Best Health Insurance in Germany Public vs. Private Options 2024

8. Private Coverage in German Health System

German private health insurance (“Private Krankenversicherung”) is often associated with many advantages. This may be shorter waiting times for an appointment with a specialist, use of the latest medical techniques, single or twin hospital rooms, or treatment by the head physician. 

However, these benefits are usually only part of more expensive plans. In contrast to statutory health insurance, there is no general service catalog. In private health insurance, customers look for a plan that includes benefits that are important to them and that they can afford. When visiting a doctor, the patients pay the bill themselves and get the full or part of the cost reimbursed according to the contract terms. Patients have a free choice of doctor. As with public health insurance, coverage is available throughout Europe. Moreover, a lot of plans include worldwide coverage for limited stays abroad.

As it is not a public welfare but a profit-oriented system, everyone has to cover the risks of falling ill with their contributions. Private health insurers can choose their customers and might reject them, for example, due to a pre-existing condition. The only exceptions are basic and standard tariffs with limited benefits. Here, private insurers must accept anyone who is not subject to statutory health insurance or has already been privately insured.

9. Membership in a Private Health Insurance in Germany

Only some people are entitled to switch to public or private insurance companies. Most German citizens do not fulfill the requirements to select private health insurance. Only in a limited number of cases, individuals can opt for private German health insurance:

1. Employed individuals: If your income exceeds the mandatory insurance limit (“Versichungsplichtgrenze”), you have the option to choose private health insurance. You must return to the public scheme when your income falls below this threshold. However, you can also apply to remain with your private health insurance in certain cases, for example, if you voluntarily reduce your working time due to parental leave or caring for a family member.
2. Self-employed individuals: Self-employed and freelancers can choose to join private health insurance regardless of their income.
3. Students and interns: Only at the beginning of the study program can students choose to get exempted from statutory health insurance. However, this may also make it difficult to get back to public health insurance after graduation. Also, student plans of statutory health insurance providers have very favorable rates.
4. Pensioners: Retired people usually remain in the private system if they were in it before. Others can also get exempted and change to private health insurance at the beginning of their retirement. However, this is usually not reasonable from a financial point of view.
5. Public officials: Civil servants are eligible to choose private health insurance.

Even if you are mandatorily insured in public health insurance, you still might opt against private health insurance. In contrast to private insurers, statutory health insurance also covers family members and guarantees stable or even lower contributions as a pensioner. Once you subscribe to private health insurance, changing back to the statutory system is only feasible in a few cases (e.g., you fulfill the conditions for mandatory public health insurance) and becomes almost impossible at the age of 55 or older. Hence, this step should be well considered and should depend not only on your current situation but also on your future situation (e.g., family planning).

10. Finding the Cheapest Private Health Insurance in Germany

Contributions to private insurance policies do not depend on the income. Private insurers define the cost of the policy based on factors like the covered treatments, the age of the individual patient, and their pre-conditions. As a family, every person needs to be insured individually. There is no family coverage like in the public system or sick payments during a child’s illness.

It is suitable for you as long as you are single, young, and healthy. If the risk of illness is low, the premiums are low – often, private health insurance is cheaper than statutory health insurance. However, you will probably pay a higher insurance premium with age. Therefore, finding a plan that remains affordable in the long run is crucial.

Nevertheless, just looking for the cheapest private health insurance is not wise. Mainly, cheap tariffs often offer little protection. For some treatments, they even pay less than the statutory health insurance companies. In the event of illness, this can become a cost trap if you have to pay for essential services out of your pocket. Upgrading from a cheap entry-level plan to increased coverage usually comes with extra charges.

In statutory health insurance, it is straightforward to switch providers; with private health insurance, it is more complicated. It is theoretically possible, but members would lose a large part of the reserves that the insurer has accrued for the future. Also, they would have to pass another health check with the new insurer. It is, therefore, wise to choose a plan with good benefits right from the start.

11. Best Private Health Insurance Companies in Germany

The search for private health insurance is much more complicated, and choosing the wrong plan can be expensive in the long run. Entry-level options, as well as other offers, sometimes lack important benefits. Hence, it requires time and profound consultation to choose private health insurance.

An insurance broker such as Feather Insurance can support you with consultation insurance broker such as Feather Insurance can support you with consultation. They also publish prices for different plans on their website for better understanding.

If this is not worthwhile for you, or you are in doubt, the safe choice is to pick statutory health insurance.

12. Alternative Option: Expat Insurance in Germany

If you have just moved to Germany, you might hesitate to sign up with a costly statutory or private health insurance plan. Perhaps…

• You have not settled and decided if you want to stay in Germany?
• You come here to improve your German at a language school for a set period?
• You are a digital nomad or just visiting Germany for some months and looking for coverage?
• You are a job-seeker with a German Visa requiring coverage during the initial period?

Suppose you do not have a legal status that obliges you to have permanent private or public insurance (e.g., through employment or studies at a public university). In that case, expat health insurance or “incoming insurance” is a great option. It can cover you for the first months or even two years after arriving in Germany. It is usually flexible, meaning you can easily extend it if you decide to stay longer or cancel in case you leave earlier. Insurance premiums are affordable.

Incoming insurance is mainly dedicated to covering you in case of illnesses or emergencies. This means existing pre-conditions, check-ups, or check-ups are not covered.

13. Conclusion: Public or Private Health Insurance Scheme?

Health insurance is not only reasonable but also obligatory in Germany. Finding the best private or public insurance can be tricky:

• Statutory health insurance is by far the most selected option. It covers everyone, no matter the existing pre-conditions. All treatments in line with current medical standards are included with a free choice of doctors. Premiums are dependent on income. Also, public health insurance covers non-working family members like partners and children for free.
• There are a total of 95 statutory health insurance funds. They differentiate themselves through their fees regarding additional contributions, voluntary coverages, bonus programs, and customer service. You can easily apply online.
• Only a limited group of people is eligible to select private health insurance alternatively (e.g., freelancers and employees with a yearly salary >69,300 Euros). Once they do so, the options to go back to public insurance are very limited.
• There is a wide range of private insurance plans. Some but not all of them offer better coverage than statutory health insurance, and usually, premiums increase with age. Moreover, private health insurance only makes sense if you are healthy. Private insurance can reject you because of pre-existing conditions.
• Most people who are in doubt about whether private health insurance is worth it for them in the long run, e.g., as they might join a family later or expect lower earnings, go with statutory health insurance. Additionally, improving coverage with additional private insurance, such as dental insurance, is common but not mandatory.
• Alternatively, expat insurance is a viable, flexible, short-term option for expats who have only recently arrived and need time to settle or are unsure how long they will stay.