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German Public Health Insurance: All You Need To Know

Healthcare worker explains how German public health insurance works to a patient.

You can use excellent German healthcare for free only with valid insurance; otherwise, going to the doctor will be expensive.

German healthcare is divided into statutory (public) and private sectors. Nevertheless, 80% of the German population has public health insurance.

The statutory health insurance in Germany is government-regulated public health insurance. Everyone who lives in Germany can get general coverage. The monthly rate is 14,6% of the gross salary for employees. For students, a fixed amount of about 100 EUR applies.

The public (statutory) health insurance in Germany is known as “gesetzliche Krankenversicherung,” shortly GKV. It’s the default type of health insurance.

Public healthcare is universal and available for most German residents without special conditions. However, foreign nationals will need to meet several criteria before they can get a public insurance card.

Details on Public Health Insurance

Stettoscope near laptop on top of a table

The German healthcare system comprises three main areas: outpatient care, inpatient care (the hospital sector), and rehabilitation facilities.

Statutory health insurance grants access to all these facilities, typically offering Germany’s most affordable and dependable coverage.

Government-backed public health insurance operates through public insurance companies responsible for covering your medical expenses.

Germany’s largest public health insurance providers are AOK, Barmer GEK, and TK. These insurance companies have over 100 offices nationwide where you can apply for your insurance card in person (see a complete list on this website).

Insurance brokers like Feather help non-German speakers get coverage by providing English-speaking assistance.

Furthermore, multiple independent organizations offer various healthcare policies you can select. They all offer similar services at comparable prices, with slight benefit variations.

Many people in Germany get public health insurance automatically, so they don’t have to sign up for it; this applies to:

  • Employees
  • Trainees
  • People on unemployment benefits

In other cases, you must directly apply at one of the branches. Keep in mind that statutory health insurance isn’t free. Everyone in Germany must pay for medical coverage monthly.

In the mentioned cases, they will deduct insurance contributions from the monthly salary, and if unemployed, from the monthly benefit payments.

Coverage of public health insurance

Healthcare workers discussing German public health care

In general, you don’t have to worry about additional payments or very long waiting lists. German statutory insurance covers preventive services, inpatient and outpatient hospital care.

Here is the list of typical services & care that are included and free of charge for patients:

  • Pregnancy care
  • Physical services
  • Mental healthcare
  • Dental care
  • Optometry
  • Prescription drugs
  • Medical aids
  • Rehabilitation
  • Hospice
  • Palliative care, as well as sick leave compensation

Preventive services, such as regular dental checkups, child checkups, basic immunizations, checkups for chronic diseases, and cancer screening, are provided.

Insurance reimburses all prescription drugs, but you must pay 10% of the prescription medicine cost, with a maximum of 10 EUR and a minimum of 5 EUR per prescription.

Statutory insurance covers children under 23 and unemployed spouses for free.

Note that some services, like physical therapy, require self-payment. Private doctor visits may also incur charges.

Patients with public health insurance generally receive reimbursements for treatments from “public” physicians and specialists, known as “Kassen Artz” or “Alle Kassen,” who collaborate with statutory health insurance or all insurance providers.

Additional Contributions

Your provider may charge you an “additional contribution” of up to 1.1% of total monthly costs, providing extra treatments not covered by public health insurance, depending on the provider.

  • Additional dental care, such as professional tooth cleaning or dentures
  • Flu and travel vaccinations
  • Cancer screening for children under 30 years old
  • Osteopathy
  • Homeopathy
  • In vitro fertilization (IVF)
  • Contraception

When visiting a dentist, you are limited by the list of free services they provide. Although the treatment choice is broad, you might need to pay out of pocket. We recommend taking dental insurance for such cases.

For example, public insurance pays only for particular materials, usually the most basic ones. Plus, patients pay for most cosmetic procedures, like teeth whitening.

Read more about dental care and its cost in Germany.

Requirements for Public Health Insurance in Germany

Public health insurance requirements in Germany

In Germany, health insurance is mandatory for all people. This is because everyone should have adequate access to medical services.

However, not everyone is eligible for public coverage. These groups of people can apply for statutory health insurance in Germany:

  • Employees whose annual income is less than 64,350 EUR gross (2022)
  • Pensioners
  • Full-time students
  • Trainees
  • Unemployed who receive unemployment benefit
  • Civil servants
  • Family members of an employee without income ( e.g., spouse and children)

Short-term visitors to Germany, such as tourists, language course participants, non-EU exchange students, and non-EU scientists on extended stays, cannot apply for statutory insurance. They will need to get private health insurance before arrival.

Are you a foreigner in Germany and want to have cost-effective and reliable state insurance? Here are other opportunities:

Emergency sign at a hospital emergency room

1. Students from the EU/EEA countries

They can apply for statutory health insurance in Germany by providing a European Health Insurance Card (EHIC) from the health insurance in the home country.

2. Students from non-EU/EEA countries

Non-EU students can also apply for public insurance in Germany; however, only if they are younger than 30 years and not in the 14th semester.

3. Students of preparatory language courses

Students of preparatory language courses have the same rights and restrictions as non-EU students.

4. Employees from EU/EEA countries

Workers from EEA countries and countries that have signed a social security agreement with Germany need health insurance in Germany regardless of whether they are employees or self-employed.

They have two options regarding health insurance:

  1. Get German public insurance provided through full-time employment.
  2. Use the health insurance from their country of origin when working temporarily in Germany (maximum 12 months).

5. Employees from non-EU/EEA countries

Workers from third countries will be granted public health insurance regardless of their length of stay by providing a residence permit in addition to the work permit.

6. Foreigners from EU/EEA states without employment

Citizens from EU member states can receive free treatments in Germany with their European health insurance card. It also can be used during their holidays.

Also, pensioners from European countries can use their home insurance cards.

Unfortunately, for most foreigners from non-EU countries, access to statutory health insurance is limited without getting a full-time job in Germany or full-time studies at a German university.

In exceptional cases, admission to German public health insurance may occur after twelve months. In the beginning, they must sign up for private insurance.

How much does public insurance cost?

Packets of medicine in different sizes

Cost plays a crucial role in medical services. Public health insurance companies offer fixed rates for students and select groups with no income. For others, their income dictates the insurance premium.

General rules:

  1. International students from non-EU countries will have to pay more than students from Germany or the EU. The monthly contribution is 100,59 EUR.
  2. The same amount of money will be needed to pay students of preparation language courses.
  3. German students and students from EU countries pay 82,74 EUR per month.
  4. Employees pay 14.6% of their gross monthly salary, half paid by the employer and half by the employee.
  5. Self-employed pay a full 14.6% of their income.
  6. In all other cases and for people without an income, a “voluntary” rate is available, 150 EUR per month.

Despite all these numbers, nobody pays more than 683 EUR monthly. The government regulates the maximum contribution amount.

If you are self-employed private insurance will be a better choice; it won’t depend on your income. Private companies set their rates independently and offer better coverage.

Check out the most recommended insurance in Germany, Ottonova; it was made for expats, foreign workers, and self-employed.

Moreover, the rates for statutory health insurance can vary depending on the following criteria:

  • Salary (also Holiday and Christmas pay)
  • Social assistance/benefits
  • Income from investments
  • Pension
  • Rental and rental income
  • Maintenance payments by the divorced/separated spouse
  • Statutory pension payments (including widows ‘and orphans’ pensions or Witwen- und Waisenrenten)

Read more about healthcare costs and the cost of health insurance in Germany.

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