Home Education Ottonova’s short guide to the German health insurance jungle

Ottonova’s short guide to the German health insurance jungle


German health insurance can be confusing, especially for expats and newcomers who don’t speak the local language. But that shouldn’t stop you from getting the best coverage possible. Ottonova brings you this quick and easy guide to the jungle that is German health insurance – so you can easily find your way around.

Anyone living and working in Germany needs health insurance – it’s simple. But what’s not so easy is navigating the system if you’re not sure how it works or what’s on offer. Here’s the lowdown.

How does the German health insurance system work?

Germany has a so-called dual-payer or two-tier health insurance system in which most health services are financed by the state, but a secondary, privatized form of health care also exists.

In the public system, junior insurers pay for the treatment and care of the sick and elderly, while the private system is person-centered but assumes solidarity between the healthy and the sick. Private insurers’ premiums cover their out-of-pocket health care costs, which rise as they age.

How many types of health insurance are there in Germany?

There are two main types of health insurance in Germany: public health insurance (Gesetzliche Krankenversicherung) and private health insurance (private Krankenversicherung).

State health insurance (Gesetzliche Krankenversicherung)

Almost everyone in Germany is entitled to public health insurance. Like the government system, premiums are based on income – so the more you earn (up to a certain limit), the more you pay.

Private health insurance (private Krankenversicherung)

If you are highly paid, self-employed or a government official, you may be eligible private health insurance. Your premiums are determined by the level of coverage you choose, the age at which you join the private system and your general health.

Which health insurance is better in Germany: public or private?

Depending on your income and employment status, you can freely choose between public and private insurance in Germany. Ultimately, deciding whether public or private insurance is best for you depends on your personal situation.

There are some things you should consider before making a decision: including whether you can make the choice, costs and coverage. Let’s break this down a bit more.

Am I free to choose between public and private?

Health insurance is mandatory in Germany. However, not everyone has the opportunity to insure privately.

  • Public: As a general rule, employees with a gross salary below €63,250 per year should choose the public system. The unemployed, farmers, gardeners, sailors and most students must also opt for public health insurance in Germany.
  • Private: Employees with a typical gross salary above €63,250 per year are free to choose between public and private health insurance – as are public officials and the self-employed.

Costs: How much does health insurance cost in Germany per month?

Obviously, one of the most important factors to take into account is how much your chosen German health insurance will cost you per month. It differs between public and private insurance:

  • State health insurance contributions depend on income and are calculated as 14.6 percent of your gross income, up to a maximum income threshold, plus an additional contribution rate of about 1.3 percent. That way, your contributions only grow in line with your earnings.
  • Private health insurance premiums depend on the tariff you choose, your health and the age at which you take out private health insurance. Young people who join earlier in life enjoy much lower premiums than people who join when they are older. Private health insurance premiums have risen by an average of 2.3 percent per year since 2020.

Coverage: What treatments and services does your insurance cover?

One of the main differences between public and private health insurance – apart from how your premium is calculated – is the treatment that is covered:

  • Treatment covers public health insurance set out in the German Social Code and can be changed by the legislators at any time. These include doctor’s appointments, inpatient care, outpatient care, surgery, birth care and basic dental care. However, by law, coverage is limited to “economically viable” services, meaning that more expensive or complex treatments may not be covered.
  • Coverage is provided private insurance depends on the tariff you choose and is fixed for life. You can choose which coverage is right for you and your needs.

Why choose Ottonova?

Of course, there are many health insurance providers in the market and you should definitely compare the coverage and benefits of different rates before committing. How Ottonova, Germany’s first fully digital health insurance provider offers its policyholders a full range of benefits and features, including:

  • Tariffs are specially designed for expats: Gives you the potential to save up to €300 every month.
  • Excellent personalized coverage: No more waiting times for specialists, one-room hospital accommodations, and up to 100 percent coverage of your dental bills.
  • Full support in English via the app’s chat or by phone: Get quick answers to any questions about your rate or health from your personal concierge.
  • Zero documents: scan documents using your phone’s camera and neatly organize them in your ottonova app.
  • Digital appointment: make an appointment with English-speaking doctors in just a couple of clicks.
  • Good luck to you: Get a €30 Amazon voucher afterwards signing up.

Book an optional consultation with Ottonova’s English-speaking insurance experts discover how simple and transparent health insurance can be.

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