Private and Public insurance in Germany [2024] - Live In Germany

Jibran Shahid 12 Oct 2024 Insurance in Germany

Health insurance is compulsory for everyone residing in Germany. This applies to all the people including locals, job seekers, international students, or professionals working there. There are two options for health insurance you can choose from. Private health insurance and public health insurance. The reason is not that public health insurance is a better option, but because there is a certain criterion set for private health insurance.

Multiple options are available in the market for public insurance providers. All of these providers follow the state and federal regulations in regards to what they offer and how much they cost. The focus of all companies includes coverage of all kinds of standard medical care. Minor differences can be observed between these companies e.g., whether they offer specific sports programs, homeopathic treatment, etc.

Types of Health Insurance in Germany

Public Health Insurance (Gesetzliche Krankenversicherung, GKV)
Private Health Insurance (Private Krankenversicherung, PKV)
Combination of both (public health insurance + additional private insurance)

Overview Public vs Private Health Insurance

Public Health Insurance (Gesetzliche Krankenversicherung, GKV)

Public health insurance follows federal and state regulations. In Germany, over 90 percent of the population possesses public health insurance. You can either be compulsory public insured (pflichtversichert) or voluntarily public insured (freiwillig versichert).

Compulsory vs Voluntary Health Insurance in Germany

In Germany, if an employee’s income in Germany is less than €69300 (As of 2024 ) annually or €5775 a month, then he/she must have public health insurance. This also identifies that the person is compulsory public insured.

If the person is earning more than this salary bracket, they can choose between public and private health insurance. Now if they choose to opt for public health insurance, they are voluntarily public insured.

Public insurance allows your spouse and children to be insured under your name without any extra cost. When you are visiting a doctor, you will just show your insurance card. The doctor will get the fee directly from your insurance. This means you won’t have to pay for it upfront.

There is also a possibility of reimbursing medical costs when visiting outside Germany to European countries. But not all the costs will be covered and reimbursed. You might end up having just a little portion of fee back. Thus, it is better to confirm with your insurance company first so that you can avoid unlikely surprises.

Cost of Public Health Insurance in Germany

The cost of public health insurance goes hand-in-hand with your income. The more salary you earn, the more insurance fees you pay.

The rate in 2022 is around 15.9 percent of your income. But no need to worry as there is a maximum amount you will be charged.

In order to calculate the public health insurance, let’s take an example with the maximum monthly gross salary is €4837. If you are making more than this number, you won’t have to pay more for your insurance. One of the benefits of being an employee is that your employer will be contributing half of the cost of your insurance.

Example of Public Health Insurance Cost

If a person makes €4838 a month, they will be paying around

€4837 x 15.9% \= €769

But because of being an employee, half of this amount will be contributed by the employer. So the maximum cost of health insurance one will have to pay is €385 a month.

Along with the public health insurance, there is a long-term nursing care scheme (Pflegepflichtversicherung) by the government which must be joined. In the current year, it is charged 3.05 percent of your gross income or 3.4% if you don’t have kids.

Considering the same example as above, if a person is earning €4838 and not have kids, they will be paying €4838 x 3.4% \= €165. But here, the employer will contribute for €74 max, the remaining €91 they will paying themselves.

So this means that only a monthly basis, our maximum payment for public health insurance plus our long-term nursing cost is €385 + €91 \= €476. But we must not forget that if we are earning less, we’ll be paying less.

For university students under the age of 30, they can enjoy the same benefits of public health insurance at reduced cost. In these instances, the cost of insurance plus long-term care is approximately €110 – 120 a month.

Public Health Insurance Providers in Germany

There are multiple options when you have to select a public health insurance company for yourself. The government regulates the public health insurance themselves. Therefore, almost coverage is offered by the companies. Some of the famous names in market includes AOK, TK and DAK. Please note that not all insurance companies offer English speaking staff. Also the rates and incentives can vary slightly.

You can sign up for any of the public health insurers via the super-fast and free online services:

For expats, TK is highly recommended as it offers English language and remarkable customer support.

Private Health Insurance in Germany (Private Krankenversicherung, PKV)

Private companies offer this kind of health insurance. The coverage and cost varies according to different companies and their offered packages. In order to get a private health insurance from a company, you will have to fill a health questionnaire and also do a medical test.

Cost of Private Health Insurance

The private health insurance cost depends upon your health and your age. For young and healthy people, there are usually cheap packages with enough services.

In private health insurance, you save additionally too by adding a deductible amount. This way, you will be reimbursed only after the deductible amount is capped. Similarly, you will pay the cost yourself if the medical expense is lower than the deductible amount.

Coverage of Private Health Insurance

A higher level of service is usually expected when private health insurance is selected. In terms of medical treatment and geographical locations, you get more choices. In contrast to standard coverage provided by public health insurance, here you can modify your coverage and add those services which are not part of public health insurance. For e.g.; private room at a hospital or dental services.

Eligibility for Private Health Insurance

If you lie under any of the following categories, you can choose private health insurance.

Employee having annual salary of more than €64350
Students
Self-employed
unemployed
Civil servants
Freelancers
People with mini jobs making less than €450 per month

Private Health Insurance Providers in Germany

For private health insurance, there are many options available offering different lucrative packages. You can use this website to compare different packages. Some of the private health insurance companies include:

For those not very comfortable with German language, especially expats, can opt for Feather. It specializes in providing best public and private health insurance to expats living in Germany. They are simple to use, offer English client support and a website.

Expat Health Insurance in Germany

Expat health insurance is also known as temporary health insurance. It covers a maximum duration of 5 years. For non-EU citizens, Ottonova offers quality expat health insurance. By quality, we mean that Ottonova offers full coverage of private insurance. If a person wishes to stay for longer in Germany but less than 5 years, they will even allow the renewal of a residence permit.

Feather also offers expat health insurance. They are approved to get the visa but the renewal option is not available to them. So, if someone is planning to stay in Germany for a maximum of one or two years, Feather can be a good option.

If a person plans to stay for longer in Germany, and they have an expat health insurance other than Ottonova, they need to switch to a appropriate health insurance before their permit of residence expires.

Though expat insurance is sufficient in coverage, it is not as good as public or private insurance. Serious illness or lengthy treatments are taken care of. But general treatment, dental checkups or Krankengeld (daily sickness allowance) is often not covered.

Combination of Public and Private Health Insurance in Germany

This option is usually chosen by those people who wish to remain with public health insurance. But with that, they also want to avail extra coverage offered by private health insurance. These people buy private health insurance to cover those costs which are not part of public health insurance.

For instance, there is limited coverage in public health insurance for treatment like acupuncture, private doctor or dental treatment. In this scenario. Supplemental private insurance can come handy. The acupuncture treatment can cost a fortune itself. With the help of supplemental private insurance, you can visit any Chinese doctor as you prefer and not worry about the fee.

How to Change between Public and Private Health Insurance?

From Public to Private Health Insurance

Employees having an income of more than €64350 can shift from public to private health insurance. They can also remain in public health insurance. They will then become voluntarily public insured.

From Private to Public Health Insurance

The procedure of shifting from private to public health insurance is somewhat tricky. There is a very negligible chance of changing back insurance type for people aged more than 55 years. The shift can be made from private to public for those earning less than €69300 a year, aged below 55.

People who are self-employed less than 55 years of age, can shift only if they become employed and their income is less than €69300 a year.

The system is designed in such a way because older people are more expensive than young people in public health insurance. For those who are healthy and young, it is better to choose private health insurance since it usually comes cheaper for them and they also get to avail better service. If all the young users shift to private health insurance and change back to public when they get old, there will be a severe burden on public health insurance.

The young and healthy people are required for public health insurance so that they can support those who are sick and old.

Public vs Private Health Insurance: Which is Better?

Pros and Cons of Public Health Insurance

✅ Benefits	⛔️ Downsides
No advance payment of medical bills: you can visit doctor and show your insurance card. The fees will be later transferred directly from your insurance provider to doctor.	There are many special treatments which are often not part of insurance. Also, waiting times are longer at appointments
Family insurance: Free of charge coverage for spouse and children (children up to a certain age, spouse if their income is less than a certain amount)	Insurance scheme or fee can’t be adapted according to your health status or individual needs.
Income-based Fee: if your income is less, you will pay less and hence lower financial risk	In case your income is high or you are self-employed, fees will be high as well.

Pros and Cons of Private Health Insurance

✅ Benefits	⛔️ Downsides
Better service: As a private patient, you will have better service. Also, doctors earn more from private insured, so you can get immediate appointment. Treatment you get will be of highest quality. You can get a private room for yourself instead of a shared hospital bedroom.	It’s difficult to shift back to public health insurance once you have chosen private. Only possible in exceptional cases.
Additional treatment: like acupuncture or homeopathic treatment.	Dependents are not covered in private health insurance. Individual payment has to be made for all, including children
Special treatments and services are usually covered.	For married people, if one partner has private insurance and other has public insurance, the public insurance will get more costly since income of both partners will be calculated for public insurance fee.
Pay for what you need: private health insurance comes cheap for young and healthy ones. Lot of private insurance companies offer basic tariff to customers. There are reimbursement schemes too in case you don’t require services. But that is to a certain limit.	In private insurance, you have to pay the medical bills in advance. You will be later reimbursed by the insurance company.
Low cost for those with a high salary: Monthly fee is static no matter how much you earn. Therefore, the cost is low for those who are high income earners.

Public vs Private Health Insurance: Factors to Consider

Conclusion

We have covered almost all the aspects of Private and Public insurance in Germany. If you are eligible for Private insurance then it would make sense to switch it at an early age. If you wait then it could happen that your health condition is not optimal then Private health insurance can deny your application. The purpose of this guide is to give you a detailed overview of both and then you can decide. We have mentioned some expat-friendly insurance like Feather and Ottonova.

Jibran Shahid

Hi, I am Jibran, your fellow expat living in Germany since 2014. With over 10 years of personal and professional experience navigating life as a foreigner, I am dedicated to providing well-researched and practical guides to help you settle and thrive in Germany. Whether you are looking for advice on bureaucracy, accommodation, jobs, or cultural integration, I have got you covered with tips and insights tailored specifically for expats. Join me on my journey as I share valuable information to make your life in Germany easier and more enjoyable.