commencement date to avoid possible confusion; otherwise, you may find yourself automatically registered in the government system. Most importantly, it is your decision and your employer is not allowed to restrict your freedom of choice among the various Krankenkassen or private health insurance providers.



Which health insurance is best for you depends on your situation


To sum it up, both private and public health insurance systems have their benefits. Private health insurance makes sense for everyone who isn’t planning to stay in Germany long-term. Especially if you don't have children, or if you don't want to live in Germany forever, private health insurance is often much cheaper than public health insurance. To make your start in Germany as relaxed as possible, we want to advise you to get a free personal expat-friendly consultation, for example with ottonova - your health insurance choice, to find out which one is the best choice for you :) 





Read our article on the German social security system to find out more; or follow us on Facebook and join one of our many webinars on this topic! 

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