Health Insurance in Germany: What You Need to Know as an Expat

Need health insurance in Germany? These insurance companies may be what you’re looking for. Find out how to get the best health insurance for your needs.
A picture of a German ambulance with the title: Health Insurance in Germany: What You Need to Know as an Expat

Looking for health insurance in Germany? You may be surprised to know that if you come from the European Union, you may already be covered.

If not, you still have plenty of options for public and private health insurance in Germany.

But your choices for insurance depend on your case.

Retirees may have different needs than exchange students. And the same holds true for professional workers and expats.

By the end of this guide, you’ll know which insurance is right for you, what kind of coverage you can get, and where to look for it.

Summary of this Post

If you want to get right to the point, here’s what you should know about health insurance in Germany depending on who you are.

  • You work in Germany: get social health insurance through Social Security and share the costs equally between you and your employer.
  • You work in Germany and make over 5,062.50 Euros a month: find out if human resources at your company has a private medical group policy for managers.
  • You’re self-employed: enroll into the Social Security system or apply for private health insurance.
  • You retire in Germany: if you come from the EU you can switch to Germany’s social health insurance. If you come from a non-EU country, you need private health insurance.
  • You study in Germany: enroll in a student health insurance plan under social health insurance or get private health insurance for students.
  • You travel in Germany: get travel insurance through a company like World Nomads before traveling to Germany, which you need in order to get a German visa.
  • You live in Germany: if you’re a EU citizens you can get insurance through the European Health Insurance Card. If you’re not a EU citizen, search a comparison portal like PKV Vergleich to find the best private German health insurance for your case.

Before You Come to Germany

It’s important to know that if you get sick or injured while living, working, or traveling in Germany, you can get emergency medical care without proving you have insurance first.

The German flag flying over a building.
Before you come to Germany and buy health insurance here, check what your existing policy covers you for.

No one asks you who’s paying the bill before they help you.

But don’t worry, you will get the bill eventually. And someone has to pay it.

That someone is you. Unless, of course, you have health insurance that covers you in Germany.

Check Your Existing Insurance

Here are a few ways to check if you have coverage for your time spent in Germany.

Traveling to Germany

Anyone traveling to Germany and European Union, or EU, has to have valid medical insurance.

While traveling the requirements are less strict and for all countries within the EU the same.

Travel insurance has to cover you with a minimum of 30,000 Euros.

Now, this amount is usually covered by most private medical insurance plans in any emergency out of area coverage.

But you may have insurance with worldwide coverage and therefore Germany might be covered within the limits of your existing insurance plan.

If you have local insurance, it’s worth checking for any existing emergency coverage you may have on your policy while traveling outside your area of coverage.

Also, many banks these days include travel insurance in their credit card packages.

And all countries in the EU have an intergovernmental agreement that covers anyone with existing social health insurance from any other country in the EU.

This may only apply to coverage for accidents and emergencies.

It’s worth checking with your home country’s social security health insurance for any coverage you may have while traveling in the EU, if you’re an EU citizen.

But to get treatment while traveling, you may have to get your European Health Insurance Card.

Moving to Germany

If you move to Germany your situation is a bit different.

Anyone living in Germany must have a valid health insurance through a licensed health insurance provider, not just travel insurance.

There is however a gray area for foreigners in Germany who plan to live there for up to 5 years.

In this case, you can use your existing health insurance if it covers Germany and covers inpatient and outpatient care and emergency assistance and evacuation.

Any violation against these regulations can lead to a fine of up to 10,000 Euros enforced by German regulating authorities.

You can read more about the options within Germany’s health care system and decide to keep your existing health insurance plan or sign up for a new plan.

Remember that you can only keep your existing insurance if you don’t work in Germany and stay in the country no more than 5 years.

Your two choices in Germany are social insurance or private insurance. Private insurance is a good choice if you can’t get social health insurance.

Health Insurance in Germany

Are you an expat, exchange student, EU citizen, retiree, freelancer, or business owner living in Germany?

If so, you must have either social health insurance or private health insurance.

You don’t have a choice in this matter. You have to proof that you’re insured.

The only question is if you’re insured compulsory or voluntarily under social health insurance or you’re entitled to get private health insurance.

Without going into too many details, basically if you’re employed you are insured automatically through the social security scheme.

If you’re freelancer, self-employed, or business owner, you must choose between voluntary getting social health insurance or signing up for private health insurance.

There are some exceptions for certain occupations.

Social Health Insurance

We talk about social health insurance in Germany because it’s a valid option and for many people, even expats, as it’s compulsory for most people.

Some people have a choice. So why would you want to join any social health insurance scheme if you have the option of getting private health insurance?

Generally speaking, it’s because social health insurance in Germany covers mainly everything, without restrictions on pre-existing or chronic conditions.

And social medical care in Germany is well organized and you get the right treatment when you need it.

Of course nothing is perfect and the same is true for social health insurance in Germany, otherwise people wouldn’t need private health insurance.

Now the question is: Do you want to buy private health insurance if you can get full coverage through social health insurance?

For instance, with social health insurance you may have to wait for an appointment at a specialist if it’s not an emergency.

But this doesn’t apply to all regions and for all specialist and treatments.

Also, some doctors are only available for private insured patients, but overall there are a variety of doctors available in the social health insurance system.

If you have social health insurance you’re supposed to first go to a general practitioner, who then refers you to a specialist if needed, but this isn’t mandatory anymore.

Working in Germany

If you or a family member work in Germany you are automatically enrolled into Germany’s Social Security system.

A silhouette of a man walking into the archway of a building.
If you work in Germany, you’re automatically enrolled in Social Security.

Social Security in Germany is compulsory for any employment and is non-negotiable.

Therefore you don’t have to worry about what kind of insurance to get if you work in Germany. You get social health insurance straight away.

The only exception is if you make a certain amount of money.

In general, employers deduct 14.6% of your salary for social health insurance and 3% for long term care insurance.

Another 18.6% goes to your pension and 2.5% goes to unemployment insurance.

You pay 50% of the costs for health insurance and your employer pays 50%.

But only the employer pays for liability and statutory accident insurance.

Now, if you or a family member works in Germany the other members of your family are insured for free.

This is called familienversicherung in German.

It means all family members are covered under one policy, including kids up to the age of 25 if they’re students or have no income.

However, if your partner or perhaps your child is earning money on their own, they need to be insured separately.

We mentioned that your income can be ab exception when working in Germany and getting insurance.

If you make more than 5,062.50 Euros as of 2019 you can choose to get private health insurance.

However, there are advantages and disadvantages to choosing private health insurance, which we talk about in the next section.

Also, even if you get private health insurance you still have to pay into your pension and unemployment insurance if you make up to 6,700 Euros.

If you make anything above that amount and have private health insurance, no other deductions are taken from your income.

Self-Employed

If you’re self-employed in Germany you can enroll in social health insurance if you had social health insurance in your home country before moving to Germany.

This goes for everyone, not just EU citizens.

If you had private health insurance in your home country then you need to get private health insurance in Germany as well.

Depending on age, social health insurance in Germany might be more expensive than private health insurance.

This is because rates for the social health insurance are based on income rather than age and personal medical history.

Each year your statutory health insurance company checks your income by checking your income tax report.

If you’re self-employed and make 5,062.50 Euros a month, 14% of your income goes to health insurance and 3% goes to long term care insurance.

You have to choose coverage for sick days separately at another 0.6% of your premium.

Or you can get insurance for sick days separately through a supplementary medical insurance plan.

There are no minimum premiums for voluntary social health insurance.

In 2019 the minimum premium was set to 171 Euros a month, which can be very attractive, especially for small business owners and startup entrepreneurs.

Social health insurance might be the best choice for you if you have a family in Germany because they get free coverage.

Retiring in Germany

If you want to retire in Germany you must have health insurance.

A retired couple standing at a kitchen table each holding a glass of wine.
If you come from the EU, you could get health insurance in Germany under certain conditions.

If you have private health insurance that covers you for inpatient and outpatient care, this might be enough, even if your policy isn’t licensed in Germany.

Nobody expects you can cancel your existing policy and apply for a new one when you retire.

EU Retirees

If you’re insured through Social Security in your home country, you could get your European Health Insurance Card.

But this card is only for emergency care and you may have to travel back and forth to your home country for any other treatments.

This may not be convenient for you. So you may want to switch your existing social health insurance from your EU home country to Germany.

To do this, fill out Form S1 from the health insurance company in your home country and send it to the health insurance company of your choice in Germany.

You don’t cancel the social health insurance in your home country. You just let them know you moved to Germany and that’s it.

If you’re not insured you need to get a private health insurance.

Unfortunately, you can’t join Germany’s social health insurance system while retired in Germany if you didn’t have social health insurance before you retired.

Non-EU Retirees

Unfortunately, if you’re not a EU citizen you can’t get social health insurance when you retire in Germany.

If you have private health insurance, keep it. If you don’t have insurance, you need to get some.

Skip to the Private Health Insurance section to find out more.

Studying in Germany

If you study in Germany you must have insurance.

A row of bookshelves in a library.
If you come to Germany to study, you must have health insurance.

As we said earlier, students can be insured through family packages for free up to the age of 23 if their parents are insured through Social Security.

Most likely, you can’t do this if you’re an exchange student in Germany.

But if you come from within the EU you can prove your existing social health insurance through the European Union Health Insurance card.

If you come from outside the EU, you have to check if there’s a intergovernmental social security agreement between your country and Germany.

If there’s no agreement, you can apply for student health insurance under the social health insurance system.

You get the same benefits as everyone else, except you pay less.

The current premium rate in 2019 for student social health insurance is about 70 Euros plus 20 Euros for long term care insurance.

But these rates depend on each health insurance company.

You can get this reduced insurance rate if you study in Germany for a maximum of 14 semesters or you’re no older than 30.

You can find the student rates from all different health insurance companies on Krankenkassen. But the website is only available in German.

You can find more info on student health insurance on the official website of Germans Academic Exchange Service. This website is in English.

Private Health Insurance

Individual Private Medical Insurance, or IPMI, is mostly better than social health insurance and has some advantages, but it can be more expensive.

You may come across people in Germany who recommend private health insurance over social health insurance, but be careful.

In regards to pre-existing conditions and also costs for additional family members, private health insurance may not be the right choice for you.

The advantages for private health insurance in comparison to social health insurance are:

  • higher dental coverage
  • easier access to medication
  • better treatment if hospitalized in semi-private rooms

Also, private health insurance offers you a wider range of access to doctors that only treat privately insured patients.

With private health insurance you don’t usually have to wait to get treatment and you can get an appointment with a specialist much quicker.

It’s possible that private health insurance is much cheaper than social health insurance.

If you make over 5,062.50 Euros a month or you’re a young startup entrepreneur, private health insurance may be a good choice.

For example, if you make 6,000 Euros a month you have to pay 380 Euros as an employee or about 760 Euros if you’re self-employed for social health insurance.

If you get private health insurance and you’re healthy and younger than 30, you can get private health insurance for under 250 Euros a month.

But this leads to the disadvantages. Under IPMI you don’t get free coverage for family members. You have to pay extra for each of them.

This means you may end up paying over 1,000 Euros each month to insure your family.

For some people it’s worth the money. For others, they’d rather stick with social health insurance.

Also, under private health insurance pre-existing conditions could be an issue.

IPMI rates are based on your individual age, medical history, benefits, deductibles, and area of coverage.

If you have any pre-existing conditions you may end up with an extra fee or even an exclusion.

Private health insurance companies increase their premiums once in a while as well.

But once you’re insured you technically stay in your age bracket. We explain this further down the guide.

IPMI and Working in Germany

If you can get private health insurance, keep in mind that your employer still has to pay half of the premium of any standard plan.

But you can’t buy a premium plan and expect your company to pay for it.

If you get a premium plan then your employer has to pay the maximum amount they would have to pay for social health insurance.

Also, the shared premium is just for you, the employee, not for your family members.

IPMI and Studying in Germany

If you study in Germany you can get IPMI as well.

This private insurance is cheaper for students and can even be cheaper than social health insurance.

If you’re an exchange student enrolled in a university in Germany, you must have either private or social health insurance.

But there are cases in which you can get student travel insurance, which is offered by many companies.

You can buy these plans for one semester or up to five years. They cover mainly everything too, but can cost around 50 Euros a month.

Supplementary Private Health Insurance

If you have social health insurance, supplementary private health insurance can be a cost effective way to cover what your social health insurance doesn’t.

Benefits of supplementary private health insurance are usually already covered under any IPMI plan.

For example, such insurance can cover you for:

  • More sick days
  • Better dental coverage
  • Long term care
  • Hospital stays
  • Daily hospital benefits
  • More outpatient coverage
  • Travel insurance

You can choose to buy all add-ons or just the ones important to you. Some make more sense than others.

Sick Days

Sick-day allowance insurance limits you to 70% of your last income under social health insurance and applies to employees and self-employed voluntary members.

A sick person lying under a blanket on a couch.
You may need supplemental health insurance to cover you for extra sick days.

If you’re self-employed, this insurance can be a good way to get income protection in case of any long term inability to work.

These insurances can be set with different deferment periods. The less waiting time, the more expensive it becomes.

Dental Coverage

You get limited dental coverage under social health insurance for major dental treatments like crowns or prostheses.

Also, for routine and minor treatments like fillings you may have to pay if you wish to receive better filling material.

Basically, the coverage for major procedures is only 50% of any standard treatments.

This means if you wish to have an inlay instead of a crown you may end up with an 80% copayment.

Supplementary dental insurance is a good way to minimize the financial risk for costly dental treatments.

Long term Care

Long term care can be very expensive, especially if you have no family members to help you.

Additional long term care insurance gets you better coverage than social health insurance and can help lower your financial burden in such a case.

Hospital Stays

Supplemental insurance for hospital stays gives you better benefits for admissions in semi-private or private rooms, specialists, and medical treatment, and more.

Daily Hospital Benefits

Daily hospital benefits provide you a daily allowance and can cover additional costs you may have while admitted.

Outpatient Coverage

Supplemental outpatient insurance covers treatments that are limited under most social health insurance plans.

These treatments include Chinese traditional medicine or other alternative medicines, but can also include classes and other medical aid.

Usually this kind of insurance is not worth the money, because the coverage is very limited but costs a lot.

Travel

You should have travel insurance if you travel abroad once in a while.

If you move to Germany, get travel insurance from a company in Germany because the coverage usually includes all areas except your country of residence.

But it’s not a must to buy in Germany.

Normal annual travel insurance for trips of up to six weeks are extremely cheap in Germany and cover much more than you usually get on the international market.

Social health insurance provides sufficient coverage in the EU, but not for any other countries.

IPMI plans on the other hand may give you sufficient coverage while traveling anywhere in the world. But you need to check them carefully when applying.

Depending on your needs and situation, supplementary medical insurance may or may not make sense for you.

But if you’re employed then you may check with your company if they have a supplementary medical group policy in place.

More and more companies in Germany offer additional employee benefits through such group policies these days.

Private Medical Group Insurance

Apart from supplementary group medical insurances, private medical group insurances are very rare, but possible to get if you run a company in Germany.

To get private medical group insurance at your company you need at least ten employees who can get private medical insurance instead of social health insurance.

So only big companies with enough high-income employees can get a group policy.

Another issue can be that for small groups, all employees need to have the same benefits, which can be challenging to set up.

But some companies have these policies in place and cost about 10% less than comparable individual policies.

Travel Insurance

If you travel to Germany and you’re not covered by any of the insurance mentioned above, then getting travel insurance is a must.

A windmill in an open field of grass.
Travel insurance lets you see all of what Germany has to offer without worrying about the costs of accidents or illnesses.

If you don’t have insurance, you may be denied your Schengen Visa for Germany.

But also it’s just careless to travel anywhere in the world without proper insurance.

As mentioned, the minimum coverage requirement for Germany is 30,000 Euros, but you can get coverage for over one million US Dollars.

You may want a higher limit for at least two reasons.

First, the premium difference between 30,000 Euros and 100,000 Euros in coverage is not as much as you may expect.

And more importantly, 30,000 Euros may not be sufficient enough if you have a major accident or get seriously sick.

You can buy Schengen travel insurance online or through an insurance broker of your choice anywhere in the world.

But check the details before buying.

Travel insurance covers you for delayed and cancelled flights and loss of luggage, but some don’t focus on the important part—health insurance.

Travel insurance that does focus on health insurance are usually much more expensive than your average travel insurance plans.

Offshore Private Medical Insurance

If you’re an expat who works in Germany, your have limited choices for insurance and most likely you’ll be insured through Social Security.

If you’re not employed and plan to stay in Germany up to five years, you can get insurance through an offshore company if it meets the standards of Germany’s laws.

If you move to Germany temporarily and have insurance that covers you in Germany for inpatient, outpatient, and emergency evacuation, you can keep this plan.

If you don’t have insurance you can buy any offshore plan you like as long as it covers the benefits mentioned in the last paragraph.

But there is no guarantee that in your particular case German authorities will accept the coverage you have. They may even force you to buy licensed insurance.

Insurance Plans Explained

Apart from offshore non-licensed private medical insurance, all health insurance in Germany are full care plans that include at least standard benefits for:

  • Hospital stays
  • Pre- and post-hospital rehabilitation
  • Outpatient treatment
  • Maternity care
  • Emergency assistance and evacuation within Germany
  • Limited coverage for dental, eye, and hearing
  • Limited coverage for checkups

Health insurance in Germany also covers medical treatment for:

  • Accidents from terrorism
  • Traffic accidents including motorcycles
  • STDs
  • Amateur sports

But you have limits for particular benefits. The differences are in the details.

Social Health Insurance

You can’t read about the terms, conditions, benefits, and exclusions of social health insurance because it’s based on Germany’s social health insurance law.

Make sure your insurance broker explains what you’re covered and not covered for with your insurance plan.

This law says that all medical treatment is covered as long as a medical practitioner prescribes the treatment and it’s within standard procedure.

Now, that doesn’t mean you’re fully covered for everything.

In fact, there are some treatments you won’t be covered for, especially if they aren’t standard and not approved.

Many new or experimental treatment needs time to be evaluated within the system before they’re accepted and covered by social health insurance.

Also, you need to be aware of the many copayments, excesses, and deductibles within the social health insurance system.

  • Over the counter drugs aren’t covered
  • 10% copayment for prescribed medication
  • 10% copayment for home nursing and alternative medication
  • 10% copayment on medical aids
  • 10 Euros a day for hospital stays and post-hospital curative treatments and rehabilitation at a max of 28 days
  • 10% copayment for ambulance or taxi transportation
  • 10% copayment for regular transport if medically necessary
  • No copayment for ambulance in emergency situations
  • No coverage for glasses for adults no coverage for adults; children up to 18 are covered
  • 50 % copayment for in-vitro fertilization for woman between 25 and 40
  • Routine Dental: only standard treatments
  • Fixed co-insurance subsidy on major dental work; all costs after fixed amount need to be paid by the patient

General Exclusions

There aren’t exclusions under social healthcare. But everything considered not medically necessary or standard treatment won’t be covered.

These alternative treatments include homeopathy, acupuncture, naturopathy, osteopathy, and Chinese and Oriental traditional medicine.

Apart from these alternative treatments, if a doctor within the social health insurance system prescribes a treatment, it’s covered.

Some social health insurance companies cover certain alternative treatments on a case-by-case basis.

For example, chiropractic care is covered if practiced by a medical practitioner, but not by a non-medical alternative healer.

Pre-Existing Conditions

Pre-existing conditions are covered without restrictions within the benefits of social health insurance.

Once you’re enrolled you don’t need to worry about pre-existing conditions in terms of insurance coverage.

Private Health Insurance

Private health insurance covers you for everything that social health insurance does, but with better benefits.

In Germany you can’t pick certain benefits such as only inpatient or plus outpatient or plus dental like you can in many other countries or through offshore IPMI plans.

And you can’t buy private health insurance for just hospital stays. All insurance plans include everything.

But again, the differences are in the details.

IPMI in general offers better benefits in comparison to social health insurance.

Plans

Generally speaking there are three types of IPMI plans in Germany you can buy from most insurance companies.

Standard Plans

Standard Plans cover—within limits and with copayments—specialists, medication, modality, medical aids, room and board while in the hospital, dental care.

Standard plans don’t cover alternative medicine and outpatient psychiatric care.

Comfort Plans

Comfort Plans cover at least semi-private rooms in hospital, better dental care, and offer full coverage for medical aids.

Comfort Plans also cover alternative medicine, psychiatric care, specialist, and medications within.

You may have to make copayments for certain benefits.

Exclusive Plans

Exclusive Plans cover everything without copayments except for major dental work where you have to make copayments or excesses.

Also, with IPMI plans you can add annual deductibles to lower your monthly premiums.

You can pay deductibles of up to 1,000 Euros a year, but less or more is possible too.

One advantage of private health insurance is the no-claim discount.

Basically, all companies offer discounts by refunding up to two months of your last year’s premium if you haven’t claimed anything during the year.

For example, if you pay 300 Euros a month and have claims worth 500 Euros for the previous year, it’s wise not to claim anything and get a 600-Euro refund.

With IPMIs you can skip most of the paperwork that usually comes with filing insurance claims.

In this way, Germany’s IPMI companies save a lot of paperwork on small claims and in return you can save a fair amount of money and time.

But not all companies offer the same refund policies so it’s worth comparing this particular detail before signing up.

Another important point are the rates for IPMI when getting older.

All IPMI plans are designed with and include aging provisions, parts of your premium which are used to compensate premium increases because of aging.

Because of this, you pay more in the beginning than you have too, but less than you’re supposed too as you age.

Your medical insurance rates stay stable and increase only moderately because of inflation, not because of age.

General Exclusions

There are no general exclusions under private health insurance. Everything medically necessary is covered at least partially.

As we explained earlier, there are benefit exclusions possible due the plan you choose, but there are no general exclusions.

Pre-Existing Conditions

Private health insurance companies in Germany have to make money and therefore can refuse to cover you for pre-existing conditions.

Private health insurance companies have the right to:

  • Accept you without limitations or surcharges
  • Accept you with surcharges
  • Accept you with exclusion of a particular condition
  • Deny you coverage

If you or a family member has a pre-existing condition it’s worth considering social health insurance instead.

But there’s no harm in getting an offer to compare your options and check whether you can get private health insurance if you have the choice.

Cancellations or Non-Extensions

By law in Germany once you’re insured no insurance company can cancel your policy unless you don’t pay and even then it isn’t easy for them to do.

Even if you have an accident or get sick and they have to pay a million Euros every year for you, they still can’t cancel your coverage.

Health insurance plans are unlimited in Germany and not only valid for one year.

But you have the right to cancel your policy at the end of each year if you give a three-month notice.

If you leave Germany you have the right to cancel your policy regardless of timing. This goes for private and social health insurance.

Areas of Coverage

Your social health insurance is valid in Germany, but also limited within the EU and for emergencies worldwide on a case by case basis.

IPMI plans are fully valid within the EU as well as worldwide for up to one month while traveling.

But this can vary from policy to policy and should be confirmed by your insurance provider before starting your vacation.

Age Groups and Restrictions

There are no age restrictions for health insurance in Germany.

You can get lifetime coverage once you insured, if you actually consider retiring in Germany.

Also there are no age limits for signing up to an IPMI plan.

But this doesn’t mean you can easily find private health insurance if you’re over 60.

As we explained, private insurance companies have the right to deny any application, which happen more likely for retirees than for working professionals.

But this happens mostly because of pre-existing conditions, not because of age.

For social health insurance, you need to enroll before the age of 55. But even then you’re not guaranteed coverage once you retire.

Payment Terms

You usually pay for IPMI plans and social health insurance directly from your bank account without additional fees.

If you work in Germany, your share of the payment is deducted from your salary and your employer takes care of payment.

Optional Coverage Choices

With social health insurance, you can’t add benefits except if you have supplementary private health insurance.

With private health insurance, you can add certain benefits to get first-class treatment.

Paperwork

As expected, insurance comes with a lot of paperwork. Here is some of the more important paperwork you should know about.

Applications

For all insurance types you need to fill out an application form and send it back to the insurance company.

Many companies have online applications, but these need to be printed out and signed before you send them back.

Social health insurance companies need your basic information to move forward with your application, but they don’t need health certificate or medical histories.

IPMI companies need your application, a full medical history questionnaire, and a current health certificate.

Direct Billing, Settlements, and Pre-Authorizations

As soon as you enroll into social health insurance at any statutory health insurance company of your choice, you get a membership card.

If you need to see a doctor you have to show this card and that’s it. The payment is settled directly between your insurance company and the doctor.

In an emergency, you can show your card later on. But it’s always best to carry it with you.

Regardless if you have private or social health insurance, in an emergency you need to get in touch with your insurance company asap.

The hospital usually does for you as long as they get your insurance info. But they always treat you, even without the information.

For any scheduled or outpatient surgery or other long term treatment, you need to inform your insurance company in advance.

With social health insurance your doctor does that for you. With private insurance you need to do it yourself. There’s no direct billing set up in Germany yet.

You need to pay outpatient costs out of pocket and make a claim later with your insurance company.

But again, this also helps to reduce paperwork for the insurance companies as they pay back no-claim discounts.

Denials of Claims

The main reasons you may be denied for a claim are that your treatment falls under alternative medicine or it wasn’t necessary.

But rehabilitation, major dental work, and others may also be denied because you’re not covered for that particular benefit under your insurance plan.

The best way of prevent denials is to double check with your insurance company before going for treatment, especially if it’s something extensive or out of the ordinary.

If you’re denied you can submit an official objection to the insurance company. They then double check their decision.

You can even use the official ombudsman to arbitrate the dispute. In this case, send an email to [email protected].

If that doesn’t work, you can sue the insurance company.

Finding the Best Insurance Plan

The choices you have depend on your personal circumstances. So before you pick an insurance plan, let’s recap.

Employed

If you work in Germany you get social health insurance through Social Security. The costs are shared equally between employer and employee.

Employed with High Income

If you have uninsured family members, compare prices between IPMIs and social health insurance, where family members are covered for free.

Also find out if human resources at your company has a private medical group policy for managers, which could be a good alternative.

Either way, your employer has to pay 50% of the costs.

Also, if your employer offers supplementary private health insurance in addition to social health insurance, then this might be worth considering.

Self-Employed

If you’re self-employed, your choice of insurance depends on the health insurance you had before you moved to Germany.

You’re either allowed to enroll into the Social Security system or apply for private health insurance. Either way, no one splits the costs with you.

Retirees

If you retire in Germany and have had social health insurance within the EU before moving to Germany, then you can switch to Germany’s social health insurance.

If you come from a non-EU country, then you need to get private health insurance.

Students

You can enroll in a student health insurance plan under social health insurance or get private health insurance for students.

Tourists

Get travel insurance before traveling to Germany, which you need to get a German visa anyway.

Expats

If you don’t have to work but want to spend your time in Germany, you still need health insurance.

If you’re a EU citizens, you can prove your insurance through the European Health Insurance Card.

But if you’re not a EU citizen, you need private health insurance.

You can buy insurance through a licensed German insurance broker or offshore company if you plan to stay less than five years.

If you’re interested in private health insurance search online comparison portals like PKV Vergleich to find the best German health insurance for your case.

Online portals are good for getting a reference or overview of options. But they can’t give proper explanations and advice for your particular case.

You may want to check with a licensed and experienced international broker like Hofmann-vers.

Even though the website is in German, English inquires are okay.

You can find a list of all 45 private health insurance providers in Germany on Krankenkassenzentrale.

The most commonly known companies are probably Allianz and DVK, but these are also some of the more expensive.

Allianz, even though a bit more expensive, has a good reputation when it comes to paying debatable claims.

All other insurances companies are very reliable too, even if you’ve never heard of them.

All licensed private health insurance companies in Germany are safeguarded through a protection fund for private health insurers.

If you’re looking for social health insurance, Krankenkassenzentrale has a list of insurance companies.

The popular ones are AOK, TK, and Barmer.

However, smaller insurance companies usually offer more benefits and can be slightly cheaper.

Which one you choose also depends on the region you live in, because not all companies are available throughout Germany.

Recommended Insurance Plans

You won’t find any real differences in price with social health insurance companies and only minor differences in benefits.

As a result, recommending a specific company for social health insurance is difficult.

However, not all companies can offer customer service in English.

Based on this alone, Barmer is a smart choice if you’re an expat and can’t speak German.

If you plan to get an IPMI plan, you have many choices as an expat apart from the standard private health insurance plans.

These plans offer better rates than most private medical insurance plans do.

You can find these plans on Inter.de.

Health insurances for temporary stays of up to five years are available through many insurers in Germany for less than 100 Euros per month.

Technically, anyone can buy these plans: students, retirees, freelancers, and so on. But not everyone is eligible.

One easy and straight forward option for expats is to get travel insurance through Hanse Merkur.

But you do have other choices through ERV, for example.

If you’d rather have longterm health insurance that you can take with you wherever you may move next in the future, then we recommend ACS.

ACS covers you in Germany, in Europe, and beyond.

Resources

If you move to Germany from another EU country, you may need to fill out Social Security forms or other important paperwork.

You can download all the important forms on Europa.

Since this article is about health insurance in Germany, we didn’t cover other topics too deeply.

But it’s worth mentioning one thing about Social Security in Germany: If you work in Germany for more than five years you get a pension.

If you work in Germany for five years or more, you get a pension.

Don’t start making big plans, because the pension isn’t much.

Also, many countries have intergovernmental agreements with Germany.

This means you can transfer your pension the Social Security system of your home country if you have social health insurance in your home country.

You could also get a refund on part of your pension if you work in Germany for less than five years.

If you work in Germany temporarily, you can apply for a refund on part of your pension after 24 months have past since the last payment was been made.

For either of the transfer or refund options above, you must apply for it but your former company may help you.

In addition, you may wonder if it’s necessary to speak the language in Germany.

The answer is mostly yes, as you may have noticed after visiting the websites we link to in this guide.

If you move to a bigger city like Berlin, Munich, Frankfurt, Cologne, or Hamburg, you can survive speaking English.

But if you move to a smaller city, which are mostly very charming and beautiful, fewer people speak English. So think about learning German.

Now, on to You

Now it should be clear what direction you need to look at in terms of health insurance for Germany.

Either way it’s always possible to reach out to any insurance broker to get advice for your particular case.

Whatever you decide, make sure you get the best protection for you and your family in Germany.

Featured image by 9966 Media.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.