German Public Health Insurance: All You Need To Know

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 public 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.

Public or statutory health insurance in detail

The German healthcare 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.

Usually, it’s the cheapest and most reliable way to be insured in Germany.

Public health insurance is state-based and supported by the government. However, you won’t deal directly with the state itself but instead with public insurance companies. They will pay your medical bills.

Three of Germany’s largest public health insurance providers are AOK, Barmer GEK, and TK. These insurance companies have over 100 offices across the country 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 to get coverage by providing English-speaking assistance.

Additionally, several independent organizations offer different healthcare policies you can choose from. They all provide similar services for comparable prices; only the benefits can differ slightly.

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 some other cases, you will need to apply directly at one of the branches. Keep in mind that statutory health insurance is by no means free. In fact, everyone in Germany has to pay for medical coverage each month.

In the cases mentioned above, insurance contributions will be deducted from the monthly salary and, if unemployed – from the monthly benefit payments.

Coverage of public 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 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 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 spouses for free!

Be aware that for some services, you will need to pay yourself, for example, physical therapy. You also might pay when visiting a private doctor.

Generally, patients with public health insurance get reimbursed for treatments at “public” physicians and specialists. These are called “Kassen Artz” or “Alle Kassen”. They cooperate with statutory health insurance or with all insurance providers.

Additional contributions

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 that aren’t covered by public health insurance, such as:

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

When visiting a dentist, you are limited by the list of free services that they provide. Although the treatment choice is quite 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

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)

People who are only for a short period of time in Germany, e.g., tourists, regular language course participants, exchange students from non-EU countries, and non-EU scientists even on a more extended 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 cost-effective and reliable state insurance? Here are other opportunities:

1. Students from the EU 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 the 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 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?

Cost is another important question when it comes to medical service. Public 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 you will pay for 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 need 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 personal income.
  6. In all other cases and for people without an income, a “voluntary” rate is available, which is 150 EUR per month.

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

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.

Recommended products and services in Germany:

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Anna

Anna is an enthusiastic expatriate with experience of living in Germany, Austria and Greece. She shares her passion for living abroad on this website.

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