Health Insurance System in Germany
In Germany, there is a comprehensive health insurance system intended to ensure the population’s medical care, and every resident is mandated to be health insured. You can choose between statutory health insurance (german: Gesetzliche Krankenversicherung or GKV) or private health insurance (german: Private Krankenversicherung or PKV).
- Statutory Public Health Insurance
- Private Health Insurance
- Which Health Insurance to Choose?
- Health Insurance for Self-employed
Statutory Public Health Insurance
Statutory or Public health insurance (german: GKV) is a part of the social security system and ensures medical care for the population. It is offered by health insurance companies, which can be chosen either by the employers or by the insured persons themselves. Contributions to public health insurance are borne equally by employees and employers. It’s based on income. Statutory health insurance provides comprehensive medical care and includes benefits such as visits to the doctor, hospitalization, medication, and much more.
Details on Public Health Insurance can be found on the website of the German Federal Ministry of Health (German language only).
Switching from Public Statutory Health Insurance to Private Health Insurance is easier than from Private Health Insurance to Public Statutory Health Insurance.
Private Health Insurance
Private health insurance (PKV) is an insurance that represents an alternative to public health insurance. The contributions to private health insurance depend on the age, gender, and state of health of the insured person. This insurance can increase over time. Private health insurance offers comprehensive medical care, including services not covered by statutory health insurance.
You can find details about Private Health Insurance on the website of the German Federal Ministry of Health (German language only).
Which Health Insurance to Choose?
Employees whose gross income does not exceed a specific limit are insured by a public health insurer. The specified limit changes every year. The limit for 2024 is €69,300, for 2023 is €66,600, and in 2022 it was €64,350. If an employee earns more than the stated amount in a year, they can choose to remain with the public health insurance or switch to private health insurance.
Health Insurance for Self-employed
In Germany, self-employed can choose between private and public health insurance. Private health insurance is more attractive when you are younger, but it also has many disadvantages.
With private health insurance, there is no free family insurance for children and partners, annual premiums increase, there is no option to have public health insurance in retirement,…
Perhaps it is therefore better to insure with a public health insurer because you can also insure family members for free, your health does not play a role in how much the monthly insurance amounts will be, and you are entitled to cheap health insurance for retirees.
However, there is one condition! Self-employed can choose public statutory health insurance only if they have already been insured at public health insurer for at least 12 months earlier. If they were covered with public health insurance for less than 12 months, then they have no choice, and only private health insurance remains. The self-employed can return to public health insurance only if they give up their self-employed job and are public insured as employees based on their income.
3 hacks how you can switch from private to public health insurance
Once you’re in private health insurance, you’re stuck there forever.
This is a common belief, but the reality is more nuanced.
While it’s often challenging to switch back to the public health system after opting for private insurance, it’s not a closed door. Several scenarios allow for this transition.
But why consider going back to public health insurance?
Often, the desire to switch stems from not choosing the right private plan initially and costs that are over the top. Therefore, be very careful at the beginning, when you decide to choose private plans.
But if in any case, you need to go back, here are three possibilities for how that works:
1️⃣ Are self-employed and switch to being an employee earning under the threshold you must join the public scheme. Also if that´s just for a month.
2️⃣ Are an employee and work less, or take a job with an income under the threshold, you have also to go back.
3️⃣ Are receiving unemployment benefits (Arbeitslosengeld I) from the German Agency of Labour automatically enrolls you in the public health system.
The Threshold is 69.300 € per year in 2024, so 5.775 € per month gross income.
These exceptions don’t apply if you’re over 55, where shifting from private to public insurance becomes significantly more complex.
Curious about whether private health insurance is the right choice for you?
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