What Is Statutory Health Insurance in Germany?

Health Care

You can use excellent German health care for free only if having valid insurance otherweise it will be expensive. German health care divided into statutory (public) and private sectors. Nevertheless, 80% of the German population have statutory health insurance.

The statutory health insurance in Germany is government-regulated public health insurance. Everyone who lives in Germany can sign up for it, the monthly contributions are fixed at 14,6% of the gross wage.

The statutory health insurance in Germany known as gesetzliche Krankenversicherung, shortly GKV. This is the default type of insurance. It’s available for every German resident without any special conditions. However, foreigners sometimes have to fit several criteria if they want to be insured this way.

Statutory Health Insurance in Detail

First and most important: 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.

Normally it’s the cheapest and most reliable way to be medically insured in Germany.

Statutory Health Insurance is state-based and supported by the government, however, you won’t deal directly with the state itself instead with companies mentioned below.

Three of the largest providers of statutory health insurance in Germany are AOK, Barmer GEK, and TK. They have over 100 offices across the country where you can apply for insurance coverage. (a complete list – in German – is available here).

Additionally, several independent non-profit organizations offer different healthcare policies you can choose from. They all provide similar services for similar prices, but with slightly different weightings and benefits.

Some people in Germany get statutory health insurance automatically so they don’t even have to sign up for it:

  • Employees
  • Trainees
  • Unemployment if they use unemployment benefits

However, in some other cases, you will need to apply anyway.

Even if you get statutory health insurance automatically it’s by no means free, in fact, everyone in Germany has to pay for health insurance e.g, health services.

In the above-mentioned cases, contributions to the insurance will be deducted from the monthly salary and in case of unemployment the contributions are deducted from the benefit payments.

The Coverage You Can Expect From Statutory Health Insurance

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 services/care you can expect:

  • pregnancy care
  • physical services
  • mental health care
  • dental care
  • optometry
  • physical therapy
  • prescription drugs
  • medical aids
  • rehabilitation
  • hospice
  • palliative care
  • as well as sick leave compensation

Preventive services include regular dental checkups, child checkups, basic immunizations, checkups for chronic diseases, and cancer screening at certain ages.

All prescription drugs are reimbursed by insurance, but you have to pay 10% of the cost of any prescription medicine, to a maximum of 10 EUR and a minimum of 5 EUR per prescription. 

Statutory insurance will also cover your children under 23 years of age and unemployed spouse for free!

Be aware that sometimes you will need to pay from your pocket, if you, for example, go to the private doctor with your statutory health insurance. You will only get reimbursed by choosing Kassen Artz or Alle Kassen. These professionals cooperate with statutory health insurance or with all insurance providers.

Additional contribution

Depending on your provider, you may also be charged an “additional contribution” of up to 1,1% of the total costs (per month). This extra contribution sometimes entitles you to extra treatments not covered by statutory health insurance, such as:

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

There are some restrictions you will face by the dentist, especially in materials – statutory insured patience get the basic one and they also need to pay for not necessary procedures, which are only cosmetic for example. Aesthetic teeth cleaning almost always incur an additional fee.

Requirements for Statutory Health Insurance

Health insurance is an obligation in Germany, so all people can have access to free medical services. Therefore Statutory health insurance doesn’t require anything in exchange.

These groups of people can be sure they can claim statutory health insurance in Germany:

  • Employees whose annual income is less than 62,550 EUR gross
  • Pensioners
  • German Students
  • Trainees
  • Unemployed who receive unemployment benefit
  • Civil servant
  • Family members of an employee without income ( e.g. spouse and children)

People who are only for a short period of time in Germany, such as tourists, regular language course participants, exchange students from non-EU countries, non-EU scientists even for longer stay can’t apply for statutory insurance. They will need to get private health insurance before arrival.

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

1. Students from the EU

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 this kind of insurance, however, only if they are younger than the age of 30 and not in the 14th semester.

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

4. Health insurance coverage for workers from EU/EEA citizens

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

There are two options for health insurance:

  1. Statutory insurance in Germany through employment.
  2. If working temporarily in Germany (maximum 12 months). They can use their health insurance of the origin country.

5. Health insurance coverage for non-EU workers

They will be granted a statutory health insurance regardless of their length of stay by providing a residence permit in addition to the work permit.

When working independently or while looking for a job, the situation for EU citizens in Germany is not as clear as for employees. Even in these cases, however, health insurance in Germany is almost always possible: either with one of over 100 statutory health insurance companies

6. Foreigners from EU/EEA without a job

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 card.

Unfortunately, for most foreigners who come from countries outside the EU, statutory health insurance is not possible without getting a full-time job in Germany.

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

How Much Does It Cost?

Cost is another important question when it comes to medical service. Statutory health insurance companies have fixed rates for students and some other groups without an income. For the rest of the people, income will determine how much should you pay for the insurance per month.

General rules:

  1. Foreign 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 need to pay students of preparation language courses.
  3. Students from EU countries and Germany pay 82,74 EUR per month.
  4. Employees pay 14,6% of their gross monthly income, half paid by the employer and half by the employee.
  5. Self-employed people will pay a full 14,6% of their income.
  6. In all other cases and for people without an income, a “voluntary” rate is available, which is 150 EUR per month.

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 insurance in Germany, Ottonova, it’s especially structured for foreign workers and self-employed.

Despite all these numbers, nobody pays more than 683 EUR monthly.

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)

You can read more about the costs of health insurance in Germany in this article.

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