How Does Health Insurance Work in Germany?

Germany offers two primary types of health insurance, provided by over 100 insurers (known as Krankenkasse). Health insurance is compulsory, so you must select one of these options (though it’s possible, though uncommon, to combine both).

The two main options are:
Public Health Insurance (Gesetzliche Krankenversicherung, GKV) and Private Health Insurance (Private Krankenversicherung, PKV).

Public Health Insurance is available to most people and provides comprehensive coverage. Private Health Insurance, on the other hand, is an option for higher earners and typically offers more flexible and higher-quality coverage. As of 2024, you can only opt for private health insurance if your annual income exceeds €69,300. For those earning less, public health insurance is mandatory. So, what sets German private health insurance apart from public options?

• Extensive Coverage Options: Private health insurance in Germany offers a broader range of services, such as faster access to specialists, private hospital rooms, and a greater choice of medications.
• Lower Wait Times: With PKV, you can often bypass long waiting times in public healthcare and receive quicker treatments.
• Doctor Preferences: Many doctors in Germany prefer or only accept private health insurance patients, ensuring better access to top specialists.
• Flexible Premiums: Premiums for private health insurance in Germany are based on the individual's age, health, and the level of coverage selected, often making it cost-effective for young, healthy individuals.

However, there are some considerations when choosing private health insurance in Germany:

• Rising Costs: While private health insurance may be affordable initially, premiums can increase as you age and face health issues.
• Claims Process: PKV requires policyholders to pay upfront for medical expenses and then file claims, which may involve submitting forms in German (though English-speaking insurers like ERGO Versicherung make this process easier).
• No Coverage for Dependents: Unlike public health insurance, which covers spouses and children, private health insurance does not automatically extend coverage to dependents.
• Potential Overprescribing: Some doctors may prescribe more treatments or medications, knowing that private health insurance will cover the costs.

Public Health Insurance is usually more advantageous for those with dependents (e.g., a non-working spouse or children), as it covers family members without additional costs. The cost for GKV is approximately 14.6% of your gross annual salary, split between you and your employer. If you opt for private health insurance, your employer will also contribute toward the premiums.