The Government health care system (GKV) is a statutory health insurance scheme in Germany. Roughly 70 million German residents have their GKV insurance.

Who must be part of GKV?

As mentioned above, this health insurance scheme is statutory, in other words, by law, every citizen in German is obligated to have its GKV insurance. Since stands still if the person seeks a better health insurance scheme by a private provider. This means that every German resident whose earnings lay under a fixed amount of money are part of this insurance plan. The ceiling amount of money set for this scheme change from time to time. In 2018, everyone who earns less than €59,400 per year or €4,950 per month, so to say, is obligated to take its GKV.

How much you pay for your GKV health insurance?

There is a specific amount you must pay for your GKV insurance. The premium required for your GKV insurance in Germany is currently 14.6% of your gross salary. This is paid equally by your employer and by you; 7.3% each of you. This However, the actual 113 Krankenkassen (health insurance providers) carry a supplemental charge to their clients which in average is 1% of your salary. Note that with this monthly premium you cover your non-earnings dependent like your spouse or your children.

Benefits

The intention behind the introduction of the mandatory health insurance in 2007 was that every citizen has the basic medical needs covered by its GKV health insurance. Those who get this insurance benefit

• Inpatient care
• Outpatient care by a licensed medical practitioner (Kassenarzte)
• Basic dental care
• Regular check-ups

Additionally, the insurance package involves a nursing care known as Pflegepflichtversicherung. Disabled people can seek help from a nurse practitioner to do bathing, feeding and similar daily activities.

Important notes

When getting a GKV health insurance you must read carefully what it covers, because if you go beyond its coverage you’ll have to pay on your own. Your GKV health insurance it doesn’t cover any medical treatment in a private hospital, a private doctor or surgeon, specific dental care.

Note that the German health care system may still apply when you’re abroad. However, it doesn’t cover every single country in Europe. So, when you’re somewhere outside Germany make sure your insurance will protect you.  

While your membership in this insurance plan is mandatory, the choice of the service provider is upon you. Further on you can switch between them easily. Your membership at each of them lasts for 18 months. After the end of this period of time, you’re free to decide if you want to change because of premium policies or other conditions.

Contributions for 2018 are as follows:

The difference between public health insurance and private health insurance in Germany

First things first. Health insurance is mandatory for every citizen and resident in Germany, regardless of their income. On the other hand, whether you choose public or private health insurance is upon your decision and it depends entirely on your earnings.

Medical care coverage is different for each insurance scheme

The health insurance aims to cover basic medical needs, including a basic dental care and regular checkups. In contrast, the private health insurance can cover more specific medical treatments. Moreover, you can get medical treatment in a private hospital or even ask to have your personal doctor who will be taking care of you whenever you need.

You pay different premiums for public and private health insurance

The premium rate you pay for your public health insurance is not the same as for the private health insurance. For your public health insurance, you pay much lower as for the private health insurance. There’s a nationwide basic premium rate for the public health insurance, which is the same for every citizen no matter his/her income. This amount of money needed to be paid for your public insurance may change. Currently, the basic premium rate the public health insurance charges is 14.6% of your gross income. The private health insurance charges higher premiums which vary according to your earnings and the risks you’re willing to take.

GKV and PKV: Whom it covers?

Your public health insurance in Germany may cover your dependents too, for example, your spouse/wife or your children. A private health insurance, on the other hand, it usually covers only the applicant who has been taking the insurance.

As a GKV insurer, you pay a nominal fee in hospital

If you’re holding a public health insurance you will have to pay a nominal amount of money when getting a hospital rehabilitation while for the rest the insurance provider will take care. Whereas, if you’re holding a private health insurance you won’t be paying a single cent. All you need to do is to show your membership chip card and your provider will take care of everything.

The geographical coverage is different

The public health insurance has a limited geographical coverage as opposed to a private health insurance provider which most of the time have a wider coverage. Being insured under the GKV scheme you’d expect to have basic medical assistance if you’re caught by surprise by an illness in some particular countries, but that’s all. If you’re privately insured your medical care will normally include more health coverage.

You or insurance providers: who pays for remedies?

If you’re insured with a public health insurance provider then 10% must be paid with a maximum of 10 euros and a minimum of 5 euros per prescription. Non-prescription medicines must be paid in full. Furthermore, the pharmacy is obligated to find the cheapest remedies required by you. On the other hand, if you’re privately insured then you will take top-brand remedies. At the moment when you’ll get the medicines, you’ll have to pay and then send the receipts to your health insurance company which is supposed to take care of reimbursement.

Frequently Asked Questions About Health Insurance

1. How do I apply for a health insurance?

There are currently 113 official public health insurance companies in Germany, known as Krankenkassen, but the Government doesn’t set the one to choose. Since you have this freedom to choose all it takes to be entitled is to contact the company of your choice and see if their offers suit you. Normally they will guide you through the whole process and paperwork needed.

2. How long can I stay without being insured?

If you’re an international coming to Germany you need to register for the mandatory health insurance scheme within 30 days from the day you register at a residence address. If you’re an employee-to-be in Germany then it is expected that your employer will take care of all the paperwork at least two weeks before you start your job.

3. How do I get a health insurance in Germany?

Health insurance in Germany is mandatory for everyone. There are many health insurance companies known as Krankenkassen you must look for and apply for their insurance packages. Once you find the one it suits you must initiate the process of the health insuring by contacting your chosen provider. They will give the details and the paperwork required for your entitlement to their insurance framework.

4. What if I am an expat and I don’t know German?

There’s no need to worry about this. Most doctors and pharmacists in Germany know English or any other language so communication won’t be any problem and you will address your health concerns easily. Furthermore, if you’re holding a private medical healthcare insurance there will easier than that. Private insurers make adds a significant contribution to the doctors’ supplemental incomes and so they pay greater attention to their privately insured patients. Being so, most of them know at least a foreign language other than the German language.

5. Do I get fined if I don’t have health insurance?

You must have a thing clear from the very beginning, health insurance is mandatory by law in Germany. With this being said, if you don’t have a health insurance, you’re actually breaking the law. And surely breaking the law means you’ll be charged a fine. So, when residing in Germany the first priority of yours will have to be seeking your health insurance otherwise you know the consequences. Although this is to say you need to be insured every moment in Germany, there may be a time-limited tolerance, but very narrow. Any single moment beyond this time limit will lead to a penalty for you.

6. How much does my membership with a Krankenkassen last?

When signing up with a particular Krankenkassen (health insurance provider) you will be a member of their insurance scheme for 18 months. After that, you’re free to decide if you want to continue with them or change to another company whose offer seems more attractive to you. If you’re holding a public health insurance and you want to change your insurance scheme to private insurance, then you can do by sending your provider a notice 2 months ahead.

7. Do I have to pay for my children’s insurance?

It depends on the type of health insurance you’re holding. If you have a GKV then your insurance is supposed to cover all your non-working and non-earning workers, including here close relatives like your spouse/wife or children.

8. What if I suddenly get sick in Germany while in a short visit?

If you’re in a temporary stay in Germany and get suddenly sick your health insurance in your home country covers your medical needs in specific circumstances, otherwise not. If you’re an EU/ EEA and Switzerland citizen and entitled in your country’s public health insurance framework then you can seek health care in Germany if you end up sick. In 2013, EU countries initiated a joint health care system so the citizens of each other could get required medical treatment all covered by their health insurance in their homeland. This normally applies in specific circumstances, for example, in emergency cases, or you need a treatment because you get acute symptoms or you’re an expectant other. When getting to the hospital you have just to show them your European Health insurance Card (EHIC) and they will take care you get the necessary medical care. After returning home, your health insurance provider will reimburse your insurance account.

9. Is health insurance an admission requirement?

In a way, the fact that health insurance in Germany is mandatory by law confounds international students about the time when they must seek health insurance. Many fear that they cannot apply for a university place without being health insured in the first place. False! You’re free to submit a university application without being health insurance ahead of your landing in Germany. Once you get admitted and land in Germany you must seek your health insurance plan.

So, have in mind, that while for the university application, there’s no need to be health-insured, when it comes to being enrolled at the university you need to be insured otherwise the University will turn down your admission.

After you receive the admission letter, the university is supposed to give you the necessary information around relevant issues relating to your staying in Germany as an international student. Also, you’re free to ask their counselling services for still more specific procedures on how to seek health insurance as for the other needs you may have through the way.

10. Can I use my homeland health insurance plan in Germany?

It wholly depends if there’s any agreement between respective states, therefore your country and Germany. Also, note that countries’ health insurance policy, including here Germany, toward a foreign country change depending on the country.

For example, back at home, your health insurance may cover numerous medical needs, but in Germany, there are limited medical services covered by your insurance provider. Furthermore, there are countries with whom Germany may not have a single agreement about this issue and your health insurance won’t cover anything. In this context, you must personally ask your health insurance provider and other relevant national authorities in your home country and they will inform you in details.

11. Does my insurance plan cover me when I’m home on holidays?

Except for particular countries with whom the German state doesn’t have a bilateral agreement, your German health insurance plan is supposed to cover you even when you’re staying home during holidays. However, there may be specific circumstances and specific situations at which your insurance won’t cover you while being out of Germany. If you have this concern you must ask your health insurance provider in Germany and other involved authorities that will tell you if they offer a health insurance plan that perfectly matches your needs.

12. If I graduate before my health insurance membership expires should I still pay for it?

When you get your health insurance plan you basically sign a contract with the Krankenkassen company and as any other contracts, it has its own conditions and terms. Therefore, you need to stay in line with them.

In principle, this contract specifies that your Krankenkassen membership lasts for 18 months. After this period of time, you’re free to choose if you want to continue or resign. However, you can still switch off your membership before this deadline by sending a notice to the health insurance provider you have chosen in Germany. Also, you need to contact a Residence Registration Office and tell them you want to cancel your insurance. They may give you a form to fill so they can remove you from their database. Finally, they set a time limit after which you’re no longer entitled to the health insurance program in Germany. This time limit is usually two weeks or so.

13. Can my health insurance plan cover my relatives?

Lucky for you. One of the extra benefits that the health insurance system in Germany is that your insurance can cover your relatives who at the moment when they need the medical assistance were visiting you. Surely, your insurance will only cover basic needs until your relative can return home for further rehabilitation.

Other Types of Insurance in Germany

Germany features a high level of safety awareness; and many consumers want to be well protected against all kinds of eventualities of their everyday life by taking out an insurance policy. On the average, a German citizen pays about 2,400 €/year for six insurance policies; this amount has doubled in the course of the past 20 years. 50% of the insurance contributions are paid for private old-age provisions. The figures are per-capita expenditure, i.e. a three-person family pays 600 €/ month for insurances in the average. In the following we will clarify for which insurances/ provisions the money is spent and which insurance policies are common in Germany.

Which insurances are available in Germany?

In general, insurances can be sub-divided into two large types: the personal insurances on the hand and the property insurances on the other hand. While property insurances offer protection from destruction, damage or loss of the insured objects, personal insurances financially protect the insured person from particular risks of life.

Insurance protection can be arranged individually

In addition to the insurances described above, numerous particular individual insurances are offered in Germany. This wide range of policies which is rather confusing for non-professionals bears the risk of over-insurance. Compiling your insurance portfolio, you should consider very carefully which insurance policies are economically reasonable and affordable for you. The risks of life change with advancing age, e.g. Marriage and children, loss of job, taking up self-employment or the beginning of retirement can entirely change your life situation. A regular insurance check is therefore highly recommendable to ensure your financially and individually suitable insurance protection at all stages of life.