Key takeaways
- Germany offers one of the best healthcare in the world at an affordable price.
- German healthcare is based on solidarity. It ensures everyone gets the same high-quality medical service irrespective of their income.
- There are two types of health insurance in Germany: private health insurance and public health insurance.
- Health insurance is mandatory in Germany.
This is how you do it
- Use our “Health Insurance Finder” tool to check which health insurance is best for you.
- If you are confused, get help from an expert. You can book an appointment with the expert we recommend here.
Table of Contents
German Healthcare System Overview
The German healthcare system is based on solidarity. Everyone gets the same health services regardless of their contributions and health risks.
Germany has two types of health insurance.
- Public health insurance (Gesetzliche Krankenversicherung (GKV))
- Private health insurance (Privat Krankenversicherung (PKV))
Both employers and employees contribute to the health insurance system, along with government subsidies. 89% of Germany’s population is insured with public health insurance, and the rest is insured with private insurance.
The German healthcare system provides comprehensive coverage, including
- doctor visits,
- hospital stays,
- preventive care, and
- medications.
Usually, you don’t pay anything or very little to access healthcare in Germany.
How Does the German Healthcare System Work?
Everyone in Germany is legally required to have a valid health insurance policy. Residents can choose between public and private health insurance.
Both the insured individual and their employer contribute equally to the health insurance premiums. If you are self-employed, you bear all the costs.
Every resident gets a health insurance card. They can use it to obtain medical services such as doctor’s visits, hospital care, medicines, etc.
Your German health insurance also covers you within the EU and the countries with which Germany has social security agreements.
However, the health insurance coverage outside Germany is not comprehensive. Thus, travelers should get international travel health insurance.
Types of health insurance in Germany
There are two types of health insurance in Germany.
- Private health insurance (Gesetzliche Krankenversicherung)
- Public health insurance (Privat Krankenversicherung)
Other types of health insurance are available for expats for short-term stays.
- Expats health insurance: It’s for people living in Germany for up to five years. If you plan to stay longer, get private or public health insurance instead.
- Travel health insurance: For travelers visiting Germany. You are not allowed to work in Germany with this health insurance.
Expat health insurance
Expat health insurance is suitable for the following people
- Applying for an “opportunity card.” You must show proof of a private health insurance policy to get an opportunity card visa. The embassy does not accept travel health insurance.
- You are coming to Germany for a short-term course, such as an internship, language course, etc.
You can get expat health insurance from Feather* or Dr Walter*. Both offer good plans and English customer care.
NOTE: Once you get a job or enroll yourself in a full-time course, you must get public or private health insurance. Expat health insurance doesn’t offer comprehensive coverage as public or private insurance.
Private and public health insurance overview
| Public health insurance | Private health insurance |
| Definition | |
| Default health insurance for German residents. The federal government of Germany regulates it. | A voluntary health insurance option. Private insurance companies offer this. |
| Eligibility and requirements | |
| Employees: Mandatory if earn below the income threshold (69,300€ gross annually as of 2024). Voluntarily insure themselves if they earn above the income threshold. Self-employed, freelancers, and doctors: Voluntarily insure themselves irrespective of income. Students: You get public insurance by default if you are under 30 before starting your studies. However, you can change to private within the first three months of your course start. Artists: You must insure yourself with “Artists’ Social Insurance Fund (Künstlersozialkasse (KSK)) | Employees: You must earn above the income threshold (69,300€ gross per annum as of 2024) Self-employed, freelancers, and doctors: Voluntarily insure themselves irrespective of income. Students: Voluntarily insure themselves. Non-EU students above 30 can only get private insurance. NOTE: Private health insurance can reject your application if you have existing medical conditions. |
| Costs and contributions | |
| Contributions are a percentage of your gross monthly income, between 19.9% and 20.3%. As of 2024, the maximum gross monthly salary considered to calculate the premium is 5175€. Employee: The premium is split equally between the employee and employer. Self-employed: You pay the whole premium yourself. Student: Get a special student tariff. It costs between 114€ and 130€ depending on the insurer. Non-working spouse and children: You can insure your non-working spouse and children for free in your family health insurance. Unemployed: If you earn less than 1178.3 € gross per month and aren’t insured for free in family insurance, you pay a minimum premium of around 192.07 € per month (as of 2024). Retired or pensioners: You pay a subsidized health insurance premium. However, you must be insured with statutory insurance for at least 90 percent of the time in the second half of your working life. | Premiums depend on your age, health, and chosen coverage. For a healthy 35-year-old, it costs around 650€. Employee: The premium is split equally between the employee and employer. However, employer pays at most what they may have paid if you were insured with public insurance. Self-employed, unemployed, doctors: You pay the whole premium yourself. Student: No special student tariff. Non-working spouse and children: You must get a separate policy for your non-working spouse and children. Child: 90 € to 120 € per month Retired or pensioners: Your pension insurance pays a subsidy, and you cover the rest. |
| Coverage and benefits | |
| You get a health insurance card. You show the card and can avail yourself of health services without paying a cent. Coverage includes doctor visits, hospital care, prescriptions, and preventive care. | Coverage depends on the plan you choose. You can tailor the coverage based on your needs. In addition to public insurance coverage, you can access private hospital rooms, shorter waiting times, the latest medical treatments, etc. |
How do you access health services in Germany?
| Do you need an appointment? | How long it takes to get an appointment? | |
| Family doctor | No (You should call the clinic before going) | Same day or the next day |
| Specialist | Yes | Private health insurance: within a week. Public health insurance: 4 to 8 months |
| Dentist | Yes | Depends on your location and urgency. It’s easy to get a dentist appointment in Germany. |
| Hospitals | No | You can go directly to the hospital in an emergency. The waiting time depends on the patient’s health condition. |
Family Doctors (Hausartz)
When you are ill or have a medical problem, your first point of contact is your family doctor (Hausartz in German). Usually, you don’t need an appointment to visit, but always confirm this with your doctor.
Specialists in Germany
If you require a specialist’s consultation, your family doctor will write a transfer order (Überweisung). You must make an appointment.
- Statutory health insurance members wait 4 to 8 months for an appointment. They need an Überweisung.
- Private health insurance members can get an appointment on the same day or week. They don’t need an Überweisung.
Dentists in Germany
You must get an appointment. You get a dentist appointment faster than other specialists.
- Public health insurance covers basic dental care. So, locals get supplementary dental insurance to cover dental costs.
- Good private health insurance plans offer comprehensive coverage with 70% to 90% coverage of dental costs.
There are 36,320 dental clinics in Germany as of 2023 [7]. The majority of them are private clinics run by individuals.
Hospitals in Germany (Krankenhaus)
You can go to any hospital for treatment. Every hospital in Germany has an emergency area that is open 24/7.
There are 1893 hospitals in Germany as of 2022 run by the government, private, and NGOs. [6]
- Number of public hospitals (Öffentliche Krankenhäuser): 539
- Number of private hospitals (Privat Krankenhäuser): 756
- Number of hospitals run by NGOs (Freigemeinnützige Krankenhäuser): 598
Need medical advice outside normal working hours
You can call the patient service at “116 117″ for medical advice 24/7. They also offer advice via chat.
Medical emergency
A medical emergency is an injury or illness that poses an immediate risk to a person’s life or long-term health. In a medical emergency, you should call “112” (valid all across Europe).
Pharmacies in Germany (Apotheke)
Pharmacies are open from 08:00 to 18:00 (Monday to Friday) and 08:00 to 12:00 (Saturday). Some pharmacies are open longer and even on Sundays.
You can also buy medicine online on websites such as Shop Apotheke, Apodiscounter, etc.
- Over-the-counter (OTC) drugs: You don’t need a doctor’s prescription. You pay for it yourself. Public health insurance doesn’t cover the costs, but good private health insurance tariffs do.
- Prescribed medicine: You need a doctor’s prescription. Your health insurance policy covers the costs. However, you may have to pay 5€ to 10€ if you have public health insurance.
How do you find a doctor in Germany?
- Google search
- Call your health insurance provider for support in finding and scheduling a doctor’s appointment.
- Appointment booking platforms: Doctolib, Jameda, Zava, and Doctena.
- Dentist: Official government website to find dentists. You must go to your federal state’s website to search for dentists.
Many doctors don’t accept new patients in big cities like Berlin, Stuttgart, etc. The situation is even worse for pediatricians (Kinderartz). In such scenarios, your health insurance company can help you find one.
NOTE: The problem of getting a doctor’s appointment applies to individuals insured in statutory health insurance. Privately insured people get appointments within a day or week.
How do you pay for the medical services in Germany?
| Public health insurance | Private health insurance | |
| Doctor visit | Show your health insurance card to access the service without paying a cent. | You pay first and get reimbursed |
| Pharmacy | Pay a small amount or nothing | |
| Dental services | Pay the invoice amount after deducting health insurance subsidies | |
| Other services, such as physiotherapy | ||
| Hospitals | Show your health insurance card to access the service without paying a cent. | |
Coverage and benefits of the German health system
| Services | Public health insurance | Private health insurance |
| Preventive Care and Wellness | ||
| Routine Check-ups and Screenings (cancer screenings, blood tests, etc.) | 💛💛🤍 | 💛💛💛 |
| Vaccinations | 💛💛💛 | 💛💛💛 |
| Mental Health Services | 💛💛💛 | 💛💛🤍 Depends on the plan |
| Alternative Medicine (Homeopathy, acupuncture, etc.) | 💛🤍🤍 | 💛💛🤍 Depends on the plan |
| Hospitalization | ||
| Free choice of hospital (Nearest hospital or private clinics) | 💛💛🤍 | 💛💛💛 |
| Accommodation (Shared rooms or private rooms) | 💛💛🤍 | 💛💛💛 |
| Treatment (Doctor at duty or chief doctor) | 💛💛🤍 | 💛💛💛 |
| Dental | ||
| Treatment (Root canal, tooth fillings, etc.) | 💛🤍🤍 | 💛💛💛 |
| Dentures (Implants, inlays, etc.) | 💛🤍🤍 | 💛💛💛 |
| Maternity and Child Healthcare | ||
| Prenatal Care (Regular check-ups, ultrasounds, prenatal screenings, courses, midwife, etc.) | 💛💛💛 | 💛💛💛 |
| Childbirth Options (Give birth at a hospital, birthing centers, or home with midwife assistance) | 💛💛🤍 | 💛💛💛 |
| Postnatal Care (Midwife support, postpartum depression, etc.) | 💛💛🤍 | 💛💛💛 |
| Pediatric coverage (Child’s regular checkups, vaccinations, etc.) | 💛💛💛 | 💛💛💛 |
| Chronic disease | ||
| Long-term Care (Care due to chronic conditions or disabilities: at home or in care facilities) | 💛💛🤍 Both systems offer the same coverage. | |
| Rehabilitation Services (Physical therapy, occupational therapy, speech therapy, etc.) | ||
| Home Care Services (Nursing care, assistance with daily activities, medical equipment for home use, etc.) | ||
| Support Groups and Resources (Access to support groups, resources for patients and their families to better understand and cope with the health conditions, etc.) | ||
| Healthcare for Seniors | ||
| Geriatric Care (Regular check-ups, preventive measures, etc.) | 💛💛🤍 | 💛💛💛 |
| Nursing Homes and Assisted Living (Traditional nursing homes, assisted living facilities, shared senior apartments, etc.) | 💛💛🤍 | 💛💛💛 |
| End-of-Life Care (Palliative and hospice care services, pain management, emotional support, etc.)Doctors respect your wishes, which are written in the living will. | 💛💛🤍 | 💛💛💛 |
💛💛🤍 – Good coverage. The health insurer pays part of the costs, and you must bear the rest.
💛🤍🤍 – Poor coverage. Little to no costs are covered.
How can you get German Health Insurance?
First, you must determine which health insurance, private or public, best suits your needs. You can use our “Health Insurance Finder” tool to do this.
Statutory health insurance
TK (Techniker Krankenkasse) is the biggest health insurance provider in Germany based on the number of insured members. It’s also expat-friendly and offers a website, mobile app, and customer service in English.
You can register with TK online by using our online registration service.
Get Public Health Insurance in Germany via Feather
- Get public health insurance in Germany from one of the four insurers.
- Complete the application process in English.
- Public insurance is the best choice for most expats living in Germany.
Private health insurance
We recommend getting private health insurance through an insurance broker. Brokers are experts who can suggest which policy is best for your needs.
Insurance brokers offer their services for free. The insurance company pays them upon successful contract completion. So, you must contact a broker who you can trust.
You can book an appointment with the insurance broker we recommend here. They have worked in the health insurance domain for over a decade and specialize in helping expats.
Book a free call with a health insurance expert
- German health insurance is a complicated product. There are several factors that must be considered before deciding which health insurance is best for you. An expert can guide you and help you pick the best option for you.
- An Insurance broker is liable for their advice. This means if the policy they recommended doesn’t offer the coverage you requested, they are liable to pay the damages incurred in the future.
NOTE: Insurance brokers are liable for their advice. So, if you bear any damage due to their wrong advice, the broker is liable to pay the damages.
Navigating the German healthcare system as an expat
Language Barriers and Translation Services
Doctors and medical staff usually speak German. In big cities, it’s easier to find English-speaking doctors. You should bring a friend or relative who can act as an interpreter.
Currently, health insurance companies don’t reimburse the translator’s costs. [1] However, the government has proposed that health insurance should cover it. [2]
Cultural differences in medical treatment
German doctors are more direct in their communication style, emphasize natural remedies, and avoid prescribing medicines whenever possible.
In many cultures, patients expect to get medication to relieve pain when visiting a doctor. Don’t expect it in Germany.
Patient Rights and Responsibilities
You have the same rights as German citizens in the healthcare system. You have the right to choose your doctor and access your medical records.
Complaints and Dispute Resolution
In case of disputes with your doctor or medical staff, you can file a complaint with your health insurance provider or the medical association of your federal state.
You even have the right to sue the doctor. You need a lawyer to take matters to the court. You can get legal insurance to cover the lawyer and court fees.
How confident are Germans in their health insurance policy?
As per the survey of Rober Bosch Stiftung, 60% of the Germans have lost confidence in the German healthcare system. Three years ago, it was only 30% of the people.
It’s a big and justified drop. The German healthcare system is struggling due to increased expenses and reduced income.
The healthcare expenditure was 497.7 billion euros in 2022 and is increasing consistently each year.
The factors contributing to the rising healthcare expenditure are
- Germany’s aging population. More old people (60 and above) mean more medical expenses. 31% of the German population is 60 or above as of 2024. The situation will worsen as one-third of the German population will be 60 or above by 2050. [4]
- Inflation is increasing the cost of medical treatments, medicines, etc.
- Medical science progress: Innovations in the medical field offer patients better and more treatment options. This leads to increased medical spending.
- Longer life expectancy: Life expectancy in Germany is around 81 years [5]. Statistically, each year costs the health system about twice as much as the previous one.
To cover these healthcare costs, Germany needs more young earners to contribute to the public healthcare system. However, the population of young professionals is decreasing.
All these factors make people lose their trust in the German healthcare system. People fear that the German public healthcare system will no longer be able to offer high-quality service at an affordable price.
Moreover, experts predict that health insurance premiums will increase drastically in the future.
Facts and Figures About the German Healthcare System
- Number of people insured in public health insurance: 74.31 million*
- Number of people insured for free in public health insurance: 16 million*
- Number of people insured in private health insurance: 8.71 million*
- Number of public health insurance companies in Germany: 96 (as of 2023)
- Number of private health insurance companies in Germany: 36*
- Healthcare expenditure: 497.7 billion euros (as of 2022)
- Total aging reserves in private health insurance: 336 billion euros*
- Number of hospitals in Germany: 1893*
*as of 2024
New reforms in the German healthcare system
- 2024 Digitalgesetz (DigiG): Public health insurance companies must create an electronic patient file (ePA) for all insured members by 14 January 2025. ePA will contain a patient summary file, hospital discharge letters, laboratory results, and a patient’s emergency data.
- 2023 Care Support and Relief Act (PUEG): Contribution to long-term care insurance is increased to 3.4% (if you have children) and 4% (if you have no children). In return, the benefits are increased for those needing care and their caring relatives.
- 2022 GKV Financial Stabilization Act (GKV-FinStG): The legally set average additional contribution will rise to 1.6% in 2023. It was 1.3% in 2021 and 2022, 1.1% in 2020, and 1.7% in 2024.
- 2021 Law for the Further Development of Health Care (GVWG): Improve quality and transparency in healthcare and promote hospice and palliative care.
- The 2021 Act on the Digital Modernization of Care and Nursing (DVPMG): Speed up and secure digital communication in the healthcare sector.
German healthcare vocabulary
Vocabulary that comes in handy when visiting your family doctor (Hausartz).
- Pain: Schmerzen – Just put this word before any body part that hurts. Eg, Bauchschmerzen, Kopfschmerzen, Halsschmrezen, etc.
- Fever: Feber
- Cough: Husten
- Cold: Erkältung
- Vomit: Erbrechen
Vocabulary you need in an emergency
- There’s been an accident: Es gab einen Unfall
- Can’t breathe: Kann nicht atmen
- Heart attack: Herzinfarkt
- Blood group: Blutgruppe
FAQs
Is healthcare in Germany free?
No, healthcare in Germany is not free. Every resident in Germany must have valid health insurance.
Residents can access medical services at no or very affordable prices using their health insurance policy.
What happens if you don’t take health insurance in Germany?
Everyone must have a valid health insurance plan in Germany. But you aren’t committing a crime if you don’t have one.
However, you have to pay a significantly higher amount if you later want to take out health insurance. This is because the health insurance companies calculate the amount due retroactively.
Moreover, you need a health insurance policy to get a German visa.
More topics
References
- https://www.pkv.de/wissen/private-krankenversicherung/
- https://www.bosch-stiftung.de/en/storys/germans-are-losing-faith-their-healthcare-policy
- https://www.gesetzlichekrankenkassen.de/leistungen/leistungen.html
- https://www.deutsche-rentenversicherung.de/DRV/DE/Rente/In-der-Rente/Kranken-und-Pflegeversicherung-der-Rentner/kranken-und-pflegeversicherung-der-rentner.html
- https://www.gesundheitsmarkt.de/anzahl-statistik-zahnarztpraxen-deutschland/
- https://www.destatis.de/DE/Themen/Gesellschaft-Umwelt/Gesundheit/Krankenhaeuser/Tabellen/eckzahlen-krankenhaeuser.html
- https://www.pkv.de/verband/ueber-uns/mitglieder-pkv-verband/
