Health Care in Germany: Is It Free?

German healthcare is one of the 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?

Health care in Germany isn’t free, however, in most cases, you won’t pay for treatments but your insurance will do it instead. In order to use German health services, everyone has to contribute monthly payments for public or private health insurance.

However, exceptions can be found everywhere including German health care. In some cases, one might avoid insurance payments or to reduce the amount of the premium. In this post, you will learn all about German health care and all the possible ways to use it for free or at minimum costs.

How German Heath Care Works?

In Germany, people don’t pay their medical bills in the doctor’s office but it doesn’t mean they receive services for free. Many are mistaken that Germany provides free healthcare for all, young and old, poor and rich. However, it’s only partly true.

Germany obligates everyone to have health insurance, whether you are just visiting the country or actually living here. An insured person is eligible to use health services at no extra costs as long as the insurance premium has been paid. If talking about public health insurance, which 90% of the population is using, one pays around 14,6 % of their income for it if self-employed.

In the case of employees, the employer will share the obligation to pay for your insurance by half. Therefore, the company will contribute 7,3% of your salary from its budget and you (employee) pay the rest 7,3% of your gross monthly salary.

The amount you pay for private insurance isn’t fixed as in the case with public insurance. Private insurance companies set their rates independently from your income. Premiums vary from one insurance provider to another and depend on the selected package and coverage.

Private insurance often tends to be cheaper for young professionals but gets progressively more expensive.

For notice, workers with public health insurance don’t lose it when changing jobs or if they get fired. However, for owners of private premiums, different rules might apply.

Private health insurance provided by Feather gives you many benefits as a foreigner in Germany. This company speaks English, coverage is more than sufficient, packages are personalized to your situation, and sign-up happens conveniently online. Feather is the next-generation insurance provider, which you can trust. Read reviews here.

Which Healthcare Services You Can Use for Free?

Usually, your health insurance will cover all necessary treatments, operations, procedures, analysis, and most of the medicaments prescribed by the doctor. Germany doesn’t have a deductible system like for example in the US.

The German health care system is divided into three main areas: outpatient care, inpatient care (the hospital sector), and rehabilitation facilities. The statutory health insurance will give you access to all these facilities.

When visiting the doctor a patient shows the insurance card and the invoice gets paid automatically by the provider. Although, the services of some health practitioners might be not included in your coverage, and 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. Additionally, insurance often doesn’t pay for various examinations for the early detection of diseases. In all these cases, a patient is responsible for his/her bills.

On another hand, German law says the following for services that can be covered by insurances: “The services must be adequate, functional and economical; they must not exceed the level of the necessary”.

Nonetheless, any health insurance in Germany will pay for your stay in hospital if you need inpatient care.

Read more about health care expenses you can expect in Germany: Cost of the Private Health Insurance.

When Heath Care Is Free in Germany?

German insurance will give you the right to use German healthcare services to the extend your insurance package allows, everything above must be paid by the patient.

However, if you are living in Germany on consistent basis 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 won’t fall into the responsibility of the patient.

Read our guide to the German health care & insurances.

Volunteering/FSJ or BFD

If you 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 that program.

Costs for health insurance will be covered by the organization that hired volunteers for work. Therefore, your monthly health care 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 and to the max. 1 year, but BFD can be completed for longer – 2 years. You also have to be at least 16 years old and a maximum of 27 years old for the FSJ program, BFD, on another hand, doesn’t have any age restrictions.

You will also benefit from improving your german in daily life and gaining some life experience.

This was my choice after the Au-Pair program, it also the easiest and cost-effective way to spend another year in Germany.

A volunteer visa does not require you to have either funds or accommodation, moreover, the institution, where you will work, pays a salary, and sometimes accommodate. The maximum salary is 402 EUR plus the amount of your rent if the organization does not provide accommodation.

Usual places to work state organizations like hospitals, junior sports clubs, services for disabled people, preservation of historic monuments, ambulatory services, integration houses, civil protection and disaster management, church communities, children’s homes such as kindergartens.


An unemployed person is automatically insured in the 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 receive medical service for free. You can only receive this benefit if you have already paid for 12 months to the unemployment insurance during the last 2 years of living in Germany.

Thanks, unemployment insurance, which each employee in Germany has you can expect some gifts 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.

Overall, 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 your health insurance will be paid by the government.

Read more in article: Health Insurance in Germany as an unemployed

Au-Pair Program

Au Pair is a nanny who comes from another country to Germany for one year to learn the German language and culture. In terms of this program, guest families are obligated to pay for your health insurance, as well as for 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 excellent German healthcare at no cost.

In exchange for it, a nanny takes care of kids and does light housework, in total up to 30 hours per week. Good options for young females, they can apply before turning 26 years.

Private and Public Insurance: The Difference

German health care 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 he/she earns more than 5,062 EUR gross per month or 60,744 per year then they can apply for the private one.

Health insurance is obligatory for all people in Germany, even tourists must have one. Foreigners who came here for study, volunteering, or work can get public insurance.

The main differences in German insurances 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 moreover, offer better coverage.

Check out the most recommended health insurance in Germany, Ottonova, it’s customized 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 and needed services and treatments by the doctor as well as ambulant stay (in the hospital). You will also receive prescribed medicine for free or sometimes partially free.

However, some specialist care, such as eye care, dental care, and alternative medicine might be not available or comes with limitations on what you can claim with public insurance.

In general, necessary conservative dentistry and surgical treatments are covered by both health insurance.

In terms of payment for treatments, private clients will need to pay in advance or directly after the treatment. Only after the treatment and actual payment you can reclaim your money back from the insurance company.

In the case of public insurance, you don’t have to compensate for medical services from your pocket, all bills will be sent directly to the insurance provider.

With the public coverage, family members of the insured employee will be also members of the same insurance company and have the same claims. Moreover, one doesn’t have to pay additional fees for your non-working spouse 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, companies are looking firstly on your income, secondly on age, and thirdly on pre-existing conditions. Consequently, older people with some health issues will need to pay relatively big 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 income. Private insurance with minimal coverage can be easier oranged than public because the second usually takes time to approve and it will require you to live permanently in Germany.

On another hand, public health insurance takes everyone under the coverage, independently from your salary, age, or diseases.

The Benefits of Private and Public Health Insurance in Germany:

Faster and Individual service Available for all people at all income
Cost efficient for high earners and self-employedAdditional insurance for family members
Better conditions in a hospitalWide range of providers
Access to exclusive doctors and wider range of servicesGet accepted with preconditions
Convenient for a short stay in GermanyEasier to apply and receive

Recommended products and services in Germany:

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