Health insurance is mandatory in Germany: This applies to permanent residents as well as to international students or employees staying temporarily. We are here to guide you through the differences between Germany’s two distinct insurance systems, i.e., private and public health care, and to provide information on coverage and contributions as well as on how to choose or switch your individual insurance plan.
Germany's health insurance options
In Germany, you are free to choose your doctor, whether it is for the common cold requiring a prescription, a sick leave notice, or for the ongoing treatment of a chronic illness by a specialist. Health insurance is a legal requirement and is therefore mandatory for everyone in Germany, including permanent residents, immigrants, and international students.
To offset the potentially high costs associated with various treatments and medical services, two separate insurance systems are in place: statutory and private health insurance. While both systems guarantee a similar level of medical care, there are substantial differences between the two. These distinctions include eligibility criteria, costs, services covered, and more.
What is public health insurance?
The most common form of health coverage in Germany is public health insurance, or statutory health insurance. Membership in this system is mandatory and nearly everyone is automatically eligible to receive this kind of insurance. The following groups are entitled to statutory health insurance:
Public health insurance providers such as Barmer cover the costs of various essential medical services. This includes routine check-ups with general practitioners or specialists, emergency hospital treatments, basic dental care, and prescribed medications. However, certain services may only be partially covered or require full payment by the patient, such as specific vaccinations.
If you have children, they can be included in your public health care plan at no additional cost. The family coverage option is applicable until the children reach a certain age and can be extended until they turn 23 if they are still attending school or undergoing an apprenticeship. Students are covered up to the age of 25.
The solidarity principle in statutory health insurance
The solidarity principle underpinning statutory health insurance in Germany ensures that everyone has equal access to medical treatment, irrespective of their employment status or medical history. Your monthly premium is directly tied to your income, meaning that lower-income individuals pay lower contributions, while those with higher incomes contribute more.
However, higher earnings do not lead to continuously increasing contributions, as there is a capped threshold in effect. Consequently, only your gross income up to an annual amount of 62,100 euro is considered for contribution calculations.
People with statutory health insurance generally do not have to pay at the doctor. Important preventive check-ups are also completely free of charge.
How does private health insurance work in Germany?
Private health insurers are private companies that provide either basic health insurance or supplementary health insurance coverage. Unlike its statutory counterpart in Germany, private health insurance is less common as it is available to a smaller eligible population. To qualify for this system and to become a member, certain criteria must be met. An important consideration is your annual income, which must surpass a designated threshold. As of 2024, you must earn a gross income of more than 69,300 euro per year to be eligible for private insurance. Moreover, certain professions or statuses automatically qualify for private health insurance, e.g. self-employed individuals and civil servants.
Private health insurance encompasses all essential medical care services. Additionally, you must choose your own coverage options by including special treatments in your insurance plan. This can extend to specific dental care or optician’s services, which typically fall outside the coverage of the statutory health insurance. It is important to note that, unlike statutory health insurance, patients may under certain circumstances be required to pay for treatments and health care services upfront. Subsequently, the private insurer reimburses the cost after the patient submits the invoice – in cases where treatment was indeed necessary. Insurers may demand a cost estimate beforehand.
It is also important to note that it is possible to complement public health insurance with supplemental private insurance for additional services.
Calculating premiums in private health insurance
Unlike the public insurance system, private health insurance premiums are not influenced by your income. Instead, your age and medical history determine the amount you have to pay each month. Although these individual insurance plans may come with a higher premium, privately insured patients often enjoy advantages such as shorter wait times for doctor’s or specialist’s appointments.
