INFOYER I Health Insurance in Germany

Whatever the purpose of visit or stay in Germany, health insurance is mandatory for all (since 2007) – students, employees and businessmen. Health services can be very expensive in Germany and even tourists or those visiting the country for a short period are advised to get health insurance prior to the journey. 
In most cases this is private health insurance (Private Krankenversicherung or PKV) whereas those moving to Germany or preparing themselves for a long stay in the country generally opt for public health insurance (Gesetzliche Krankenversicherung or GKV)
Almost 85% of the population is covered by public health insurance and the rest covered privately, making the health care system in Germany one of the strongest in the world. 
A full time salaried employee gets part of the total insurance contributions paid by the employer while the rest is deducted from the salary. As soon as you start working, your employer signs you up with one of the following standard public health insurance companies – TK, AOK or SBK. Often you are asked to state the company of your choice. Self-employed individuals pay the entire insurance premium out of their own pockets. 
To understand the public and private health insurance systems in Germany better, it might be useful to get into further details of each of these systems.

Health Insurance in Germany: State Health Insurance (GKV)

The regulation as of 2015 requires everyone earning 54.900 € or less per annum or 4.575 € or less a month to be affiliated to a public health insurance scheme. There are almost 120 companies one can choose from. The minimum tenure for membership with an insurance company is generally 18 months, after which you can discontinue and change providers with 2 months’ notice. You also have the choice to change if your existing provider demands additional or an increased premium. 

In patient care at your nearest hospital under the care of the attending doctor, outpatient care with registered doctors including basic dental care are covered by all public insurances. Private doctors/surgeons, private hospital rooms, complicated dental or eye procedures or alternative medical treatments (homoeopathy etc.) are not covered. Non-earning members in the household need to be registered and are usually covered at no extra cost. 

Pflegepflichtversicherung or the long term nursing care insurance is another government scheme which takes care of long terms nursing needs in case of prolonged disability and both an earning member and his/her dependents ought to be registered under this scheme. 
To avail of any other additional benefits that are not covered – for instance, those that are mentioned above and others that may entail accessing care even outside Germany, you would need to get a private health insurance policy. 

Health Insurance in Germany: Private Health Insurance (PKV)

If you are in need of a wider range of medical services spread across borders over a larger geographical area, opt for a private insurance plan that may even allow you to seek private medical care in your native language. There are various available premium-benefit combinations and one can choose according to personal needs from nearly 40 different providers in Germany. A large portion of the premium payments are tax deductible since 2010.

Private medical insurance normally covers only the individual and not dependents as in the case of most state insurance plans. Not all international insurance companies are registered in Germany or abide by German regulations and therefore it is recommended that you check before you consider buying an expatriate insurance policy instead of a govt. policy. 
If you earn more than 54.900 € per annum and wish to be insured privately, you need to inform your employer. Else you will automatically be registered under a state health insurance scheme. Your employer is obliged to make relevant contributions only if you are able to provide certification from the German government for your private insurance policy.

Limited term policies are difficult to extend and often cause stress if you have to extend your stay in Germany beyond the insured term. 

Health Insurance in Germany: Other types of Insurances

In case of illness, your employer pays full salary for 6 weeks, post which the state insurer takes over and pays a percentage of your income upto a maximum of 78 weeks. If your income is above a certain level (above 2500 € approx.) it might make sense to get additional sick pay insurance. 

Travel insurance is a necessity for those visiting non EU countries. Even within the EU, most policies make you eligible for only partial reimbursement of costs incurred.

Supplemental dental insurance may be useful for those in need of complicated dental procedures as these can be very expensive and are generally not covered by insurers. 

Prescriptions drugs are usually covered and costs reimbursed with a co-payment aspect. Over the counter medication is neither covered by private or public insurers.