Germany’s healthcare system is made up of a combination of compulsory health insurance and private medical care. It is mandatory for all residents of Germany to have either state or private health insurance and any expats planning to stay in the country for more than a year will need to prove that they have this in order to receive their residence or work permit.
If you are planning to work for an employer in Germany then the likelihood is that you will qualify for public health insurance (Krankenkasse). All employees must be insured in this statutory system, unless their revenue exceeds a specific amount, they are public officers or they are self employed/freelance. If their revenue exceeds this earnings threshold then they will have the choice to opt out of the public health insurance system and join a private system instead. There are a large number of different state insurance companies which you can choose to pay funds into. The most popular are AOK, Barmer and TK (Techniker Krankenkasse).
The main benefits of being in the state insurance system is that some of your family members – including a non-working spouse and children up to a certain age – will be covered for free. The cost of state health insurance is approximately 12 per cent of your net income (of which your employer pays half – up to a certain amount). However, while this public insurance covers most healthcare costs, adults will still need to pay 10 Euros per quarter which is due at the first appointment to see a doctor or a dentist (this is free for children under the age of 18). If you are then referred to see another doctor then you will not have to pay this fee a second time. The choice of which doctor to see or medical practice to use is totally down to you (so if you don’t speak German it may be possible to find a doctor who speaks English). You may also need to pay for some stays in hospitals and some prescription drugs.
If you are planning to be self-employed/freelance or choose to opt out of the state insurance system (if you are eligible to do so) then you must take out some form of private health insurance. However, this can be problematic as not all insurers will insure people who don’t have resident permits to live in Germany (which you will need to have health insurance to get in the first place!). You may need to shop around a bit if this is the case. It’s also important to note that through private insurance each person in your family will need to be insured separately. There are a number of different private health insurance companies in Germany all of whom offer different services and levels of cover, and some of which will offer expat packages.
Retirees who emigrate to Germany will also need to take out private health insurance – although those who come from some European countries (including the UK) may qualify for state health care, so it can be worth checking before you leave your home country.