Private or Public Health Insurance?

We help you to understand the pros and cons and choose the best option for you.

Below you will find a list of frequently asked questions. Browse through the topics to find answers.
How does the German Health Care System look like in general?

Germany is well known for having one of the best health care systems in the world, providing its residents with comprehensive health insurance coverage. Approximately 85% of the population are mandatory or voluntary members of the statutory health insurance, whereas the rest have chosen private health plans. What keeps up quality is, luckily, that both systems are in a way competing with each other.

I am only a short-term visitor in German - Do I need comprehensive health insurance?

When you are a temporary visitor here in Germany you are allowed to take out limited international travel health insurance as long as it fulfills the specific requirements of the Schengen Agreement.

Who can opt for a private health insurance plan?

Generally everybody who ist not a mandatory member of the statutory health insurance can switch to private. This is: Self-employed people, freelancers and public servants. Employees, too, may switch to private when they earn more than the so called social ceiling which is 59.600 € gross at the moment. The social ceiling is slightly lifted by law every year.

How do private health insurers calculate the contributions?

In contrast to the statutory health insurance system, where the insurance premiums are calculated according to the income of the insured persons, private health insurance providers calculate their premiums according to the insured person’s risk at the time of taking out the policy. This depends on several factors, in particular the starting age and the individual health status. In addition, the agreed scope of benefits; for example, by agreeing on a yearly deductible (own share) you can reduce the monthly price. And since 2013 gender no longer has any influence on the calculation of the contribution amount.

What do I have to consider as a self-employed person?

As a self-employed person, you pay your complete contribution out of your own pocket. Regardless if you are a member of the statutory health insurance scheme or if you are privately insured. You do not receive any subsidies. With a private health insurance plan you can arrange your individual coverage according to your requirements and wishes and also influence the premium amount.
Since self-employed people often no longer have an income in the event of illness, daily sickness benefit insurance is particularly important for them. With a daily allowance, which can be agreed as of the 4th day of illness, you can secure your livelihood even in the event of loss of earnings.

Do I have to take out health insurance in Germany?

Yes, Health Insurance is mandatory in Germany. Every resident is bound by law to be insured by a German provider for at least hospital and out-patient medical treatment. Listen ladies! This must also include coverage for pregnancy.

I am an employee earning less than 59.400 Euro gross per year. Can I opt for a private plan?

You are compulsorily insured in the statutory health insurance if you are earning less than the so called social ceiling of €59.400 € gross per year (2018). This threshold is slightly lifted by law every year.

Are there people who can not enter the private health insurance system?

Bankrupt people or applicants with chronic deseases might have problems to apply for private health coverage.
And employees who earn less than 59.400 € gross/year cannot switch to private, because they are mandatorily insured in the statutory health scheme. But the good news for those people is: You may take out supplementary private health insurance on top to improve benefits.

Why do I need a daily sick-pay (Krankentagegeld)?

Your employer will continue to pay you wages if you fall ill as an employee, but usually only for 42 days. As a privately insured person, you should take out private daily sickness benefit insurance in order to financially secure a long-term illness.

If you are self-employed, you can also agree on an earlier date for payment of the daily sickness benefit. This can be of existential importance, as income is often missing at the beginning of the illness.

It is up to you how much daily sickness benefit you wish to insure. However, it may not be higher than your net income from your professional activity. Your average earnings over the last 12 months are taken into account. You should therefore always report a permanent reduction in your income to your daily sickness benefit insurance.

Mirja Link-Lundehn

Mirja Link-Lundehn

co-founder of KLforExpats and licensed insurance expert

 

I love the daily business working side-by-side with clients. I like supporting them – especially when it’s urgent, in the event of a claim. It makes my day when I can find an attractive solution for a tricky situation!

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