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Private Health Insurance in GermanyComparison 2019

especially for employees, self-employed and freelancers

General Information

Since 2009, every person with a permanent place of residence in the Federal Republic of Germany has been obliged to take out health insurance. Health insurance is required even for short-term stays in Germany; otherwise no visa will be issued.

Particularities of the German health insurance system

German health insurance is characterised by a dual system consisting of statutory health insurance (SHI) and private health insurance (PHI). While SHI is accessible to everyone, certain conditions apply to private health insurance.

Citizens from countries of the European Economic Area¹ (EEA) and foreign nationals from countries with which Germany has a social security agreement² can be insured in the health insurance system of their home country. The insurance benefits of other countries can differ considerably compared to Germany. The insured party may thus have to make a financial contribution or take out supplementary insurance.

Statutory health insurance (GKV/SHI) and the solidarity principle

Statutory health insurance contributions are dependent on income. The basis is the total gross income, from which a uniform contribution rate of 14.6 percent (as of 2018) is levied. This is divided equally between the insured party and the employer, i.e. 7.3 percent each.

Each health insurance company also levies a different amount of additional contribution, which is paid only by the employee. If the contribution assessment ceiling (2018: € 4.425 per month) is exceeded, income above it plays no role in calculating the contribution.

Statutory health insurance allows children and spouses to also be insured free of charge with a family insurance policy.

Some groups of persons must be members of a statutory health insurance fund. They include:

  • Employees (gross income below the income threshold for compulsory insurance)
  • Pensioner (if the pre-insurance period is fulfilled)
  • Recipient of unemployment

Individual benefits in private health insurance (PKV/PHI)

The following groups of people are often privately insured:

  • Employees (gross income above the income threshold for compulsory insurance)
  • Public servants
  • Self-employed persons and freelancers

Membership in a private health insurance (PHI) scheme is not possible for everyone. Employees can be insured in the PHI scheme if their gross income is above the income threshold for compulsory insurance (2018: € 4.950 per month).

Persons concerned have to apply for exemption from compulsory insurance. Private health insurance companies often require a minimum period for permanent residence in Germany. Foreign policy holders must prove a long-term insurance period. Many private insurance companies offer special rates for this group, which are adapted to the needs and length of stay.

If you apply for a private health insurance scheme, you will be asked detailed questions about your state of health (health check). German insurance cover expires as soon as the policy holder returns to his or her home country.

Note: Private Health Insurance

Private health insurance contributions depend on state of health, age and scope of benefits, regardless of income. The premiums are different for each individual policy holder.
The benefits offered by PHI are hardly subject to any state regulations and are often more extensive than with statutory insurance. The benefits can also be precisely adapted to the policy holder. The policy holder initially pays any treatment costs in advance. The insurance company reimburses these costs upon submission of an invoice (cost reimbursement principle).

Matthias Wolf

Matthias is a German national who grew up in the UK before returning to Germany and working at senior levels in the German insurance industry such as Süddeutsche Krankenversicherung – an insurance company that specialises in health insurance and pension planning and Lechtor Independent Insurance Brokers – focussed on developing international client markets.

Matthias recognised the need for more services for expats in English but was struggling to make the impact on the market as he did not have the full support of his locally-focused German IFA employer.