Foreigners move to Germany with dreams of good jobs and a good life. And they are not disappointed. Two-thirds of expats rate their job security positively. This is a significant increase compared to the global average of 57%. About 66% of expats say that they have good work-life balance and only 2% of expats in Germany worry about personal safety. (Source). Another great aspect of life in Germany is their superb standard of healthcare. The country has very low rates of infant mortality and high per capita ratios of practicing physicians in the population. No wonder it’s such a popular destination!
Here is what foreigners and expats need to know about enrolling in health care in Germany.
Since 1883, Germany has had a national health care system, one of the earliest such models in the world. Today, the country operates as a universal, multi-payer healthcare system.
The German healthcare system puts a strong emphasis on choice. Expats and residents can choose from three options for health insurance. The most common option is the government-regulated public health insurance system. 92% of the population is covered through this system (known as the gesetzliche krankenversicherung or GKV) which provides a standardized level of coverage throughout the country. Additionally, private health insurance and a combination of the public and private models are available as options.
The most common and the most economical choice for health insurance is the government regulated public health insurance system. It is administered by approximately 113 “Krankenkassen” or “sickness funds”.
The price is based on gross income. The monthly cost is traditionally split between employer and employee, making coverage a bargain price. Even better, spouses, civil partners, and children are also covered under this plan. It’s cheap, it’s comprehensive, and it’s easy – thanks to the fact that employers handle the paperwork.
The second choice is to opt for local private health insurance (Referred to as Private Krankenversicherung or PKV). This choice is only open to residents whose income is greater than €57.600 per year, or €4.800 per month. Private insurance is normally more expensive than that offered through the public health insurance system. Furthermore, it only covers the individual, not family members, and coverage is local – in Germany only. Finally, the cost isn’t based on income but rather on health risk, which could make for a very pricey situation. However, private health insurance allows patients to have a higher level of comfort, privacy, and choice when they access some healthcare services and can be worth it for some people.
For expats who feel strongly that private health insurance is the way to go, you’ll need to inform your employer right away to avoid automatic registration in the public system.
The third choice is an ideal one for expats. It combines both models of insurance. It includes the economical and comprehensive services of the public health insurance plan and is topped up with an additional private plan that can cover outpatient services (like dental visits and physiotherapy) as well as some of the plush luxuries that come with private insurance, like enjoying private hospital room accommodations.
A third option would be to purchase a global health insurance plan that will cover you in Germany and throughout the world. This option is great for expats or foreigners who would like coverage in Germany, at home, and in any other country in the world. Private global medical insurance offers benefits over and above local private plans. First, they are global and will cover you anywhere in the world. Further, they can be more comprehensive and provide you with access to a wider variety of healthcare facilities and doctors. For expatriates moving to Germany, we would recommend two options. Cigna Global is a leading international health insurer with great service and benefits. Cigna Global offers a modular plan design allowing you to pick and choose different modules to tailor the plan to your needs and budget. The second option, designed for US citizens living abroad, is the GeoBlue Xplorer plan, which offers similar benefits and service to Cigna. GeoBlue Xplorer is offered in association with Blue Cross and Blue Shield of America and comes with the excellent BCBS network of doctors and hospitals and the highest quality of doctors worldwide. For other options, view our list of the best international health insurance companies.
For visitors, see: Health, Safety and Travel Insurance Advice for Travel to Germany
Proper healthcare coverage is no joke for expats in Germany, and it’s not only so you have adequate care when you’re injured or ill. Expats are required to obtain a residence permit at the local foreigners’ registration office (known as the ausländeramt) in order to maintain their legal status in Germany. In order to qualify for your residence permit, you’ll be asked to show proof of health insurance coverage. You’ll also need a certificate of health known as “Gesundheitszeugnis für Aufenthaltserlaubnis”, issued by a doctor in Germany. Therefore, it’s important to research your options, make a decision about public versus private plans, and inform your employer (if applicable) as early as possible. A delay in setting up your health care insurance means a delay in obtaining your residence permit, which puts your time in Germany in jeopardy.
Unfortunately, not every expat has a traditional employer to take care of the paperwork. Freelancing expats, or global nomads, have to be their own administrator. After deciding whether to go with a public or private insurance plan, self-employed expats must next choose a provider and fill out an application with them. You’ll be asked to provide standard information, like your name and address, as well as information about your work, and your previous insurance status. In addition to submitting the form, you’ll also have to include a passport photo (for your future ID card) and provide banking information for payments.
Whether you’re self-employed or fall under the domain of an employer, if you’re part of the public health care system you’ll have to decide which of the many Krankenkasse you want to sign up with as your administrator. No matter which Krakenkasse you choose, your costs will be the same as rates are based on income. The deciding factor for many is the additional services or perks offered by individual Krankenkasse, including no-claims bonuses, discounts on travel plans, or access to multilingual staff. One common Krankenkasse (Techniker Krankenkasse or TK), is well known for its English services and thus is often recommended to expats but the choice is yours. Expats have access to the same number of providers as citizens.
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