What is the role of health insurance in Germany? What are the benefits of the different types of insurance? How much does an insurance policy cost and what does its price depend on? These and other important questions are addressed in today’s article.
Germany is known for one of the best insurance systems in the world, but it’s quite confusing. By law, you cannot live in Germany without health insurance, and if it turns out that you live without it, you have to pay a fine. At the same time health insurance in Germany – it is not only a guarantee of treatment if necessary, but also a significant burden on the personal budget of each resident of the country. Let’s see how the system works!
The public health insurance system in Germany was introduced by Otto von Bismarck. The law, aimed primarily at factory workers, was passed on June 15, 1883.
It was the first stone in the foundation of German social insurance, which today also includes pension insurance, unemployment insurance, nursing care insurance and accident insurance.
In 2007, Germany reformed its health care system and passed a law on compulsory health insurance, which prohibited living in the country without insurance. The fact is that at that time there were about 400,000 people in the country who – for reasons of economy – were not insured at all. In 2011, the Federal Statistical Office recorded only 137,000 people with no health insurance contract, and therefore deprived of the opportunity to receive medical care in case of need.
Private or public health insurance?
There are two types of health insurance companies in Germany: public (gesetzliche Krankenversicherung or GKV) and private (private Krankenversicherung or PKV). The insurance covers the cost of doctor’s appointments, treatment and even the cost of medicines to be bought by the patient. The cost of public insurance will depend on your income, while the cost of private insurance you can determine yourself.
90% of people in Germany are holders of public insurance, because the possibility to choose the type of insurance will depend on your occupation and income. If you earn less than 64350 euros per year, you can only choose public insurance, and insurance is compulsory for you (die Pflichtversicherung). If your income is more than this amount, private insurance is also available to you and you are insured voluntarily (die freiwillige Versicherung). The same choice is available for civil servants, holders of a Minijob (der Minijob – work with a salary not exceeding 450 euros per month), students, doctors and the self-employed (selbstständig). By the way, the self-employed pay the full cost of insurance, while for salaried workers half of the payments are covered by the employer.
If you are married to a German citizen, you have the right to use your spouse’s insurance free of charge.
Public health insurance in Germany
How much does public health insurance cost in Germany? As a rule, public insurance costs between 14.6% and 15.6% of your monthly income, and between 7.3% and 8.3% for salaried employees. If you earn more than €58,000 per year, you pay the maximum insurance cost, around €400 per month.
In total, the cost of public insurance per month ranges from a minimum of 100€ for students to 845€ for the self-employed. You can calculate the exact amount of insurance for you with special online calculators from Die Techniker or the AOK.
An undeniable plus is that all state insurance is about the same, so you can go to any organization: e.g. AOK, DAK, Barmer or Die Techniker. The latter organization also provides its services in English, which can be helpful for recent migrants.
- Advantages of public insurance:
- Public health insurance in Germany is cheaper than private health insurance if your earnings are low (the lower your salary, the cheaper the insurance);
- It is cheaper for students under 30 years of age;
- Your spouse or child can use your insurance for free.
Private insurance in Germany
The cost of private insurance does not depend on your income, but on your age, your state of health and the list of services you want to be included in it. If you are young and perfectly healthy, an insurance policy will cost you €175 per month or €350 if you are self-employed, no matter how much you earn – it is much cheaper than public insurance. But it’s worth bearing in mind that as you get older or acquire chronic diseases, the cost of insurance will increase.
The famous principle of solidarity (i.e. everyone is responsible for everyone) of the state health insurance is based on the same percentage of contributions. All of the company’s clients pay an equal portion of their own income, and for this money they are entitled to pay for all necessary medical services. This means that a cafe cleaner and the top manager of a large company are treated equally by doctors. The decisive criterion for the insurance fund is the indisputable need for treatment, and if different treatment options are possible, the cheapest one is chosen.
The German state singles out a special category among “self-employed” workers – “free artists”. It refers to people of creative professions who earn freelance creative money. They are painters, photographers, musicians, journalists, and publicists. “The KSK (Künstler Sozialkasse), the state social insurance fund, takes the freelance artists under its wing and shares with them the costs of health and pension insurance instead of the employer.
Other types of insurance
Germans like to be one step ahead and try to anticipate everything, so in addition to the basic insurance there is Zusatzversicherung – additional insurance. For example, the state health insurance in Germany does not cover all costs: the patient will pay for a single room in the hospital, an appointment with the head doctor or his passion for unconventional medicine. Or if a patient has permanent dental problems, he can take out Zahnzusatzversicherung (by the way, the most common in Germany), which will cover the cost of crowns, dentures or braces. The cost of such insurance is determined individually with an insurance agent.
Another type of health insurance in Germany is the Pflegeversicherung or long-term care insurance policy. This covers the costs for long-term treatment after accidents, serious illness or old age. Insurance is compulsory and costs around 3.05% to 3.3% of annual income.
Insurance for foreigners and travelers
There is a special kind of temporary insurance for those who are going to move to Germany, apply for a residence permit for the first time, or plan to live there for less than 5 years (e.g. students) – something between the tourist insurance and the standard insurance. This insurance costs not so much (from € 72 per month), but it covers only a minimum range of medical services and may last only up to 5 years (that is, with such an insurance for the extension of residence permit in Germany the second time you can not). Moreover, you should not wait for 5 years until the end of such an insurance – to begin the transition to public or private insurance must be at least six months. It is recommended to get such insurance at Feather or Ottonova (they also offer services in English). By the way, if you are interested in opportunities to go to study in Germany, read our article about scholarships to refinance studies offered by various German organizations.
How to get and use insurance?
To get health insurance in Germany, you just need to go to the office of any insurance organization. If you are working, you have to tell your employer that you are going to take out health insurance.
You will then receive a plastic card (die Krankenversichertenkarte), which will have your photo and basic information. By the way, if you are insured in Germany, you do not need an insurance policy to travel around Europe. If you have a public policy, the bill from the doctor will be sent to the insurance company without your involvement. If you are privately insured, the doctor will send the bill by mail (yes, a paper letter) and you will need to forward this letter to your insurance company.
German health insurance – bottom line
Health insurance in Germany is really necessary for everyone, because medical services and medicines are expensive – just to check your eyesight at the ophthalmologist costs about 25 euros. In recent years, the German government has adopted many laws that increase the cost of the budget for the insurance system, but at the same time make it more convenient and profitable for citizens. For example, one of the areas of development of the German insurance system is the digitalization of the health system, which will reduce appointment times and make it more convenient to exchange information on the progress of treatment.
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