Public health insurance coverage is not comprehensive in many areas, such as dental, nursing care, travel, etc. So, locals get supplementary insurance policies to cover the gaps.
That’s not the case for privately insured individuals, as they can decide what coverage they want when getting private health insurance. Hence, privately insured people usually don’t need supplementary insurance.
There are six main supplementary health insurance in Germany.
- Supplementary hospital insurance (Krankenhauszusatzversicherung)
- Hospital daily allowance insurance (Krankenhaustagegeldversicherung)
- Daily sickness benefit insurance (Krankentagegeldversicherung)
- Supplementary outpatient insurance (Ambulante Zusatzversicherung)
- Supplementary dental insurance (Zahnzusatzversicherung)
- Travel health insurance (Auslandreiseversicherung)
Table of Contents
1. Supplementary hospital insurance (Krankenhauszusatzversicherung)
Supplementary hospital insurance is an add-on to your public health insurance. It provides additional coverage during your hospital stays.
What does supplementary hospital insurance cover?
It offers the following coverage.
- Hospital of your choice
- Treatment in the private clinic
- Family room to accommodate both parents in the same room at the time of childbirth
- Accommodation in a single or double room, depending on your tariff.
- Treatment by the chief physician or a specialist of your choice.
- Extended visiting hours and additional amenities like TV, telephone, or internet access.
- Reimbursement of co-payments for hospital stays (10 euros per day for up to 28 days per year).
- Coverage for outpatient operations in hospitals ( Operations in which you leave the hospital on the same day).
- Treatment in mixed institutions: Institutions that have spas and other rehabilitation facilities. You need written confirmation from the insurer before starting the treatment.
What does supplementary hospital insurance not cover?
- Treatments that are not medically necessary, such as cosmetic surgeries.
- Pre-existing conditions (depends on your policy).
- Psychiatric treatments or rehabilitation measures.
- Treatments abroad unless specifically included in the policy.
When does taking it make sense?
- Highly qualified doctors and surgeons are expensive. Unless only the chief physician is qualified to treat you, public insurance won’t pay for them. This is when supplementary insurance pays.
- You can choose the hospital and the doctor who will treat you. You can search for preferred specialists and choose the hospital where they practice. The supplementary insurance will cover the costs of choosing a different hospital and the expensive specialist’s fee. These costs are not covered by public insurance.
- You have a family history of certain diseases and want to ensure the best possible treatment.
- You frequently have a higher risk of needing hospitalization.
When does taking supplementary insurance not make sense?
- Taking supplementary insurance to get a private room in the hospital is not worthwhile. You can pay for the private room yourself instead.
- You are over 60. The premium will be very high, which will not be worthwhile.
- Your pre-existing disease is not covered.
Cost
The cost of supplementary hospital insurance depends on the following factors:
- Age: The younger you are, the less you pay.
- Health condition: Pre-existing conditions may lead to higher premiums or exclusions.
- Chosen benefits
- Deductibles: The higher the deductible, the lower the premium.
Monthly premiums of comprehensive insurance plans with aging reserves cost between 25 € and 95 €.
Best supplementary hospital insurance
Our research found the following supplementary hospital insurance among the best.
2. Hospital daily allowance insurance (Krankenhaustagegeld-versicherung)
Daily hospital allowance insurance pays a daily allowance for your hospital stay for medically necessary treatments ( § 192 para. 4 VVG ). Publicly insured people must pay 10€ per day for a hospital stay. You pay other costs, such as for telephone and television usage. Daily hospital allowance insurance covers such costs.
What does daily hospital allowance insurance cover?
- It pays a fixed daily allowance you agreed to when signing the contract for your stay in the hospital.
- The daily allowance you receive is tax-free.
- You can choose a daily allowance between 60€ and 150€.
- You get the complete agreed daily allowance, irrespective of how much you pay at the hospital.
What does daily hospital allowance insurance not cover?
Daily allowance insurance plans have a three-month waiting period. You don’t get paid if you are hospitalized during the waiting period unless you have had an accident.
Does hospital daily allowance insurance make sense?
No, you don’t need hospital daily allowance insurance.
Publicly insured people pay 10€ per day as a co-payment for the hospital stay. This co-payment is limited to a maximum of 28 days in a year. So, you pay a maximum of 280€ in a year for hospital stays.
You can use your cell phone for services like internet and TV. Hence, there is no need to pay the hospital for these services.
Based on the above reasons, we concluded that taking hospital allowance insurance is not worth it. It’s better to save some amount in a savings account* instead. In addition, other insurance, such as supplementary hospital and sick pay insurance, makes more sense.
How much does hospital daily allowance insurance cost?
The cost of supplementary hospital daily allowance insurance depends on the following factors.
- The amount of the daily allowance you choose
- Age
- Occupation
- Current health
You can get supplementary hospital daily allowance insurance for around 10€ per month.
3. Daily sickness benefit insurance (Krankentagegeld-versicherung)
Daily sickness benefit insurance pays a fixed daily rate if you are unable to work due to illness or an accident after a certain time. The daily sickness benefit is tax-free and exempt from social security contributions.
Don’t confuse “sick pay or sickness benefits” from public health insurance with “DAILY sickness benefits insurance” from private insurance companies. You take daily sickness benefits insurance to top up your sick pay paid by the public insurance.
When does it make sense to get daily sickness benefit insurance?
Daily sickness benefit insurance is a very important supplementary insurance policy. You understand its value when you cannot work for a long time due to sickness. You should consider getting it depending on your occupation and health insurance.
Employees insured with public health insurance
Your employer pays the salary for the first six weeks when you are sick. After that, public health insurance pays the sick pay. The sick pay is 70% of your gross salary and 90% of your net salary (whichever is lower). There is also a limit on the maximum gross salary considered when calculating sick pay.
The maximum sick pay is 70% of the monthly contribution assessment limit of 5,175€. This means the maximum sick pay you’ll receive is 3,622.5€ gross per month as of 2024. After deducting the social security contributions, you’ll get around 3,152€ per month net sick pay.
Based on your current salary and expenses, you can easily check if 3,152€ is enough to cover your expenses. If not, you should get daily sickness benefit insurance to cover the gap. This insurance is particularly vital for sole earners in a family.
NOTE: The collective agreement in some companies stipulates that the employer tops up the sick pay to the actual net wage. You don’t need sick pay insurance if you work for such a company. So, check with the workers’ council (Betriebsrat) or HR about this.
Self-employed insured with public health insurance
As a self-employed individual, you don’t get paid by any employer for the first six weeks. You must take care of your income yourself. Thus, having sickness benefit insurance is vital.
Like employed individuals, you should at least opt for sick pay from public health insurance while signing up. Additionally, you can take daily sickness benefits insurance.
Self-employed have two options
- Get an optional sickness benefit tariff from your public health insurer.
- Get supplementary daily sickness benefit insurance from a private insurance company.
Privately insured individuals
You can get daily sickness benefit insurance as part of your private health insurance. However, it’s not a must. You can also take daily sickness insurance from a different provider. But you must get it. Otherwise, you’ll have no income when you fall sick for a long time.
Civil servants
Civil servants don’t need daily sickness benefit insurance as they get paid by their employer indefinitely.
How much does daily sickness benefit insurance cost?
The cost of the daily sickness benefit insurance depends on the following factors.
- How high the daily sickness benefit is. You choose it based on the gap between your net monthly salary and sick pay from public insurance.
- Your age
- Occupation
- From when you wish to get the daily sickness benefit
Best daily sickness benefit insurance
You can compare the daily sickness benefits insurance on the comparison portal ACIO.
4. Supplementary outpatient insurance
Public health insurance only covers medically necessary treatments. If you want to cover treatments outside of conventional medicine, you must pay for them yourself. This is where supplementary outpatient insurance steps in. It pays for such treatments.
Supplementary outpatient insurance bundles different types of insurance, such as travel, dental, alternative medicine, etc., and sells the bundle. Unfortunately, the coverage of each insurance type is not comprehensive.
Moreover, you usually need comprehensive coverage in a specific domain, such as dental, travel, etc., but not every area. Additionally, most insurers limit the type of treatments and reimbursement amount.
Is supplementary outpatient insurance worth it?
No, outpatient insurance is not worth it.
- It’s better to get public health insurance that offers better services in the areas that are important to you. We find TK the best public health insurer for expats in Germany. You can register with TK here.
- You can get supplementary insurance to cover a particular area.
- Lastly, you can get private health insurance for the best coverage possible.
How much does supplementary hospital insurance cost?
The cost depends on your age, health condition, and services. It ranges between 7€ and 80€ per month.
5. Supplementary dental insurance (Zahnzusatzversicherung)
Public health insurance offers basic coverage for dental treatments. You usually end up paying from a few hundred to thousands of euros from your pocket. This is where dental insurance shines. It covers the dental treatment costs.
What does it cover?
- 100% dentures (Zahnersatz) cost coverage (reimbursement up to the maximum GOZ rate)
- 100% dental treatments (Zahnbehandlung) coverage (root canal, plastic fillings, etc.) (reimbursement up to the maximum GOZ rate)
- Preventive dental care coverage (Professional dental cleaning)
- No waiting period
- 100% anesthesia coverage
What does it not cover?
- Known dental diseases
- Application rejection: Many supplementary dental insurance providers reject your application if you have serious or existing dental issues. Hence, taking a good dental insurance policy is advisable as soon as you start seeing dental health issues or enter your 40s.
- Annual reimbursement limit in the first few years: Dental insurance providers put a reimbursement limit in the first 4 to 5 years of signing the contract. During this time, you pay the excess amount.
- Limit on material and equipment costs: Dental insurers often limit material and equipment costs for dental treatments. For example, your insurer refers to a list of prices and services for materials and laboratories while reimbursing the treatment costs.
- Limit on number of implants: Another limitation some dental insurance companies put in is the number of implants. For example, your dental insurer will cover 8 implants in total.
When does it make sense to get supplementary dental insurance?
There are five things one should consider before taking dental insurance in Germany.
- Age
- Health habits
- Dental treatment cost
- Dental insurance cost
- Existing dental problems
Age
| Age | Percentage of adults with missing teeth, tooth decay, or cavities. |
| 20–34 years | 82% |
| 35 – 49 years | 92.5% |
| 50 – 64 years | 96.4% |
Based on the data, we encourage people over 35 to consider getting a supplemental dental insurance policy. You should also consider the reimbursement limit in the policy’s first 4 to 5 years. So, if you take dental insurance at age 35, you’ll have no limits at age 40.
Health habits
You must answer the following questions to determine when and what dental insurance you may need.
- How much time and effort do you spend on your dental care?
- How often do you visit a dentist for preventive dental care?
- Do you smoke?
- Do you have a history of dental diseases?
People who don’t visit a dentist regularly and smoke should get dental insurance sooner rather than later. We recommend that smokers over 35 get dental insurance. On the other hand, non-smokers who maintain their dental hygiene and visit a dentist regularly can delay taking dental insurance based on their dental health.
Individuals with healthy habits and teeth should still take dental insurance when they reach 40. The reason is simple: the probability of developing a dental problem is very high once you reach 40, and there is a reimbursement limit period of 4 to 5 years.
Dental treatment cost
Dentures are the most expensive dental treatments in Germany. They may cost from 720 € to 4500 €. Hence, taking out a good dental insurance policy is worthwhile if you need many high-priced dentures in the future.
Dental insurance cost
Last but not least, consider the cost of supplemental dental insurance. Sometimes, dental treatments are cheaper than dental insurance contributions. Hence, observe carefully what treatments you may need before taking dental insurance.
Existing dental problems
Many dental insurers don’t accept patients with existing dental problems. Even if they accept you, insurers charge high premiums. Thus, it’s vital not to wait too long to get dental insurance.
Conclusion
We understand it’s difficult to know when to take supplemental dental insurance. But you can use the above factors to determine a good time to take one. In general, start thinking about dental insurance once you reach 35.
How much does supplementary dental insurance cost?
Dental insurance costs depend on your age, the services you opt for, and your health condition. A comprehensive dental plan for a 35-year-old costs around 35€ per month.
Best supplementary dental insurance
In our research, we found
- Concordia (Zahn Sorglos)
- Deutsche Familienversicherung AG* (Exclusiv 100),
- Barmenia* (Mehr Zahn 100 + Mehr Zahnvorsorge Bonus),
- and Feather* (Advanced)
among the best dental insurance plans in Germany as of 2024. You can read how we found the best dental insurance plans here.
NOTE: Feather is an insurance agent and sells Barmenia’s dental insurance policies. The benefit of taking insurance from Feather is that you can file claims and get customer support in English.
6. Travel health insurance (Auslandreiseversicherung)
International travel health insurance covers the treatment costs you may incur while traveling outside Germany. It is called Auslandreiseversicherung in German.
Suppose you are on a vacation and break your leg. Not only will it ruin your trip, but it will also blow up your vacation budget. In such situations, travel health insurance can come in handy. It covers your treatment costs and the cost of bringing you back home if necessary.
Do you know a single day in a hospital in the USA can cost 194,000€? This was the case with one of the Debeka members [1]. If you don’t have international travel insurance, you must pay this cost from your own pocket.
What does it cover?
- Free choice of doctor and hospital at your holiday destination
- Reimbursement of costs for essential treatments like outpatient and inpatient treatment, treatment of sports injuries, and reimbursement for necessary aids such as crutches.
- Dental treatments, repairs to existing dentures, and temporary dentures
- Reimbursement of costs for the accommodation of an accompanying person in the hospital if a co-insured minor child requires inpatient treatment
- You should ensure that the provider pays for the return transport if it makes medical sense and justification—and not only if it’s absolutely necessary. “Repatriation makes medical sense” means you can be treated abroad, but treatment in Germany promises better success. Thus, you should be brought back home.
- Reimbursement of costs of the return transport of an accompanying person. Suppose your minor child falls ill and has to be brought back to Germany with an accompanying person.
- Transmission of messages to the insured person’s family or company in the event of illness abroad (assistance service)
- 24-hour emergency service
- Cover search and rescue costs of at least 5,000€.
- Covers any number of trips within a year
- Covers a trip for up to 56 days. The insurance covers all your trips within a year. So, if you took three trips of 50 days each, all of them are insured.
- It covers the country you are traveling to.
- Your insurance coverage should be extended until you are fit for transport.
- Insurance company takes part in the ombudsman process
- Covers pre-existing illnesses
- Travel insurance doesn’t cover the treatment costs you know you’ll need before the trip. However, suppose your pre-existing illness, like asthma, is being treated, and you are fit to travel. But your illness (asthma in this example) worsens during the trip. In this case, your insurance policy should cover the costs.
- Illnesses caught during a pandemic. Covid has taught us many lessons. One is to ensure coverage for pandemic diseases when traveling abroad, including COVID-19.
- Your travel health insurance should offer coverage, even if the Foreign Office issues a travel warning for your destination country due to a pandemic.
- If your partner is pregnant, ensure your travel insurance covers the cost of premature childbirth, miscarriage, or complications during pregnancy.
- Transfer/burial at the place of death (up to 10,000 €)
- Hospital daily allowance of 15€ per day
What does it not cover?
- Psychotherapy and psychoanalytic treatments.
- Costs of preventive examinations of a pregnant woman and childbirth.
- Good tariffs do not generally exclude pre-existing illnesses. However, it doesn’t cover the treatments you already know you’ll need before the trip. Example: You suffered a back injury before your vacation. You have already started physiotherapy sessions and know you’ll need more sessions during your trip. Such planned and foreseeable treatments are not covered by international travel health insurance.
- If you visit a country where the Federal Office has issued a travel warning due to war or terrorism, the travel insurance won’t cover you. However, if the travel warning was issued after the start of the trip, then you are covered.
- Spa treatment for rehabilitation measures.
Is travel insurance worth it?
Yes, international travel health insurance is totally worth it. It costs only 8€ per annum for individuals, and families can be insured for as low as 19€ per annum. For such a low cost, it covers hundreds of thousands of euros of your medical treatment expenses abroad.
How much does travel health insurance cost?
It costs only 8€ per annum for individuals, and families can be insured for as low as 19€ per annum.
Best travel health insurance
Our research found Barmenia* and Münchener Verein* to be the best international travel health insurance providers in Germany for short trips (up to 56 days).
If you are traveling for more than eight or ten weeks, you need different travel health insurance. For longer trips, you can get Protrip World* from Dr-Walter. It offers coverage for trips up to 24 months. It suits digital nomads, au pairs, pupils, students, and travelers.
Conclusion
Privately insured individuals
If you have private health insurance, you can customize it and get coverage in your desired areas. Thus, you don’t need supplementary insurance policies. This can save you a lot of money every month.
NOTE: Before getting private health insurance, consult an independent insurance broker. You can book a call with the insurance broker we recommend here for free.
Publicly insured individuals
Public health insurance covers only medically necessary treatments, excluding many vital and expensive treatments. Moreover, the coverage of public health insurance has decreased over time and will continue in the future.
Thus, supplementary insurance policies are good alternatives for people
- insured by public health insurance AND
- not eligible for private insurance.
However, you don’t need all the supplementary insurance policies. As per experts, you should consider getting the following supplementary insurance policies based on your situation.
- Travel health insurance: If you are traveling outside Germany.
- Dental insurance: If you are 35 and above.
- Supplementary daily sickness benefits insurance: If you are self-employed or a high-earner.
- Supplementary hospital insurance: If you want the best inpatient treatment (like a privately insured patient)
Other supplementary insurance plans are usually not worth it.
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