German healthcare is one of the most reputable in Europe and the world. Everyone who lives in Germany has access to high-quality medicine and competent doctors. Are you wondering if their services are free of charge?
Healthcare isn’t free in Germany. However, you won’t pay for medical services directly; instead, it’s paid by public health insurance. German healthcare is funded by the taxes that residents pay every month. For employees, it’s 14,6% of their gross salary.
However, exceptions can be found everywhere, including in German healthcare. In some cases, one might avoid insurance payments or reduce the premium amount. In this article, you will learn the main points of German healthcare and ways to use healthcare for free or at minimum costs.
Healthcare system in Germany and how it works
Many believe that Germany provides free healthcare for all, young and old, poor and rich. However, it’s only partly true. In Germany, people don’t pay a bill when visiting a doctor, but it doesn’t mean they receive medical services for free.
Healthcare in Germany is publicly funded, meaning the cost of health and medical expenses is shared by taxpayers. As an employee, you contribute 14,6% of your monthly income to public health insurance.
Germany obligates everyone to have health insurance (we recommend Feather), whether you are visiting the country or living here. An insured person is eligible to use health services at no extra cost as long as the insurance premium has been paid.
90% of the population uses public health insurance. Employees and self-employed pay around 14,6 % of their gross income to the German healthcare fund that provides insurance for them.
For employees, the employer pays a share of their health insurance. Therefore, the company will contribute 7,3% of your salary from its budget, and you (the employee) will pay the remaining 7,3%.
In contrast, the amount you pay for private insurance isn’t fixed, as is the case with public insurance. Private insurance companies set their rates independently from income.
Premiums vary from one insurance provider to another and depend on the selected package and coverage.
Private insurance is often cheaper for young professionals but gets progressively more expensive.
For notice, workers with public health insurance don’t lose benefits when changing jobs or getting fired. However, for owners of private premiums, different rules might apply. You can read more in our article about health insurance for the unemployed.
Which healthcare services can you use for free?
Generally, health insurance covers all necessary treatments, operations, procedures, analysis, and most of the medicaments prescribed by the doctor. Germany doesn’t have a deductible system like in the US.
The German healthcare system is divided into three main areas: outpatient care, inpatient care (the hospital sector), and rehabilitation facilities. Statutory health insurance will give you access to all these facilities.
When visiting a doctor, patients show their insurance card, and providers automatically pay the invoice. Although the services of some health practitioners might not be included in your coverage, therefore, the bill will be handed to you.
It also depends on the insurance type: public or private. Coverage of public providers often doesn’t include specialists like ophthalmologists, psychotherapists, and cosmetic procedures at the dentist’s office, for example.
Read our guide on the cost of medical treatment in Germany.
Additionally, insurance often doesn’t pay for various examinations for the early detection of diseases. In all these cases, patients are responsible for their bills.
On the other hand, German law says the following for services that insurance can cover: “The services must be adequate, functional, and economical; they must not exceed the necessary level.”
Nonetheless, both types of health insurance in Germany will pay for your stay in the hospital if you need inpatient care.
Read this guide to learn how much private health insurance can cost you.
When is healthcare free in Germany?
German health insurance will give you the right to use German healthcare services to the extent your insurance package allows. Everything above must be paid by the patient.
However, if you live in Germany permanently, insurance will cover most of your needs. In some cases, you even don’t have to pay for the insurance.
If you fall into one of the categories below, the costs for monthly contributions will be paid either by the government or the hiring company.
Read our guide about health insurance costs and cheapest insurance options in Germany.
Volunteering/FSJ or BFD
If you have never heard about FSJ or BFD in Germany, you probably didn’t know that volunteers don’t have to pay for their health insurance during the program.
The hiring organization will cover the costs of health insurance. Therefore, your monthly healthcare costs will be zero, but you still will have public insurance and can use all medical services.
Usually, the program goes for half a year to a maximum of one year, but BFD can be completed for longer – 2 years. You also must be at least 16 years old and a maximum of 27 years old for the FSJ program. BFD, on the other hand, doesn’t have any age restrictions.
You will also benefit from improving your German in daily life and gaining some great experience.
A volunteer visa does not require you to have funds or a rental agreement. Moreover, the institution where you will work pays a salary and sometimes provides accommodation.
The maximum compensation is 402 EUR plus the amount of your rent if the organization doesn’t provide accommodation.
Usual places to work include state organizations like hospitals, junior sports clubs, services for disabled people, preservation of historical monuments, ambulatory services, integration houses, civil protection and disaster management, church communities, and children’s homes such as kindergartens.
An unemployed person is automatically insured by statutory health insurance, which is paid by the government until they find a new employer.
But it doesn’t mean you can just come to Germany, don’t work, and use medical services for free. You can only receive this benefit if you have already paid for 12 months of unemployment insurance during the last two years of living in Germany.
Thanks to unemployment insurance, which each employee in Germany has, you can expect support from the government, including monthly payments of at least 60% of the net wage, paid accommodation, and other free or cost-reduced goods/services/support.
A monthly compensation might not exceed 6,700 EUR in West Germany and 6,150 EUR in East Germany. You can claim it only when you lose your job.
Hence, you need to work for 12 months in the country to receive these benefits so that the government will compensate for your health insurance.
Read more: Health insurance in Germany as an unemployed.
Au Pair is a foreign nanny who comes to Germany for one year to learn the German language and culture. As part of this program, a guest family must pay for your health insurance, accommodation, and food.
Additionally, Au-Pair receives monthly pocket money (salary) of at least 260 EUR per month. Some families might pay more. So Au-Pair in Germany can use German healthcare at no cost.
In exchange for it, a nanny takes care of children and does light housework, in total up to 30 hours per week. It’s a good option for young females. They can apply before turning 26 years old.
Private and public health insurance: the difference
German healthcare is divided into two categories: public and private. Currently, 80% of the German population are customers of public health insurance organizations, and the rest of private insurance companies.
Usually, each employee will automatically be granted public health insurance, and only when they earn more than 5,062 EUR gross per month or 60,744 EUR per year can they apply for the private one.
Health insurance is obligatory for all people in Germany. Even tourists must have one. Foreigners who came to Germany to study, volunteer, or work, can get public insurance.
The main differences in German insurance are that private have a more customized and personalized approach, and the client gets shorter waiting times and better hospital conditions.
For example, patients with private health insurance enjoy staying in a single or double room at a hospital instead of a small shared room with three or four beds.
If you are self-employed private insurance will be a better choice, it won’t depend on your income. Usually, private providers set their rates independently and offer better coverage.
Check out the most recommended health insurance in Germany, Ottonova. It was made for foreign employees, expats, freelancers, and self-employed. Another option would be private insurance from Feather, which is suitable for self-employed people with relatively high incomes.
Both of them provide the most common & necessary medical services and treatments. You will also receive prescribed medicine for free or partially free.
However, some specialist care, such as eye care, dental care, and alternative medicine, might be unavailable or have limitations on what you can claim with public insurance.
Generally, both health insurance types cover necessary conservative dentistry and surgical treatments.
In terms of payment for treatments, private clients will need to pay directly after the treatment. You can reclaim your money back from the insurance company after the treatment.
In the case of public insurance, you don’t have to pay a bill yourself. All invoices are sent directly to the insurance provider.
With public coverage, family members of the insured employee can also be members of the same insurance company and have the same claims. Moreover, they don’t have to pay additionally for non-working spouses and children.
So you are thinking about which insurance to take? Here are factors to consider:
- Your age
- Your legal status and family situation
- Your salary and occupation
- The intended duration of your stay
- The services and benefits you prefer
Private insurance isn’t available for everyone. When examining clients, companies look firstly at your income, secondly at age, and thirdly at pre-existing conditions.
Consequently, older people with some health issues will need to pay relatively high compensation for insurance or won’t be considered at all.
Thus, private health insurance can be of particular interest to adults in good health and with high incomes.
Private insurance with minimal coverage can be arranged easier than public because the second usually takes time to approve and require you to live permanently in Germany.
On the other hand, public health insurance takes everyone under the coverage, regardless of salary, age, or illness. Yet, only long-term residents like students, workers, and trainees can qualify for public health insurance.
The benefits of private and public health insurance in Germany:
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