The healthcare system in Germany is among the best in Europe. If you’re a foreigner working in Germany, you can access state-subsidized healthcare services. The law requires every official resident in the country to be covered by various forms of insurance, including health insurance that covers both inpatient and outpatient care through private or state insurance. To obtain a German visa or resident permit, you must show proof of health insurance, which means that visitors to the country are usually covered as well.
Citizens from Switzerland, EEA (European Economic Area, which is the European Union plus Norway, Liechtenstein and Iceland) and the European Union (EU) can access healthcare services in Germany in the same way German citizens do if they are temporary visitors or are traveling to the country.
Before you arrive, you need to obtain a European Health Insurance Card (EHIC). But expats and residents who plan to stay for more than a year should arrange to get private or state insurance.
Alternatively, temporary visitors from outside the EU can also claim state healthcare if there are reciprocal agreements between Germany and their country of origin, otherwise they are required to obtain travel insurance in Germany or pay directly for healthcare services. The German consulate in your country of origin or your local government can advise on the best way to go about this and other matters related to insurance in Germany.
Who must obtain health insurance in Germany?
The healthcare scheme provided by the state in Germany covers about 90 percent of residents. Regardless of whether you’re an EU national, you’re usually required to obtain compulsory state German health insurance (gesetzliche Krankenversicherung) provided you are
- A pensioner who has been insured for a specified period
- An employee or you’re receiving vacationing training (including apprentices and trainees) and have an annual income of less than €57,600
- Receiving some form of youth assistance
- Receiving unemployment assistance or benefits
- A farmer or you’re assisting family members
- A student at an approved institution of higher learning
- A writer, artist or in a professional under the Artists Social Welfare Act
- Not receiving any other form of healthcare services
Civil partners, spouses and children up to age 23 (or 25, if studying) of a person covered by the state healthcare scheme are eligible for family co-insurance under specified conditions, without being required to make contributions, as long as their monthly income does not exceed €415–450, depending on the circumstances.
In Germany, employees and employers both contribute to the health insurance policy, be it state or private insurance. Depending on your employment status, you can switch from state to private insurance. However, you can in some situations take a more extensive private health insurance policy.
You have the option of choosing state or private health insurance if:
- You are a civil servant
- You are self-employed
- You have no basis to join a state insurance scheme
- Your earn above the salary threshold
- You are a student who renounces their state insurance
In Germany, as with other countries, private insurance usually offers a wider range of services and faster waiting times. You’re also more likely to find an English-speaking provider. Some private health insurance policies are offered at the same cost as state health insurance.
The difference is that private insurance in Germany covers partners and children at an extra fee. It is, however, not always advisable to switch to private health insurance because premium is determined by personal factors such as age, added family members and health risks among others. Switching to private health insurance is usually viable only if you’re young and have few health issues.
If you’re plagued by health issues and obtaining private health insurance is proving difficult, you can go for a ‚Basistarif,‘ which required private insurers to accept the same conditions for providing health insurance as the government.
If you’re planning to live and work in Germany, you’re required to register with a health insurance fund in the country before you can access healthcare services. If you’re a paid employee, your employer will typically automatically register you with a German health insurance fund even though you can choose the one you want.
The standard duration of membership is 18 months after which you can change to another health insurance provider in Germany provided you give two months‘ notice before the expiry date. Sign up for German classes at Wortland because following up on matters related to your insurance when you know the language is a lot easier.
The most prominent health insurance providers in Germany include Cigna, Allianz and Aetna. Before choosing a state or private health insurance providers, it is imperative that you carry out some research on the leading providers and compare the services and costs.