Health insurance in Germany: one of the most important, painful and discussed themes out there. 

In this guide we will give you some information about the very complex health insurance system in Germany, the different types of insurances you might have and some important points you need to be aware of before deciding for an insurance. 

German health insurance: practical guide

Health insurance in Germany: how does this work?

The German health care system is combined of privatized doctor practices and a complex insurance system which is combined from both public and private insurances. 

In the next paragraphs, we will specify the different types of German insurance: 

Public insurance (gesetzliche Krankenversicherung)

The German public insurance (gesetzliche Krankenversicherung) is the most common type of insurance in Germany: 93% of the German population is publicly insured. The main idea of public health care is that the insurance provider pays for anything that requires treatment. There are no waiting periods as with private insurance and everybody is treated the same. 

German public insurance is organized in insurance providers called Krankenkassen. Those are privatized companies, which are responsible for the administrative part of insurance, mainly payment management of contributions (income) and treatment (expenses). There are 105 Krankenkassen in Germany, from which each person can choose their providers. Traditionally, expats choose their provider when they move to Germany - but can change providers later on, if desired. 

Since Germany is a welfare state, the payment for public health insurance depends on your income: we are talking about approximately 16% of your income, depending on whether you have children and on your choice of provider. There are of course minimum (appx. 200 EUR/ Month) and maximum (appx. 850 EUR/ Month) payments. 

Another important trait of the public health insurance is that children and non-working spouses can be insured with the main insurance holder - without extra charge. This makes public health care extremely worth while for families. 

Even though the public health insurance is a great, valid option, it has its disadvantages: 

Mainly, for top-earners it can be very expensive, and provide not so great value for money: since everybody is treated the same, it could be that you will end up paying the maximum contribution, and will have to wait longer in the line, or have less patient doctors treat you. 

Therefore, for young, single and healthy people (especially those who do not plan on staying in Germany on the long term), private health insurance might give better value for money, as you will be treated nicer, and will not stay in Germany long enough in order to deal with the disadvantages. 

Private insurance (private Krankenversicherung)

Private health insurance (private Krankenversicherung) acts as we know from insurances (please read the guidelines in our ultimate insurance guide!): it insures according to risk. If you want to get private insurance, the first step to take is a risk calculation. If you come from abroad, most insurance companies will ask you to take medical tests in order to evaluate the amount of risk included in insuring you. If the risk is too high (for example, if you have any preexisting conditions), it might be that you will not get the insurance. If you are changing from German public health insurance to private insurance, you will probably not have to take those tests, but rather authorize the insurance company to review your medical file. 

If you get in, you sometimes get a better deal: since insurance is calculated on risk, if you are young and healthy, you might end up paying less than what you would have paid for public insurance (where you pay based on income). Furthermore, you will get a better value for money: since doctors can charge more from private health insurance providers, they will most likely treat you nicer. 

This thing changes of course, when the risk of insuring you grows: in simple words: the more you age, the more expensive it gets. 

Furthermore, if you have a spouse and children, you will have to purchase separate insurances for them - which will increase the amount you will spend on insurances. 

Lastly, please note the deductibles: most insurance policies come with some amount of deductibles, which means that not everything will be covered fully. For young and healthy people it might mean that you will end up paying for all the medical care you consume, on top of your health insurance payments. 

To sum it up, it makes sense to think of private health care if you are a top earner, single and do not intend to live in Germany on the long term. 

Expat insurance

Expat insurance is a sub type of private insurance: those insurances are designed for expats who just moved to Germany and who are healthy. They give extremely good deals, but not such a great coverage. Additionally, you cannot keep them forever, but rather the maximum amount of time you can have them for is 5 years. 

It might be a good solution for the short term, for people who just came to Germany as freelancers or job seekers, but it will not solve your problems on the long term. 

Choosing your insurance wisely

To add to that complexity, not everyone can get all types of insurances. 

If you are employed and earn more than 450 EUR per month and less than 60K per year - you will have to get public insurance (in German, this is called Versicherungspflicht). 

If you are self employed, it might be almost impossible for you to get public health insurance. 

Therefore, you should review your situation carefully, and make wise decisions. 


Here are some questions that might help you decide:

1. Do you even have a choice? Or must you be publicly insured? 

2. Do you have any preexisting conditions

3. Do you have dependent family members (e.g. children, non-working spouse)?

4. Are you planning to stay in Germany on the long-term? 

5. How old are you? 

6. Do you have the option of getting a KSK-Membership?

What do I do when I need to see a doctor? 

Doctors in Germany work in privatized practices. Most clinics work with both private and public health insurances, and work with all insurance providers. This means that you can go see any doctor you want to see. If you are not happy with the service or therapy, you can change doctors with no problems. You also have the right to get a second opinion, if you feel that´s needed.