Healthcare System in Germany – Complete Explanation for Better Relocation

The healthcare system in Germany is excellent, but the familiarity with the substructure is one of the most important checkboxes you need to tick in your relocation checklists before planning that move. This helpful guide will cover the basic information you need about the healthcare system in Germany.

• Overview of the healthcare system in Germany
• Health insurance in Germany
• Healthcare costs in Germany
• Registration for healthcare in Germany
• Hospitals and Pharmacies
• Healthcare for Women
• Dental Insurance
• Emergency Services

Overview of the healthcare system in Germany

To begin with, all Germans and legal residents of Germany are entitled to free “medically necessary” public healthcare, funded by their social security contributions. However, citizens should still have either state or private health insurance cover for hospitalization, outpatient medical treatment, and pregnancy. It is legally mandatory for everyone in Germany to have health insurance coverage whether public or private depending on their incomes.

The development of Health Policies in Germany is done by the Federal Ministry of Health and the sector is regulated by the Joint Federal Committee.

The healthcare plans in Germany are divided into two sectors – Public Healthcare System i.e. Government’s Healthcare Plans and Private Healthcare System

Public Healthcare Scheme (gesetzliche Krankenkasse, GKV)

The public healthcare system in Germany covers treatments and services, such as immunizations, prescriptions, and dental checks across the country. This sort of national coverage facilitates low average healthcare costs in Germany contributing as an effective healthcare system in the world.

Public Health Insurance Costs in Germany

Salaried workers in Germany with gross monthly income less than 5,213 EUR and gross annual income less than 62,550 EUR as of 2020, must have public health insurance.

Even if you earn more than 62,550 EUR, you can continue with the public health system, as a voluntary user and agree to pay the maximum premiums.

Germany’s healthcare contribution costs are 14.6 to 15.6% of the total income, which equally split between the employer and the employee. An additional “Contribution rate” is charged by the state German health insurer at an average of 0.9%, paid solely by the employee.

Non-working dependents living at the same address and registered with the German Authorities are covered at no extra cost. Pensioners and people who receive unemployment benefits or assistance are also eligible for state healthcare.

Public Healthcare Registration

Generally every employer will register you with a regional German health insurance company. You are free to choose the insurer of your choice, and can do so by informing your employer within a definite period of starting work.

In other cases, when you need to arrange your own German health insurer you simply need to register with the German authorities at your local town hall. Factors to consider before opting are the insurer’s contribution rate, additional services, ease of contact, or availability of English-language information.

Once you’re registered with a social security number and begin your premium payments, you will have access to public healthcare with your health insurance card (Krankenversichertenkarte).

GKV maintains the list of all state German insurance companies to compare health insurance rates.

Public Health Insurance Coverage in Germany

The Public Health Insurance covers you for primary care with registered doctors, hospital care (in and out), and basic dental treatment.

Public Health Insurance however does not cover consultations with private doctors, private rooms in hospitals, alternative or complementary treatments such as dental implants, glasses/contact lenses for adults.

Private Health Insurance Scheme (Private Krankenversicherung or PKV)

The Private Health Insurance Scheme is limited to a set of people, you are only eligible to apply if you fall in the below criteria list:

• An employee earning more than 62,550 EUR annually as of 2020
• Self-employed
• Working part-time and earning less than 450 EUR a month
• freelance professional
• Artist
• A civil servant or certain other public employees

Private Health Insurance Costs in Germany

Unlike State Health Insurance which are priced based on your income the private health insurance costs are rather risk and patient profile based which might increase with age, health risks and added family members.

If you are eligible for private insurance, you can change from public to private health insurance but, you have to opt-out of the State health insurance first—you cannot have both.

Private health insurance entitle you to services and facilities not covered by public scheme, such as private healthcare, private hospital rooms, dental implants and complementary therapies.

Private Healthcare Registration

The application process for private health insurance is quite complicated as it might require you to take medical tests, answer questionnaire concerning your medical history and submit a proof of income.

Most private insurers in Germany require you to pay medical costs upfront and then claim reimbursements, whereas public insurance usually covers everything upfront through your social security contributions. 

The health insurance costs from private providers widely varies according to profiles, you can compare private health insurance providers in Germany on this website PKV.

Some of the top private insurance providers contact can be found through the list of members of PKV. 

It is mindful to always inquire which treatments and hospitals do your insurance company cover with the cost coverage percent as Co-payments have been increasing for certain treatments and medicines in Germany. In some areas such as dental, orthodontic treatment, and optical care, state health insurance only covers a small portion of the cost.

Hospitals

All the German states share responsibility with the central government for hospital provision in the Healthcare system in Germany.

There are three types of hospital (Krankenhauser) in Germany:

• Public hospitals (Offentliche Krankenhauser) – run by local or federal state authorities. These include Germany’s university hospitals. Most number of hospitals in Germany are Public Hospitals.
• Voluntary charitable hospitals (Frei gemeinnutzige Krankenhauser) – run by churches or German Red Cross organizations.
• Private hospitals (privatkrankenhauser) – run by private companies.

You should take your German health insurance card when you visit. Generally, the hospitals in Germany charge a daily fee of about 10 – 15 EUR with additional costs for diagnostics, surgery, and other medical procedures. Children aged under 18 years of age do not have to pay any costs.

It is important to note that hospitals have a certain amount of definite space allotted to patients with public insurance and with private insurance but the medical treatment for both public and private insurance holders is almost identical. Patients with private healthcare can demand to be treated by one of the hospital’s chief doctors and there are some private clinics that are open only to patients with private health insurance.

Hospitals in Germany do not provide personal items. You would be required to bring your own bathrobe, toiletries, and slippers.

German websites like DocInsider.de and Jameda.de can be of assistance to find doctors based on ratings from other patients.

Pharmacies and Medication

Prescription and non-prescription drugs can be easily obtained at pharmacies (Apotheken) and can refer this to search for local pharmacies.

Patients enrolled in the public health insurance scheme (with prescription on a pink slip of paper) have to pay only 10% of the costs i.e. about 5-10 EUR.

Private Insurance holders mostly get prescriptions on a blue sheet of paper which requires them to pay the full price of the drug up front and then send the receipt to your insurance company for reimbursement.

Healthcare for Women

Gynecologists are accessible in Germany through public health insurance. Public health insurance doesn’t cover most contraception costs.

Statutory insurance covers annual screenings for every woman aged over 20 for cervical cancer, breast cancer, and ovarian cancer.

State health insurance also covers the basic costs of pregnancy and childbirth. However, additional costs may be applicable for the paperwork involved in giving birth.

Private health insurance holders in Germany should check with the insurer for details about medical care for mother and baby.

Healthcare For Children

Public health insurance covers children until the age of 18. Vaccinations for children in Germany are free.

Dental insurance in Germany

If you have state German health insurance, simple routine dental procedures (filling, dental hygiene) or dental emergencies are more likely to be covered with the dentists who operate within the statutory health insurance scheme.

Otherwise, dental work in Germany can be quite expensive, and would often require you to present a cost estimate to your insurance provider prior to getting treatment.

The coverage for dental work varies greatly depending on the procedure and the individual.

There is additional private health insurance available for dental treatment. This is usually presented as a top-up insurance option called Zahnzusatzversicherung or Zahnschutz-Zusatzversicherung.

Emergency Services

The primary responders in Germany for emergencies are – Emergency Medical Services (Rettungsdienst), Fire Services (Feuerwehr) and the police (Polizei).

Pan European Emergency Number – 112

Police – 110

Ambulance (Rettungswagen or Krankenwagen) – 19222 

Non-emergency medical (doctor on call): 116 117 you can also visit the website for further details.

To find an emergency pharmacy call 0800 002 28 33 from a landline or 22 8 33 from a mobile.

Useful phrases:

Call an ambulance!: Rufen Sie einen Krankenwagen!

It’s an emergency: Es ist ein Notfall/dringend.

I’m in pain: Ich habe Schmerzen.

I need a doctor: Ich brauche einen Arzt.

I need a hospital: Ich brauche ein Krankenhaus.

There’s been an accident: Es gab einen Unfall.