Is Private Health Insurance Worth it? [2024 Expats Guide]

Key takeaways

• Civil servants and self-employed benefit most from private health insurance in Germany.
• 93% of civil servants and 39% of self-employed in Germany are insured with private health insurance.
• 95% of employed people are insured under public health insurance. However, if we see the employed people ELIGIBLE for private health insurance, then 44% are insured in private and 56% in public health insurance.
• Statutory health insurance is a better option for families with a single earner.
• Your children and your non-working spouse are not insured for free in private health insurance.
• Civil servants can save around 550 € per month, and self-employed around 250 € per month with private health insurance.

This is how you do it

• Learn about the pros and cons of private health insurance before deciding. You can use our “Health Insurance Finder” tool to check which health insurance (Public or Private) makes sense and when.
• Get advice from a fee-based advisor or an insurance broker before choosing between private or public health insurance.
• Compare private health insurance offers on Tarifcheck*.
• Expats looking for English customer support can check private health insurance from Feather*. Feather is an insurance agent and sells health insurance plans from Hallesche Versicherung.

Table of Contents

Many people new to the German healthcare system ask themselves, is private health insurance really worth it? If yes, then why are 95% of employed people insured under public health insurance?

In this guide, we’ll demystify the myth for you.

Is private health insurance really worth it?

Whether private health insurance is worth it depends on the following factors.

• Your occupation
• Marital status
• Number of children
• Age: under 35
• Health: healthy individuals

If you fall into the right categories, choosing private health insurance can save you a lot of money and provide better medical services.

The following people benefit the most from private health insurance.

	Occupation	Marital status	Number of children
Persona 1	Civil servants	Irrelevant	Irrelevant
Persona 2	Self-employed	Unmarried	Up to two children
Persona 3	Self-employed	Married, but the partner is working	Up to two children
Persona 4	Employed	Unmarried	Up to two children
Persona 5	Employed	Married, but the partner is working	Up to two children

For others, statutory health insurance is the better option from a financial perspective. Of course, if you can afford private health insurance for the whole family, it offers better services, and you should consider taking it.

You can use our “Health Insurance Finder” tool to check which health insurance (Public or Private) makes sense and when. We recommend getting advice from a fee-based advisor or health insurance broker before deciding.

Here is how we created the above table

Age and health

• Private health insurance doesn’t accept people who have chronic diseases. Even if it accepts you, the premium will be very high.
• The earlier you enter the private health insurance system, the better because of the two reasons
  • you are healthy when you are young 
  • you have more time to contribute to the retirement provisions, hence enjoy lower premiums

Spouse and children

• You cannot insure your non-working spouse and kids for free in private health insurance. However, your non-working partner and children are insured for free in family insurance.
• As you have to get a separate private health insurance policy for your children and spouse, the savings are no longer there.

NOTE: Your non-working spouse can also get public health insurance. However, their public insurance premium will be calculated based on family income. So, they’ll pay the maximum public health insurance premium (i.e. 1050€ as of 2024).

Civil servants

• The state covers 50% to 70% of civil servants’ medical costs. Thus, they need supplementary private health insurance to cover the rest. Hence drastically reducing their insurance premium.
• The state also covers up to 70% of the medical bills of a civil servant’s spouse. This is why it doesn’t matter if your partner works or not. The same applies to a civil servant’s children.

Self-employed

• Self-employed people must pay the entire health insurance premium themselves. This is why private health insurance is cheaper than public health insurance for self-employed (high earners) people.
• In the case of employed individuals, the employer pays half of the health insurance premium. This reduces the savings potential in private health insurance. 

Low earners

• Private health insurance premiums don’t depend on your income. This is beneficial for high earners, but it’s a disadvantage for low earners.
• In statutory health insurance, you pay less if you earn less. Hence, it is the better choice for people in low-income groups.

Why should you consider the long-term when choosing private health insurance in Germany?

Here is why you should consider the long-term while choosing private health insurance.

• Switching back to the public system is tough and gets tougher as you age. 
• Private health insurance might be beneficial when you are young and single. However, once you get married and have children, it can get expensive. Thus, look forward to the future while deciding.
• The private health insurance premium will continue to rise. So, you should be able to pay high premiums in the future. The increase in premiums is not because you are getting older. It’s because the whole healthcare is getting expensive due to inflation and medical progress. It has risen, on average, 3.2% in the last ten years (2004 to 2024).
• Switching private health insurance providers is expensive because of the following reasons.
  • You lose most of your retirement provisions. Hence, new insurance premiums will be higher to build up the provisions from scratch.
  • You are not getting healthier with age. So, expect a higher insurance premium or reduced services.

Private health insurance for expats living in Germany for a few years 

If you are in Germany for a few years, opting for private health insurance is usually better.

• You can get special private health insurance plans where you don’t pay retirement provisions. This reduces the insurance premium drastically. 
• Since you are in Germany temporarily, you don’t have to worry about high premiums in old age.

NOTE: For families, you must check if getting private health insurance is still cheaper. 

Before deciding, you must compare the cost of private and public health insurance for the whole family. Moreover, you should get advice from a fee-based advisor or an insurance broker before deciding.

Consult an health insurance broker

NOTE: Insurance brokers are liable for giving you advice. This means that if you asked for a particular coverage and the insurance policy recommended by them didn’t cover it, they are liable to pay for the damages

Name *

Your question *

Be as detailed as possible. It’ll help the expert in answering your questions.

Do you earn more than 69,300 € gross per annum? *

• Yes
• No

How old are you? *

Your age affects your health insurance premium

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If you would like to have a call

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You can check expat private health insurance on Feather*. Feather offers services in English.

NOTE: Feather is not an insurance company. It’s an insurance agent and sells health insurance from Haellesche Versicherung.

How much can you save with private health insurance?

Savings of single individuals in private health insurance

The following people save the most under private health insurance

• Single self-employed individuals with high income
• Civil servants

Let’s see how much each profession saves. We have made the following assumptions.

• you are a high-earner, unmarried, and have no children
• you are 30 years old
• you took a top-tier private health insurance plan

We also include contributions to long-term nursing care insurance while calculating the premiums. 

	Monthly public insurance premiums	Monthly private insurance premiums	Monthly Savings
Students	Under 23: 120 € 23 to 29: 125 € 30 and above: 222 €	Under 23: 120 23 to 29: 120 30 and above: 220	No savings
Employed	Total: 950 € You pay: 475 € Employer pays: 475 €	Total: 700 € You pay: 350 € Employer pays: 350 €	125 €
Self-employed	950 €	700 €	250 €
Civil Servants	950 € (only a few federal states cover half the health insurance cost)	400 € (State covers 50% to 70% of medical bills)	550 €

As you can see, civil servants benefit the most from private health insurance. That’s also why around 93% of civil servants and 39% of self-employed in Germany have private health insurance [1, 2].

Savings of married couples in private health insurance

Let’s see how much each profession saves. We have made the following assumptions.

• you are a high-earner, married, and have 1 child
• your partner is also a high-earner.
• you and your partner are 30 years old
• you and your partner took a top-tier private health insurance plan

	Monthly public insurance premiums	Monthly private insurance premiums	Monthly Savings
Employed	Total: 950 € You pay: 475 € Employer pays: 475 € Your partner: 475 €	Total: 700 € You pay: 350 € Employer pays: 350 € Your partner: 350 € (if employed)	250 €
Self-employed	You: 950 € Your partner: 950 €	You: 700 € Your partner: 700 € (if self-employed)	500 €
Civil Servants	You: 950 € (only a few federal states cover half the health insurance cost) Your partner: 950 €	You: 400 € (State covers 50% to 70% of medical bills) Your partner: 400 € (irrespective of if they are working or not)	1100 €

Your child’s premium is around 120 € per month. So, private health insurance is still cheaper if you have up to two children.

Don’t forget that you get better medical coverage in the private healthcare system.

When is private health insurance NOT worth it?

Private health insurance gets expensive if you are married and your partner is not working. It gets even more expensive as you have children.

We are considering only the financial aspect here. However, your health condition plays the main role in deciding which health insurance is best for you.

We made the following assumptions.

• Your partner is not working.
• You are healthy.
• You are eligible to get private health insurance. (earn more than the income threshold, 5.775,00 € as of 2024)

Employed individuals

	Monthly public insurance premiums	Monthly private insurance premiums	Monthly Savings
Married	Your premium: 475 € Your partner’s premium: Free	Your premium: 350 € Your partner’s premium in the – public system: 950 € (as your partner’s premium will be calculated based on family income) – private system: 700 €	Spouse in the public system -825 €* (475 – (350 + 950)) Spouse in the private system -575 €* (475 – (350 + 700))
Married with 1 child	Your premium: 475 € Your partner’s premium: Free Your child’s premium: Free	Your premium: 350 € Your partner’s premium in the public system: 950 € Your child’s premium in the public system: 120 €	-945 €*

*Your employer contributes to the premiums of all the privately insured members of the family. The contribution is limited to the amount the employer will pay if you are publicly insured. For simplicity, we haven’t considered the employer’s contribution towards spouse and child in this table.

Self-employed

	Monthly public insurance premiums	Monthly private insurance premiums	Monthly Savings
Married	Your premium: 950 € Your partner’s premium: Free	Your premium: 700 € Your partner’s premium in the – public system: 1000 € (as your partner’s premium will be calculated based on family income) – private system: 700 €	Spouse in the public system -750 € (950 – (700 + 1000)) Spouse in the private system -450 € (950 – (700 + 700))
Married with 1 child	Your premium: 950 € Your partner’s premium: Free Your child’s premium: Free	Your premium: 700 € Your partner’s premium in the public system: 950 € Your child’s premium in the public system: 120 €	-820 €

As you can see, private health insurance is expensive if you are married and your spouse is not working. However, this is only the financial aspect of a healthy individual.

If you are unhealthy and need special treatments and fast doctor’s appointments, you would prefer private health insurance over public.

You can use our “Health Insurance Finder” tool to check which health insurance (Public or Private) makes sense and when. We recommend getting advice from a fee-based advisor or health insurance broker before deciding.

Why do 95% of employed individuals choose statutory health insurance in Germany?

As per DESTATIS, 95% of employed people in Germany are part of public healthcare. So, one may naturally ask why employed people prefer the public system.

We must dive into the data to understand it better.

To be eligible for private health insurance, you must earn above the income threshold, i.e., 69,300 € as of 2024. However, only 9% of the employed individuals in Germany earn above the income threshold.

This means that 91% of the employed are not eligible to be insured under private insurance. That clarifies why so many people are in the public system.

Let’s check what percentage of employed people eligible for private insurance are in public insurance. DESTATIS reports that 5% of employed individuals are voluntarily insured in public health insurance, and 4% are in private healthcare. 

So, considering the employed people eligible for private health insurance, 44% (4/9 * 100) are insured in private and 56% in public health insurance.

Best private health insurance in Germany

In our comparison and test, we found Haellesche’s and Signal Iduna’s private health insurance plans among the best.

Private health insurance is a complicated product. So, we recommend the following before getting private health insurance.

• Educate yourself about private health insurance by reading neutral guides.
• Get advice from a fee-based advisors. You pay them for their time. They don’t get paid by the insurance company.
• Get advice from the consumer advice centers (Verbraucherzentrale) for free. Unlike insurance brokers or agents, they don’t get paid by the insurance company. Hence, they offer neutral advice. Consumer advice centers usually offer advice in German. But you can enquire about advice in English. In big cities, you may find an English advisor.
• Get advice from an insurance broker. They get a commission from the insurance company. However, they are liable for their advice. So, you can sue them if they offer the wrong advice.

NOTE: Always get the insurance advice from an insurance advisor or broker in writing. If you feel cheated by the broker in the future, you can use it as proof in court. You can also document the advice yourself and keep it for future purposes. 

Before contacting a professional or expert, you should know what minimum services your private health insurance plan must cover. We have created a checklist for this purpose only.

The checklist contains all the essential services a good private health insurance policy covers.

Private or public health insurance in Germany

Here are some main differences between public and private health insurance in Germany.

	Public health insurance	Private health insurance
Selection	You can go to doctors that accept patients with public health insurance	Every doctor in Germany accepts patients with private health insurance
Invoice	You use your health insurance card during the doctor’s visit. The insurer settles the invoice directly.	You are responsible for paying the doctor’s invoice. You submit the invoice to the private insurance company for reimbursement.
Drugs	– The patient pays 10% of the prescribed medicine’s cost (min. €5, max. €10) – No reimbursement for over-the-counter drugs.	Usually, full reimbursement of medicines.
Hospital	Admission to the nearest suitable clinic	Free choice of hospital or private clinic possible depending on the tariff
Hospital rooms	Usually shared hospital rooms.	Mostly private rooms, in a few tariffs multi-bed rooms
Treatment	Doctor on duty	– Chief physician – Doctor on duty in a few tariffs
Dental costs	– Full assumption of the costs of basic dental care (e.g., amalgam fillings) – Subsidy for more expensive fillings/inlays.	– No restriction to basic dental care – Pays 50% to 100% of the costs, depending on the tariff
Sick pay	– The insurer pays 70% of your gross income or max. 90% of net income from the 43rd day of sick leave. – The same applies to leaves in the case of a sick child. – Special rules apply to voluntarily insured people.	– When and how much the insurer will pay depends on your insurance plan. – The insurer doesn’t pay in the case of a sick child.
Maternity leave	– You don’t have to pay insurance premiums during maternity leave. – Special rules for voluntarily insured persons	Usually, you pay monthly insurance contributions during maternity leave.
Changing health insurance provider	You can change public health insurance providers anytime without consequences.	Changing a private health insurance provider is expensive. Even changing your health insurance plan with the same provider can be expensive.
Switching between private and public insurance	You can switch to private health insurance anytime if you meet the eligibility criteria.	Returning to public health insurance is tough, even if you are unemployed or earn below the income threshold.

Read these guides to learn more

• Private health insurance
• Private vs public health insurance
• Minimum services private health insurance must offer
• Health insurance costs
• Employer contribution to private insurance plan