In Germany health insurance is an obligation: Everyone who is resident in Germany must be able to prove they have health insurance. Therefore, this obligation also applies to people who are not German.
Tips for choosing your health insurance
Foreigners and EU citizens in Germany need health insurance, one of either private or statutory (public) health insurance. The admission of foreigners into a statutory health insurance is almost always required if foreigners are permanently employed in Germany. Anyone who has no employment in Germany as an EU foreigner can only register with a statutory health insurance if he was previously a member of a statutory health insurance in his home country.
Otherwise, EU foreigners need private health insurance. This is usually the only way for people who are not from an EU member state, and who have no job in Germany.
If foreigners work in Germany, their company may ask them about their health insurance before they start working. You can register with the health insurance company as soon as you know who your employer will be. Even foreigners without work in Germany can become a member of the statutory health insurance in many cases. EU citizens and other foreigners should therefore obtain early application documents for their health insurance. Necessary confirmations about pre-insurance can be submitted at a later time.
Foreigners from countries requiring visas
Foreigners who come from a country requiring visas must provide health insurance in order to obtain a visa for entry into Germany. The insurance must be present when applying for a visa and be valid for the entire duration of the planned stay.
The insurance for a visa must generally comply with the standard of the statutory health insurance. The immigration authorities will ask for proof of that.
Foreigners with a job subject to social insurance
Anyone who accepts a job subject to social security contributions as a foreigner in Germany is subject to compulsory insurance - regardless of his place of residence and his nationality. One usually has to become a member of the statutory health insurance.
Only if your income is above the mandatory insurance limit of 60,750 euros annually (as of 2019), you are free of compulsory insurance. Then you can optionally conclude a statutory or private health insurance.
Those who do not come from a state in the European Economic Area (EEA) or Switzerland usually require a work and residence permit before they can start a job.
Private health insurance or statutory health insurance for self-employed
If foreigners work in Germany as self-employed, they have the choice between two different systems of health insurance. You can either register with a private health insurance company or apply for admission to statutory health insurance. This does not only apply to foreigners from EU member states, but also to all other foreigners whose residency permits self-employment.
Private health insurance is an individual protection. The insured pay a monthly contribution, which increases during the course of their life. The contribution is based on the personal health risk, but above all on the age of the insured person. Before starting private health insurance, you usually have to be examined by a doctor. If you are healthy, the contribution is often very cheap for young people. The benefits are in many cases better compared to what public health insurance has to offer. Also interesting for foreigners: private health insurance is often valid worldwide.
With the statutory health insurance, the contribution is not based on the personal illness risk, but on the income. Since 2019, the general contribution rate is 14.6 percent of income Some insurance companies charge additional contributions. Any foreigner who is self-employed and decides to become a member of statutory health insurance must remember that this is a so called "voluntary insurance". The contribution varies between the minimum and maximum contribution for legally insured self-employed persons, depending on your actual income.
A big advantage of the statutory health insurance is that family members are insured free of charge without having their own income. Of course, this also applies to the family members of EU citizens and other foreigners who are members of a German health insurance.
However, not every foreigner or EU citizen who works independently in Germany can opt for a voluntary membership in a statutory health insurance fund. Decisive is the previous insurance, even if it was in another country. Only those who have been insured with public health insurance abroad can voluntarily insure themselves in a public health insurance in Germany.
Special health insurance for foreign guests
For persons who are staying in Germany for more than just a couple of weeks and need health insurance - for example, students or visiting scientists at universities - numerous private health insurance companies offer special health insurance for abroad. These are mostly called incoming health insurances which are valid for a period of up to five years and for the EU and Schengen states. Often the insurance companies offer packages including accident insurance and liability insurance.
Long-term health insurance for abroad should not be confused with regular travel health insurance. Travel health insurance usually only provides short-term stays abroad of a few weeks.