How to Use your Health Insurance Deductible to your Advantage

Typically when you receive a German health insurance quote you will find words like “Selbstbeteiligung” or “Selbstbehalt”. In English this commonly transfers to deductible, excess or co-payment.

Paying a higher level of excess means you agree to pay a certain amount each year for your treatments yourself. Choosing to apply a deductible to your private health insurance plan is a way to lower your monthly premiums. For example, a € 300 deductible (like in Plan Expert1+ from Barmenia or K300 from ARAG) would mean that it is up to you to pay the first € 300 of any treatments and medical expenses within the calendar year before your insurer steps in. Generally, the higher the excess or deductible, the more you can lower your monthly premium.

However, what seems to be a reasonable calculation for freelancers, can look quite different for employees. Employees receive a subsidy from their employer for their monthly health insurance contribution (in German: Arbeitgeberzuschuss). However, you must foot the deductible cost out of your own pocket in case of illness and medical expenses. Does that really make sense?

As with anything related to health insurance, it’s not always this black and white. You need to know how the deductibles for your insurance are structured.

Deductibles are offered in absolute monetary figures as well as a set percentage. This depends on which insurance provider you choose. Some companies such as Ottonova, Allianz and AXA offer plans that calculate deductibles based on a percentage, rather than an absolute monetary amount. For example, when you’re a member of one of these policies, your insurance contract may stipulate that per claim, you have to pay 25% out of your own pocket. This means that for a €100 medical bill, you will get €75 reimbursed, with €25 being your deductible. Generally, these policies cover most forms of medical expenses; from prescriptions to hospitalisation.

There is also a third kind of deductible offered by some insurers that is only related to certain types of medical services. For instance, this could mean that your deductible may only apply to outpatient care, but not to dental services or hospital bills. AXA and Gothaer offer such plans whereby any dental treatment you submit as a claim, does not impact your level of deductibles. This is why it’s always important to weigh up your options carefully and read the fine print. If you know that you’re a healthy person with little chance you’ll need much medical care throughout the year, but you have bad teeth, then this kind of plan might be for you.

High quality plans offered by the likes of ARAG (e.g. plan MedBest) and Barmenia (e. g. Plan Expert+1) also offer a list of preventative benefits that are excluded from deductibles. Such preventative benefits include things like dental cleaning or cancer screenings and allow you to submit these claims without them impacting on your level of deductibles. Again, here’s where paying attention to the details will pay off (literally!) in the long run. Often the cheaper plans don’t offer the same conditions or level of flexibility that you might find in a higher quality plan.